Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-05, page: 2666. Adviser: Robert P. Beasley. Includes bibliographical references.

Thesis (MTech (Biomedical Technology))--Cape Peninsula University of Technology, 2009. / The role of the mycobacteriology laboratory in the diagnosis of childhood tuberculosis has become increasingly important in the human-immunodeficiency virus era. Due to the paucibacillary nature of childhood mycobacterial disease, laboratory optimisation of mycobacterial cultivation is necessary for paediatric clinical management and epidemiological surveillance. Previous studies have shown that growth supplements markedly improve the recovery rate and time-to-detection in mycobacterial cultures. In this study, we hypothesised that specialised culture media and meat-based growth supplements would improve the recovery rate and time-to-detection in clinical samples from paediatric patients. Pulmonary sputa and gastric aspirates and extra pulmonary fine needle aspiration biopsies were processed from children less than 15 years of age routinely investigated for mycobacterial disease. The processed clinical samples were split into a control aliquot that was cultured in liquid and solid media without growth supplement, and an intervention aliquot cultured on supplemented media. The effect of enrichment of the culture media was then calculated by comparison to the control. These results indicated a significant reduction in the time-to-detection, 18.5 to 12.4 days, and an improved primary recovery rate of 14% in paediatric samples when cultured in liquid media enriched with a nutrient meat broth growth supplement. The findings of this study confirm the value of optimising mycobacterial cultivation with the use of growth supplements to enhance the detection of childhood mycobacterial disease.

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-08-26T18:01:43Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) NILMA MEDTROP VD.pdf: 2060397 bytes, checksum: 801ad4896a8a5f3c544547167d27652d (MD5) / Made available in DSpace on 2016-08-26T18:01:43Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) NILMA MEDTROP VD.pdf: 2060397 bytes, checksum: 801ad4896a8a5f3c544547167d27652d (MD5) Previous issue date: 2015-02-05 / A tuberculose (TB) é a doença mais comum da humanidade. Atualmente, a Organização Mundial de Saúde estimou nove milhões de novos casos e um milhão e meio de mortes decorrentes da doença. A rápida expansão da resistência aos fármacos antituberculose tem prejudicado o controle global da TB, constituindo um grave problema de Saúde Pública. No Brasil, a semelhença de outros países endêmicos, tem-se observado uma variabilidade na prevalência de resistência e no estado da Paraíba (PB) não há dados recentes e concisos. Dessarte, esse estudo objetivou verificar a prevalência de resistência do Mycobacterium tuberculosis aos fármacos do esquema de primeira linha do tratamento da TB utilizados no Brasil e a frequência de fatores de risco - sexo, idade, tratamento prévio e ingesta alcóolica - em pacientes adultos com diagnóstico de TB pulmonar resistente (TBP), atendidos em serviço de referência na PB durante o período de 01 de janeiro de 2003 a 31 de dezembro de 2013. Para obtenção dos dados, utilizou-se formulário padronizado, preenchido, retrospectivamente, a partir das informações contidas nos prontuários dos pacientes atendidos no período do estudo. Foram notificados 69 casos, com prevalência de 0,5%. Evidenciou-se 17,4% de mono, 14,5% de poli e 68,1% de multirresistência. A resistência à isoniazida (INH) mostrou-se importante, tanto isolada, quanto em associações; bem como e, principalmente, a TB multirresistente (TBMR). Perante os fatores de risco, o sexo masculino (73,9%), a faixa etária de 40 a 49 anos (46,4%), a realização de tratamento prévio (98,5%) e a ingesta alcóolica (57,4%) foram os de maior ocorrência. Todavia, não expressaram significância estatística no estudo realizado tendo a PB como cenário. O desfecho foi a cura para 44,9% dos casos; no entanto, o abandono ao tratamento foi considerável, principalmente para a TBP monorresistente (33,3%). As características sociodemográficas compreenderam: a cor da pele parda (68,5%), o estado civil casado (50,9%), o nível de instrução até o fundamental (67,3%) e a procedência do interior da PB (78,2%). Quanto à coinfecção com HIV/AIDS, ocorreu em 14,5%; no entanto, nesse grupo a TBMR, também, foi mais frequente. Desta feita, mais estudos são imprescindíveis no intuito de investigar genotipicamente a resistência da TB no estado da PB, visto que alguns estudos genéticos têm reportado mutações em cepas resistentes à rifampicina (RMP), estando associada a maior transmissibilidade e a resistência à INH tem sido associada com mutações de vários genes. Assim, correlacionando com outros estados e países a fim de colaborar com o enfrentamento da doença na busca do controle e cura extensiva a todos. Por outro lado, há necessidade de fortalecimento das ações do programa de controle da TB, tanto em nível estadual, quanto nos municípios. / Tuberculosis (TB) is the most common disease of humanity. Currently, the World Health Organization estimated nine million new cases and a million and a half deaths from the disease. The rapid spread of resistance to antituberculosis drugs has undermined the global TB control, constituting a serious public health problem. In Brazil, as other endemic countries, it has been observed variability in the prevalence of resistance and the state of Paraíba (PB) no recent and accurate data. Thus, this study aimed to determine the prevalence of resistance of the Mycobacterium tuberculosis to first-line drugs in TB treatment regimen used in the Brazil and frequency of risk factors - gender, age, prior treatment and alcoholic intake - in adults patients diagnosed with resistant pulmonary TB (PTB), treated on reference service in PB during the January 1, 2003 to December 31, 2013. To obtain the data, it used standardized form filled out retrospectively from the information contained in the medical records of patients seen during the study period. Were reported 69 cases, with a prevalence of 0.5%. Revealed a 17.4% to mono, 14.5% to poly and 68.1% to multidrug resistance. The isoniazid (INH) resistance was found to be important, both isolated, as in associations; as well as, and especially multidrug resistant TB (MDR-TB). In view of the risk factors, males (73.9%), the age group 40 -49 years (46.4%), the realization of previous treatment (98.5%) and alcoholic intake (57.4%) were the most frequent. However, did not express statistical significance in the study with the PB as a scenario. The outcome was the cure for 44.9% of cases; however, abandon to treatment was significant, particularly for mono resistant PTB (33.3%). The sociodemographic characteristics included: dark brown skin (68.5%), married status (50.9%), level of education up to primary (67.3%) and the origin from the interior of PB (78.2%). The co-infection with HIV/AIDS occurred in 14.5%; however, this group the MDR-TB also was more frequent. This time, more studies are essential in order to investigate genotypically the TB resistance in the state of PB, as some genetic studies have reported mutations in strains resistant to rifampicin (RMP) and are associated with increased transmissibility and INH resistance has been associated with mutations multiple genes. Thus, correlating with other states and countries to collaborate with coping with the disease in the search of control and extensive cure to all. On the other hand, there is need to strengthen the actions of the TB control program at the state level and in the municipalities.

Orientadores: Pablo Agustin Vargas, Oslei Paes de Almeida / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-06T06:22:59Z (GMT). No. of bitstreams: 1 Silva_AndreiaAparecidada_M.pdf: 1723407 bytes, checksum: 51af57adb05fc46240168f8b36dad6f5 (MD5) Previous issue date: 2006 / Resumo: Introdução: A Micobacteriose (MB) é uma das principais causas de mortes no mundo e sua incidência aumentou significativamente com o surgimento da AIDS. Objetivos: Os objetivos do presente trabalho foram comparar o padrão da resposta inflamatória nas MBs pulmonares (MBP) entre dois grupos (Grupo I: MBP; Grupo II: MBP/AIDS), e caracterizar as espécies de micobactérias através da técnica de PCR. Material e Métodos: Foram selecionados 16 casos de MBP para o grupo I e 59 casos para o grupo II, provenientes de pacientes autopsiados no Departamento de Patologia da FMUSP entre 1975 a 2004. Realizamos colorações de H&E e Ziehl-Neelsen (ZN) para o estudo histopatológico, e para o estudo imunohistoquímico utilizamos anticorpos Anti-BCG, CD4, CD8, CD15, CD20 e CD68. Selecionamos 20 casos de MBP distribuídos igualmente entre os dois grupos para a identificação das espécies M. tuberculosis e M. avium. Resultados: A média de idade do grupo I foi de 28,52 anos + 18, 21 anos e do grupo II foi de 36,2 anos + 10,36 anos. Histopatologicamente observamos o padrão de granulomas bem formados em 15 casos do grupo I, enquanto que no grupo II houve um predomínio de granulomas mal formados. A coloração de ZN foi positiva em 82,35% e 84,75% dos casos para o grupo I e grupo II, respectivamente. A imunohistoquímica para BCG foi positiva em todos os casos de ambos os grupos. O grupo I apresentou uma maior prevalência de linfócitos TCD4 (37,65%), seguido pelos linfócitos TCD8 (26,85%), macrófagos (23,71%), linfócitos B (7,31%) e neutrófilos (4,4%). Já no grupo II observamos um predomínio de macrófagos (50,28%), seguido por linfócitos TCD8 (23,75%), TCD4 (20,05%), linfócitos B (4,47%) e neutrófilos (1,45%). A espécie de M. tuberculosis foi identificada em 8 casos de ambos os grupos. A espécie M. avium foi identificada apenas em 01 caso do grupo II. Conclusão: Com o advento da AIDS houve uma mudança no perfil imunológico da MBP devido à depleção dos linfócitos TCD4. O anticorpo anti-BCG pode ser útil para identificar casos de MB que foram negativos para ZN. A Micobacteriose pulmonar foi causada principalmente por M. tuberculosis em ambos os grupos / Abstract: Introduction: Micobacteriosis (MB) is one of the main causes of deaths around the world and its incidence has been increased significantly with the emergence of the AIDS. Objectives: Our aims were to compare the pattern of the inflammatory response in the pulmonary MBs (PMB) between two groups (Group I: PMB; Group II: PMB/AIDS), and to identify the mycobacterium species using PCR technique.Material and Methods: 16 cases of PMB for group I and 59 cases for group II had been selected from autopsied patients in the Department of Pathology of the FMUSP between 1975 to 2004. We performed H&E and Ziehl-Neelsen (ZN) for the histopathology study, and for the immunohistochemical study we use Anti-BCG antibodies, CD4, CD8, CD15, CD20 and CD68. We select 20 cases of PMB distributed equally in the both groups for the identification of the M. tuberculosis and M. avium. Results: The mean age was 28,52 years + 18, 21 and 36,2 years + 10,36 for the group I and group II, respectively. The histopathology analysis showed well-organized granulomas in 15 cases of the group I, while the group II exhibited a predominance of the poorly organized granulomas. The ZN was positive in 82,35% of the cases in the group I and 84.75% in the group II. The immunohistochemistry for BCG was positive in all cases of the both groups. Group I presented a strong prevalence of TCD4 lymphocytes (37,65%), followed by TCD8 lymphocytes (26,85%), macrophages (23,71%), B lymphocytes (7,31%) and neutrophils (4,4%). The group II displayed a predominance of macrophages (50,28%), followed by TCD8 lymphocytes (23,75%), TCD4 lymphocytes (20,05%), B lymphocytes (4,47%) and neutrophils (1,45%). The species of M. tuberculosis was identified in 8 cases of both the groups. The species of M. avium was only found in one case of the group II. Conclusion: With the advent of the AIDS it had a change in the immunologic profile of the MBP because of the depletion of lymphocytes TCD4. The antibody anti-BCG can be useful to identify cases of PMB that had been negatives for ZN. The PMB was mainly caused by M. tuberculosis in both groups / Mestrado / Patologia / Mestre em Estomatopatologia

Undetected acute Pulmonary Tuberculosis in the 50,000 refugee immigrants from Southeast Asia to Canada would constitute a serious public health hazard. The 10,000 Southeast Asian refugee immigrants to British Columbia in 1979/80 were rescreened for acute Pulmonary Tuberculosis despite provincial and federal health authorities disagreeing on the need for such rescreening. This thesis demonstrates that the rescreening of the refugee immigrants was warranted by: A) Comparing the rate per 100,000 population with acute Pulmonary Tuberculosis among: 1) The Southeast Asian refugee immigrants arriving in British Columbia in 1979/80 with the rates of acute Pulmonary Tuberculosis per 100,000 population for the three-year period 1976/78 among 2) the general population of British Columbia, 3) the registered native Indian population of British Columbia, 4) the non-refugee Asian immigrant population arriving in British Columbia, and B) Estimating the increased risk of acute Pulmonary Tuberculosis to the general public from the presence of the 10,000 refugee immigrants in British Columbia. Age-specific rates of acute Pulmonary Tuberculosis and the prevalence rates of acute Pulmonary Tuberculosis confirmed bacteriologically were calculated with statistics extracted from the records of the Division of Tuberculosis Control of British Columbia, the Federal Department of Health and Welfare, and the Department of Immigration. Comparison of the age-specific rates demonstrated that acute Pulmonary Tuberculosis occurred 6 times more frequently in the refugee immigrants than in the general population of British Columbia, and 1.25 times more frequently in the refugee Asian immigrants than in the non-refugee Asian immigrants. Comparison of the prevalence rates demonstrated that acute Pulmonary Tuberculosis confirmed bacteriologically occurred 3 times more frequently in the registered native Indian population of British Columbia than in the refugee immigrants to British Columbia. The extra public health risk of acute Pulmonary Tuberculosis from the presence of 10,000 refugee immigrants in British Columbia for one year was estimated to be 730 in 10⁶ for each member of the general population of British Columbia. The rate of acute Pulmonary Tuberculosis occurring in the 10,000 refugee immigrants arriving in British Columbia in 1979-1980 confirmed that the rescreening of the refugee immigrants was warranted. Recommendations were made to centralize the rescreening program within British Columbia so as to minimize the public health hazards of acute Pulmonary Tuberculosis occurring in the Southeast Asian refugee immigrants. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Mycobacterium tuberculosis, the causative agent of tuberculosis, can manipulate host cell death pathways as virulent strains inhibit apoptosis to protect its replication niche and induce necrosis as a mechanism of escape. In vitro studies revealed that similar to lytic viruses, M. tuberculosis has the ability to induce cytolysis in macrophages when it reaches an intracellular burden of ~25 bacilli. Base on this finding, we proposed the burst size hypothesis that states when M. tuberculosis invades a macrophage at a low multiplicity of infection it replicates to a burst size triggering necrosis to escape the cell and infect naïve nearby phagocytes, propagating the spread of infection. The first part of this study investigated if the in vitro observations of M. tuberculosis cytolysis were relevant to cell death of infected phagocytes during pulmonary tuberculosis in vivo. Mice infected with a low dose of M. tuberculosis revealed during TB disease, the major host cell shifted from one type of phagocyte to another. Enumeration of intracellular bacilli from infected lung cells revealed the predictions of the hypothesis were confirmed by the distribution of bacillary loads across the population of infected phagocytes. Heavily burdened cells appeared nonviable sharing distinctive features similar to infected macrophages from in vitro studies. Collectively, the data indicates that M. tuberculosis triggers necrosis in mononuclear cells when its number reaches the threshold burst size. The previous study showed during the period of logarithmic bacterial expansion, neutrophils were the primary host cell for M. tuberculosis coinciding with the timeframe of the highest rate of burst size necrosis. The second part of this study examined this link by infecting mice with one of four different M. tuberculosis strains ranging in virulence. Mice infected with the most virulent strain had the highest bacterial burden and elicited the greatest number of infected neutrophils with the most extensive lung inflammation and greater accounts of cell death. Treating these mice with a bacteriostatic agent decreased the bacterial load and infected neutrophils in a dose-dependent manner indicating necrosis induced by virulent M. tuberculosis recruited neutrophils to the lungs. Infected neutrophils can serve as a biomarker in tuberculosis as evidenced by poorly controlled infection and increased severity of lung immune pathology.

INTRODUÇÃO: A incidência de tuberculose (TB) em Santos (SP) situa-se em 73/100.000 habitantes-ano. A prevalência média de coinfecção TB/HIV é de 16%, taxas de cura e abandono de tratamento, entre casos novos são, respectivamente, 71% e 12%. Tais indicadores sugerem elevado risco para TB multidroga resistente (TBMR) no município, com incidência estimada em 1,9/100.000 habitantes-ano. OBJETIVO: Descrever e analisar o perfil de sensibilidade às drogas (TS) de primeira e segunda linha de tratamento entre pacientes com TB pulmonar (TBP), estimar a incidência de TBMR e a proporção de TB extensivamente resistente (TBXR); analisar aspectos moleculares, epidemiológicos e institucionais dos casos de TBP resistentes em Santos (SP). MÉTODOS: Estudo descritivo de uma coorte de pacientes de TBP, com início de tratamento ou retratamento entre 01 de janeiro de 2011 a 31 de dezembro de 2012. Definiu-se como caso de TBP, indivíduos com 15 anos ou mais, de ambos os sexos, residentes no município de Santos, com manifestações clínicas compatíveis com TBP e confirmação por cultura com isolamento de Mycobacterium tuberculosis. As variáveis de interesse para o estudo foram as características sociodemográficas, história atual e pregressa de TB, aspectos relativos ao tratamento, co-morbidades, ao diagnóstico e resistência a drogas. Para as análises comparativas entre proporções foram usados os testes qui-quadrado de Pearson e o Exato de Fisher e para variáveis contínuas o teste T de Student ou o de Kruskal - Wallis. Os perfis genéticos dos isoladas resistentes a ao menos uma droga foram obtidos pela técnica RLFP e analisados pelo programa Bionumerics versão 5.0 (Applied Maths - Bélgica). A descrição da distribuição espacial da TB resistentes e clusters foram feitas mediante a inserção dos casos no mapa de Santos, por endereço de residência, segundo o índice de vulnerabilidade social. RESULTADOS: Dos 263 casos de TBP selecionados, 68,4% (180/263) eram do sexo masculino, a mediana da idade foi de 38 anos, 8,7% (23/263) eram diabéticos; 20,4% (42/206) dos casos novos apresentavam ao menos um fator de risco para TBMR; destacando-se entre estes casos 10,7% (22/206) de confecção HIV/TB; 47,3% (123/260) tiveram tratamento supervisionado, 14,7% (91/617) dos contatos foram examinados, 18,6% (49/263) foram hospitalizados durante o tratamento, perfazendo uma média de 145,4 dias por paciente. Entre os casos resistentes a ao menos uma droga, a resistência à isoniazida foi 8,4% (22/263) e à rifampicina 3,8% (10/263) dos casos. A TBMR primária foi encontrada em 1,9% (4/206) dos casos e destes 25,0% (1/4) eram TBXR. A incidência média anual de TBMR foi de 0,57/100,000 habitantes. Dos 25 isolados resistentes ao menos uma droga, submetidos à RFLP, 12 (48,0%) foram agrupados em seis grupos genéticos, com dois pacientes em cada grupo. CONCLUSÕES: A elevada proporção TBMR primária, com um caso de TBXR enfatizam a necessidade de universalizar a cultura e TS, ampliar a cobertura do tratamento supervisionado, a investigação rotineira dos contatos e o monitoramento da resistência a drogas. O fortalecimento da vigilância da resistência às drogas é indispensável para o contínuo aperfeiçoamento do Programa de Controle da TB, especialmente em regiões de elevada carga da doença / INTRODUCTION: The incidence of tuberculosis (TB) in Santos (SP) is located around 73 / 100,000-year, approximately double that found on average in the country. The average prevalence of TB / HIV is 16% cure rates and treatment dropout among new cases are, respectively, 71% and 12%. Such indicators suggest high risk for multidrug-resistant TB (MR-TB) in the city, with the incidence estimated at 1.9 / 100,000-year. OBJECTIVE: To describe and analyze the sensitivity to drugs of first and second line treatment of patients with pulmonary TB (PTB) to estimate the incidence of MR-TB and extensively drugresistant TB (TBXR), describe molecular and institutional aspects, spatial distribution, epidemiological PTB resistant cases in the city of Santos (SP). METHODS: A descriptive study of a cohort of patients with PTB residing in the city who started treatment or retreatment in the period January 2011 to December 31, 2012. The case definition PTB individuals 15 years or more, both sexes, living in the city of Santos (SP), who present clinical manifestations compatible with PTB and whose confirmation was made by culture with isolation of M. tuberculosis. The variables of interest for the study were: bacteriological / laboratory socio-demographic characteristics, current and previous history of TB, aspects related to treatment, and comorbidities. For comparative analyzes of proportions the chi-squared tests and Fisher\'s exact were used for continuous variables and the Student t test or the Kruskal - Wallis. The genetic profiles of isolates resistant to at least one drug were obtained by RFLP (length polymorphism restriction fragment) and analyzed using version BioNumerics 5.0 (Applied Maths - Belgium) software. The description of the spatial distribution of resistant TB and the clusters was made by inserting the cases in Santos map, by address of residence, which was according to the index of social vulnerability. RESULTS: Of the 263 cases of PTB selected, 68.4% (180/263) were male, th median age was 38 years, 8.7% (23/263) were diabetes; 20.4% (42/206) of new cases had at least one risk factor for MR-TB, especially 10.7% (22/206) of making HIV / TB; 47.3% (123/260) underwent supervised treatment, 14.7% (91/617) of the contacts were examined, 18.6% (49/263) were hospitalized during treatment, totaling 7127 days of hospitalization with a mean 145.4 days per patient. Among the cases resistant to at least one drug resistance to isoniazid 8.4% (22/263) and rifampin 3.8% (10/263) of the cases was found. The primary MR-TB was found in 1.9% (4/206) of MR-TB cases and of these 25.0% (1/4) were TBXR. The average annual incidence of MDR-TB was 0.57/100,000 inhabitants. Of the 25 isolates resistant least one drug, subjected to molecular characterization of IS6110, 12 (48.0%) were grouped in six clusters, with each group including two isolates. CONCLUSIONS: A high proportion of primary MR-TB, including a case of TBXR emphasizes the need to universalize culture and TS, expand the coverage of supervised treatment, routine investigation of contacts and monitoring of drug resistance. The strengthening of the surveillance of drug resistance is essential for continuous improvement of the TB Control Program, especially in regions of high disease burden

A tuberculose permanece como um dos maiores problemas de saúde pública mundial. O diagnóstico precoce e o tratamento rápido e eficiente dos indivíduos com tuberculose pulmonar ativa são medidas essenciais para a redução da morbidade, mortalidade e da incidência da tuberculose no mundo. As limitações encontradas nos métodos microbiológicos tradicionais, fizeram com que metodologias alternativas fossem desenvolvidas para melhorar o diagnóstico e o prognóstico da tuberculose humana. Neste trabalho verificamos o desempenho diagnóstico do Western blotting para pesquisa de anticorpos IgG anti - Mycobacterium tuberculosis, a utilização do teste QuantiFERON® - TB Gold e a detecção de moléculas de adesão celular (ICAM-1 e selectinas) como marcadores de prognóstico. Foram acompanhados até o final do tratamento 31 pacientes com tuberculose pulmonar diagnosticados por critérios clínicos e laboratoriais. Como controles, selecionamos população de indivíduos sadios, doadores de banco de sangue e indivíduos com outras pneumopatias. Os resultados mostraram que o Western blotting apresentou sensibilidade de 94% e especificidade de 96% no diagnóstico da tuberculose pulmonar, atendendo os requisitos da OMS para testes sorológicos. O QuantiFERON® - TB Gold apresentou sensibilidade de 83% e especificidade de 100%, após ajuste do limiar de reatividade. Os resultados das moléculas de adesão celular sugerem potencial para serem utilizadas como marcadores de prognóstico da doença. Ao associarmos os resultados do Western blotting ou do QuantiFERON® - TB Gold com a baciloscopia obtivemos sensibilidade superior a 95%; e quando associados à cultura a sensibilidade encontrada foi de 100%. O Western blotting mostrou ser uma ferramenta útil como auxiliar no diagnóstico da tuberculose pulmonar mesmo em pacientes com baciloscopia negativa. / Tuberculosis remains a major public-health problem. Rapid diagnosis and prompt treatment is the cornerstone to reduce morbidity, mortality and incidence of tuberculosis in the world. Alternative methods have been developed to overcome the limitations presented by conventional microbiological methods and to improve the diagnosis and prognosis of tuberculosis. In this study we verified the diagnostic performance of Western blotting for IgG anti-M.tuberculosis antibodies detection, QuantiFERON® - TB Gold and circulating adhesion molecules (ICAM-1 and Selectins) as prognosis markers. Thirty-one patients were followed-up during the treatment. Active pulmonary tuberculosis was diagnosed by clinical and laboratorial criteria. As group control healthy individuals, blood donors and patients with other lung diseases were included. Western blotting results showed a high performance with sensitivity of 94% and specificity of 96% for the diagnosis of pulmonary tuberculosis, attending WHO requirements for serological tests. After adjusting the threshold, QuantiFERON® - TB Gold showed sensitivity of 83% and specificity of 100%. The results of adhesion molecules suggested potential to use the test as prognosis markers. Combining Western blotting or QuantiFERON® - TB Gold with acid-fast bacilli (AFB) smear results, the overall sensitivity increase to more than 95%, and when combined with culture the overall sensitivity was 100%. Together, these findings, suggest that Western blotting could be a very useful supplementary tool for pulmonary tuberculosis, especially in patients with AFB smear negative.