Spelling suggestions: "subject:"tuberculosis -- diagnosis"" "subject:"tuberculosis -- biagnosis""
1 |
Rapid diagnosis of isoniazid resistant mycobacterium tuberculosis by high resolution melting (HRM) assayChan, Ming-yan, 陳明恩 January 2012 (has links)
Mycobacterium tuberculosis (MTB) is a major infective agent causing human tuberculosis (TB) in the worldwide. Although tuberculosis can be treated by a six-month course of antibiotics, the prevalence of extensively drug-resistance TB (XDR-TB) made the disease becomes a global health problem. In addition to the conventional MTB detection methods, molecular methods become significant in drug resistant MTB detection which can enhance effective drug treatment.
In this study, 200 MTB respiratory specimens were collected from patients with suspected tuberculosis in Tuen Mun Hospital in Hong Kong. Based on the culture method as a gold standard for MTB detection, the presence of MTB in clinical samples was determined by IS6110single tube nested real-time PCR. In addition, by using High Resolution Melting (HRM) analysis, the presence of mutant type KatG315 gene for detecting isoniazid resistant MTB was determined.
Among 66 MTB culture positive samples, 10 samples had positive acid fast bacilli (AFB) smears giving the diagnostic sensitivity 15.1%. IS6110 single tube nested PCR was amplified in 51 specimens giving 77.2% MTB detection sensitivity and 97.8% specificity. Among 51 samples positive for IS6110 PCR, 66.7% showed successful amplification in subsequent KatG-HRM assay. Two samples were confirmed to be isoniazid (INH) resistance in Public Health Laboratory Centre (PHLC). However, there was only one sample showing detectable KatG315 mutation in clinical specimen by using HRM while the other was only detected in the corresponding culture isolate.
From the result of this study, single tube nested real-time PCR demonstrated MTB detection in clinical samples and INH resistant strain with KatG315mutationcan be detected by HRM analysis. Early detection of mycobacteria allow earlier treatment of the patient, thus transmission of the disease can be controlled. / published_or_final_version / Microbiology / Master / Master of Medical Sciences
|
2 |
Molecular characterization of isoniazid-resistant mycobacterium tuberculosis in Hong KongWoo, Wai-lan., 胡慧蘭. January 2005 (has links)
published_or_final_version / Medical Sciences / Master / Master of Medical Sciences
|
3 |
Relationship between knowledge, risk perceptions and socio-demographic factors and tuberculosis diagnosis in Ntcheu District in Malawi.Chizimba, Robert Mnthenga January 2012 (has links)
A research report submitted to the Faculty of Health Sciences, School of Public Health,
University of the Witwatersrand, South Africa, in partial fulfilment of the requirements
for the degree of Masters in Public Health-Social and Behaviour Change
Communication.November 2012 / Aim of the study: The main aim of this study was to determine socio-demographic characteristics associated with being diagnosed with TB by a health care worker among adult males and females aged between18-49 years in Ntcheu district, Malawi.
Method: This was a descriptive and analytical cross-sectional study. A total of 121 adult women and men were sampled using a three-stage simple sampling technique. The 2008 Population and Housing Census enumeration areas (EAs) were used as a sampling frame. The first stage involved simple sampling of two Traditional Authorities (TAs) out of nine (9). Stage two involved selection of ten villages in each sampled TA. The third level of sampling was a selection of six households from each selected village where the first dwelling was also sampled. A structured questionnaire was developed in English and translated into Chichewa. The questionnaire was administered by a trained interviewer at each respondent’s household. Three research assistants were employed to collect data.
Results
The awareness of TB was universal with every participant reporting that they had heard about TB. Of the 121 participants, more than half were male (53.7%; n=65).The median age of the respondents was 28 years (range 18-49 years) and approximately a third of the respondents (34.4%; n=31) had 1-2 children. The study found that higher education (p=0.01), higher ownership of household assets (p=0.01), higher average monthly household income (p=0.02) and higher socio-economic status of the respondents (p=0.01) were significantly associated with higher knowledge of causes of TB. It was found that education was also associated with knowledge of the transmission of TB (P=0.01). The lower the level of education the lower the knowledge level on the correct modes of TB transmission. There was also an association between knowledge of symptoms of TB and occupation (p=0.05). It was found that farmers were less likely to know symptoms of the disease compared to other forms of occupation namely: business persons, those participants who were employed and those not employed. The study found that women had significantly lower risk perceptions of the disease (p=0.01). No association was found between socio-economic and cultural factors of the respondent and self-reported TB diagnosis.
Conclusion
The findings of this study show that a comprehensive health promotion programme is required in order to address significant gaps on knowledge of causes of TB, transmission, symptoms and risk perceptions and other related socio-economic and cultural factors in Ntcheu district.
|
4 |
Comparison of molecular epidemiological study on Mycobacterium tuberculosis using IS6110 RFLP and IS6110 PCR typing陳子明, Chan, Tsz-ming. January 2000 (has links)
published_or_final_version / Medical Sciences / Master / Master of Medical Sciences
|
5 |
An audit of discharged patient files at hospitals specialising in the management of tuberculosisWerely, Volene Joy 03 1900 (has links)
Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Background:
In her clinical practice as nursing manager the researcher was concerned about incomplete
and inaccurate documentation of patients diagnosed with tuberculosis (TB) which were
compromising the management of these patients. The primary care nurses endorsed these
concerns.
Goals and Objective:
The goal of this study was to audit nursing documentation according to the phases of the
nursing process and the discharge planning of patients diagnosed with TB discharged from
TB hospitals in the Western Cape.
The objectives for the study were to determine whether the patients were adequately
assessed and diagnosed, whether nursing care plans were formulated based on the
assessment and whether they were implemented and evaluated according to the nursing
process - including the discharged planning.
Ethics approval was obtained from the Committee of Human Research Science at
Stellenbosch University and permission was also obtained from the respective institutions.
Methodology:
A descriptive design with a quantitative approach was applied for the purpose of this study.
The total population for the study was N=1768. A systematic random sample of 12% from
each hospital was drawn: n=214, hospital A (n=142) and hospital B (n=72).
Criteria included:
all adult patients older than 18 years
patients who were discharged between 01 January 2007 and 31st December 2007
all discharged patients from the two hospitals specializing in patients diagnosed with
TB.
Instrumentation: An audit instrument based on the objectives of the study was approved as
the data collection tool. Guided by the proposed study a 10% (n=21) of the number of
discharged patient files were drawn for the purpose of a pilot study.
Reliability and validity was ensured through the use of experts in the field of nursing, research
methodology and statistics. A pilot study was also conducted to support the reliability and
validity of the study.
Data collection:
The researcher collected the data personally with the support of five trained field workers who
only assisted at hospital B and was reluctant to assist at the second hospital.
Data analysis:
Data was analysed with the support of a statistician and expressed in frequencies and tables.
Results:
All phases of the nursing process showed a low compliance. Results showed that only
n=90(42%) of the registered professional nurses checked and signed the initial assessment,
furthermore only n=53(34%) showed that a recording was made of all referral documentation
to the patient’s follow-up clinic.
Recommendations:
Recommendations based on the scientific evidence obtained from the study include the
implementation of a quality assurance programme namely standardisation, auditing, case
management of patients, education and training, rewarding of staff and further research.
Conclusion:
In conclusion guided by the research question “Are the audited discharged patient files at
hospitals specialising in the management of patients with TB in the WCDoH compliant?” The
researcher concludes that the discharged patient files are not compliant. / AFRIKAANSE OPSOMMING: Agtergrond:
In haar kliniese praktyk as verpleegbestuurder is die navorser besorgd oor die onvolledige en
onakkurate dokumentasie van pasiënte wat met tuberkulose (TB) gediagnoseer is en wat dus
die versorging van hierdie pasiënte in gevaar stel. Hierdie besorgdhede is deur die primêre
sorg verpleegsters bevestig.
Doel en Doelwitte:
Die doel van die studie is om die verpleegdokumente te ouditeer volgens die fases van die
vepleegproses, asook die ontslagbeplanning van die pasiënte gediagnoseer met TB van die
hospitale in die Wes-Kaap.
Die doelwitte is om te bepaal of die pasiënte korrek geassesseer en gediagnoseer is en of
verpleegsorgplanne opgestel is, wat gebaseer is op die assessering en versorgingsplanne
wat geïmplementeer en geëvalueer is volgens die verpleegproses, insluitende die
ontslagbeplanning.
Etiese goedgekeuring is toegestaan deur die Komitee vir Menslike Navorsingswetenskap van
die Universiteit van Stellenbosch en toestemming is ook ontvang van die onderskeie
instansies.
Metodologie:
’n Beskrywende ontwerp met ’n kwantitatiewe benadering is toegepas vir die doel van die
studie. Die totale bevolking vir die studie is N=1786. ’n Sistematiese ewekansige
geselekteerde steekproef van 12% van elke hospitaal is geneem: n=214, hospitaal A (n=142)
en hospitaal B (n=72).
Die kriteria sluit in:
alle volwasse pasiënte ouer as 18 jaar
pasiënte wat gedurende die periode 01 Januarie 2007 tot 31 Desember 2007 ontslaan
is
alle ontslag pasiënte van die twee hospitale wat spesialiseer in pasiënte wat
gediagnoseer is met TB.
Instrumentasie:
‘n Ouditinstrument gebaseer op die doelwitte is goedgekeur as die
dataversamelingsinstrument. Na aanleiding van die voorgestelde studie is 10% (n=21) van
die aantal ontslag pasiëntlêers getrek vir die doel van die loodsondersoek.
Betroubaarheid en geldigheid is verseker deur gebruik te maak van deskundiges in die
verplegingsveld, die navorsingsmetodologie en statistiek. Die loodsondersoek is ook
uitgevoer om die betroubaarhied en geldigheid van die studie te rugsteun.
Dataversameling:
Die navorser het die data persoonlik gekollekteer met die bystand van vyf opgeleide
veldwerkers wat slegs hulp verleen het by hospital B en wat teësinnig was om hulp te verleen
by die tweede hospitaal.
Data-analise:
Data is geanaliseer met die hulp van ’n statistikus en is uitgedruk in frekwensies en tabelle.
Resultate:
Alle fases van die verpleegproses het nie voldoen aan die vereistes nie. Resultate dui daarop
dat slegs n=90 (42%) van die geregistreerde professionele verpleegsters die aanvanklike
assessering nagegaan en onderteken het, vervolgens het slegs n=53 (34%) getoon dat ’n
opname gemaak was van alle verwysde dokumentasie van die pasiënt se opvolgbesoek aan
die kliniek.
Aanbevelings:
Aanbevelings is gebaseer op die wetenskaplike bewys wat verkry is van die studie vir die
implementering van ’n gehalte versekeringsprogram, naamlik standardisering, ouditering,
gevallebestuur van pasiente, opvoeding en opleiding, erkenning aan die personeel, en
voortgesette navorsing.
Samevatting: Ter afsluiting gelei deur die navorsering’s vraag nl. “Is die geouditeerde verpleegdokumente
in hospitale wat spesialiseer in die bestuur van pasiente gediagnoseer met TB in die
Weskaap se Department van Gesondheid bygehou?” Die navorser bevestig dat die
verpleegdokumente nie bygehou was nie.
|
6 |
Clinical value of a uniform research case definition of tuberculous meningitisWessels, Marie 04 1900 (has links)
Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: BACKGROUND: Tuberculous meningitis (TBM) research remains important but
obtaining adequate sample sizes of microbiologically-confirmed TBM cases is difficult,
therefore clinical cases of TBM need to be included. A uniform research case definition
for TBM was developed to assist diagnostic standardization.
METHODS: Our study evaluated the proposed uniform research case definition in a
group of children diagnosed with TBM. A subgroup of 66 children with cultureconfirmed
TBM was compared to culture-confirmed bacterial meningitis controls.
RESULTS: The uniform case definition was applied to 554 TBM patients. Sixty-six
(11.9%) patients had definite TBM, 408 (73.6%) had probable TBM and 72 (13.0%) had
possible TBM. Symptom duration >5 days, weight loss or persistent cough >2 weeks,
recent TB contact, focal neurological deficit, clear cerebrospinal fluid (CSF) appearance
and basal meningeal enhancement predicted TBM when compared to definite bacterial
meningitis with a sensitivity and specificity of 97.0% and 93.7%, respectively. When
using a probable TBM score as the diagnostic measure, sensitivity was 86% and
specificity was 100%. When using a possible TBM score as the diagnostic measure,
sensitivity was 100% but specificity was 56%.
CONCLUSION: The uniform research case definition for TBM performed well when
using a probable TBM score as the diagnostic marker. A regression model also
differentiated TBM from bacterial meningitis with good accuracy, but caution is needed
in its application to early TBM.
|
7 |
A prospective audit of the use of diagnostic laparoscopy to establish the diagnosis of abdominal tuberculosis.Islam, Jahangirul. January 2011 (has links)
HIV epidemic is one of the major challenges to the South Africa’s socio-economic development. The incidence of tuberculosis is rising in sub-Saharan Africa, and in 2009 South Africa had the second highest incidence of tuberculosis in the world. Approximately 80% of incident tuberculosis cases in South Africa are HIV positive. In HIV positive individual, abdominal tuberculosis has been reported as the most common form of extra-pulmonary tuberculosis. HIV/AIDS has resulted in a resurgence of abdominal tuberculosis in South Africa. Making the diagnosis of abdominal tuberculosis is still difficult, though the condition is common. The role of laparoscopy in making the diagnosis is undefined.
Method:
All patients with clinically and radiologically suspected but histologically or microbiologically unconfirmed abdominal tuberculosis were referred to the investigating team and laparoscopy was performed to diagnose abdominal tuberculosis. Histology was performed on tissue biopsy specimens and TB culture on ascitic fluid and peripheral blood specimens.
Results:
From January 2008 to June 2010 a total of 190 patients were referred to us. No surgical intervention was taken in 60 patients; all of them were HIV positive. Twenty six of them died (43%) in the hospital during the evaluation period before the diagnostic laparoscopy, and the rest (57%) were unfit for anaesthesia. Forty nine patients required emergency laparotomy either for bowel obstruction or peritonitis and 39% of them died. Eighty one patients underwent diagnostic laparoscopy and 77% of them were HIV positive, in 16% the HIV status was unknown. Two percent had clinical ascites. Laparoscopic findings included intra-abdominal lymphadenopathy in 56, minimal ascitic fluid in 46, intra-abdominal mass in 17, and deposits on bowel wall, peritoneum or omentum in 20 patients. Fifty five patients (68%) had positive histology for tuberculosis. In 15 patients (19%) histology revealed non-specific inflammation, no pathology was found in one patient and no specimen was taken from one patient. Eighty percent of peritoneal deposits and 77% of lymph nodes were positive for tuberculosis, whereas 35% ascitic fluid culture was positive. In nine patients (11%) an alternative diagnosis was found (appendicitis, adenocarcinoma, lymphoma).
Conclusion:
Laparoscopy was feasible and showed a high yield to establish the diagnosis of abdominal tuberculosis and to provide an alternate diagnosis. Laparoscopy was useful to establish the gross features of abdominal tuberculosis and to provide the adequate specimens for examinations. Very poor follow negated the evaluation of the clinical response to anti tuberculosis therapy. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.
|
8 |
Aids for the early diagnosis of tuberculous meningitis (TBM)Ramkissoon, Arthi. January 1985 (has links)
Mortality and morbidity rates associated with tuberculous meningitis (TBM) are substantial. The average duration of the untreated disease from onset to death is about 17 days. The prognosis of TBM is known to correlate with the stage of the disease at the time of diagnosis and commencement of chemotherapy. Early diagnosis improves the chances of recovery without neurological sequelae. Early diagnosis is a problem because the presenting symptoms are non-specific and the onset of the disease is typically insidious.
To date no single test is available that is totally reliable and specific for TBM. I have attempted to develop a reliable and easily applicable test for the diagnosis of TBM. In fulfilling this objective, the work undertaken may be divided into three major sections:- 1. Detection of soluble Mycobacterium tuberculosis antigens in the cerebrospinal fluid (CSF) of patients with TBM and in control groups by using Mycobacterium bovis BCG antigens. The technique used was that of inhibition enzyme-linked immunosorbent assay (ELISA). The principle of this technique is illustrated in Fig. 5. 2. Detection of soluble M. tuberculosis antigens in the CSF of tuberculous and control groups of patients by using antibodies raised against M.bovis BCG. The technique used was that of the double antibody sandwich ELISA. An outline of this ELISA is given in Fig. 6. 3. Correlation of chloride levels in the blood and CSF of patients with tuberculous and other forms of meningitis. It has been established that the SERUM/CSF ratio of bromide tends towards unity in patients with TBM because the permeability of the blood-brain barrier is impaired. Since both bromide and chloride are chemically similar (both being halides), it was thought that a similar pattern may exist for BLOOD/CSF chloride ratios; and this was investigated. The method used for the INHIBITION ELISA had to be standardized
before the samples could be tested. This involved investigating the acceptability of various microtitre plates; determination of the optimal working dilutions for the coating solution and conjugate; and determination of optimal conditions for the various incubation periods, both in terms of time and temperature. A total of 70 specimens was tested. These consisted of 25 normal CSF controls; 25 pleural and ascitic fluid samples; 10 TBM samples, and 10 bacterial meningitis CSF samples. It was found that a distinction
existed between the absorbance values obtained from positive TBM CSF samples (Mean 0,658 + 0,043) and that from normal CSF samples (Mean 1,089 + 0,224). The mean absorbance of the culture-positive bacterial CSF's also differed significantly from the other 2 groups (Tables VII; IX). Some overlap occurred amongst the absorbance values of bacterial culture positive CSF's (Range 0,975-0,879) and normal CSF's (Range 1,486-0,934). The mean absorbance value for bacterial positive CSF samples (0,920 _+ 0,029) differed significantly (p <0,01) from those of normal CSF (1,089 + 0,224) and TBM CSF's (0,658 + 0,043). The difference between the mean values obtained with tuberculous and non-tuberculous groups of pleural and ascitic fluid was also
significant (p < 0,01). The method used for the DOUBLE ANTIBODY SANDWICH ELISA was that of Sada et al. (1983). Before the samples could be tested, the method had to be standardized and similar investigations to those for the INHIBITION ELISA were performed. In addition, antibodies raised
against M.bovis BCG were conjugated to alkaline phosphatase since
no commercial preparation was available. Unfortunately no distinction
was recorded between negative and positive test specimens, even on
repetition of the entire procedure. Measurement of chloride was done by a fully automated procedure using the BECKMAN ASTRA-8. A total of 149 samples were tested. Of these 10 were tuberculous, 34 were viral, and the remainder were bacterial meningitis. No pattern was established that could differentiate TBM from viral or bacterial meningitis. The results obtained are tabulated in Table III and illustrated in Figures 9, 10, and 11. In summarizing, the use of the INHIBITION ELISA technique for the accurate diagnosis of TBM seems promising. However, its validity in the clinical situation will have to be assessed further and with greater numbers of specimens before it can be adopted as a diagnostic procedure for TBM. OBJECTIVE. To determine
1. The ability and reliability of the INHIBITION ELISA1 technique to detect mycobacterial antigens in pleural, ascitic, and cerebrospinal fluids. 2. The accuracy and reproducibility of the double antibody sandwich ELISA in the detection of mycobacterial antigens in CSF of patients with tuberculous meningitis (TBM). 3. Whether a correlation exists between blood and CSF chloride levels in patients with tuberculous and other forms of meningitis. / Thesis (M.Med.Sc.)-University of Natal, Durban, 1985.
|
9 |
Epidemiologia clássica e molecular da tuberculose pulmonar em pacientes da região norte de Minas GeraisPrince, Karina Andrade de [UNESP] 18 November 2013 (has links) (PDF)
Made available in DSpace on 2014-08-13T14:50:35Z (GMT). No. of bitstreams: 0
Previous issue date: 2013-11-18Bitstream added on 2014-08-13T18:01:11Z : No. of bitstreams: 1
000736114_20141218.pdf: 167852 bytes, checksum: 195f78eda97184540a4c8fa710ee18f9 (MD5) Bitstreams deleted on 2014-12-19T18:32:47Z: 000736114_20141218.pdf,Bitstream added on 2014-12-19T18:33:34Z : No. of bitstreams: 1
000736114.pdf: 2142445 bytes, checksum: 4c37b6a0b38133d350c91b6a9b7b59cc (MD5) / A tuberculose (TB) é uma doença infecciosa crônica causada principalmente pelo bacilo aeróbico Mycobacterium tuberculosis. Ela provoca problemas de saúde entre milhões de pessoas a cada ano, sendo classificada como a segunda causa de morte por uma doença infecciosa em todo o mundo. Assim, o objetivo desse estudo foi analisar a epidemiologia clássica e molecular da tuberculose pulmonar, em pacientes do Norte de Minas Gerais. Foi realizado um levantamento epidemiológico, de caráter observacional, longitudinal, retrospectivo e de delineamento quantitativo. A população foi composta por pacientes com suspeita de TB pulmonar, residentes na Região Norte de Minas Gerais, atendidos no Hospital Universitário Clemente de Faria (HUCF) da Universidade Estadual de Montes Claros (UNIMONTES), no período de janeiro de 2011 a dezembro 2012. As amostras clínicas (escarro ou lavado broncoalveolar) destes pacientes foram analisadas, através da técnica de Ziehl- Neelsen e da cultura pela método de Ogawa-Kudoh. Os isolados clínicos obtidos foram submetidos a identificação molecular, a genotipagem pelas técnicas de Spoligotyping, RDRio, ERIC-PCR e MIRU-VNTR e ao teste de susceptibilidade a fármacos. A correlação epidemiológica clássica e molecular foi realizada através dos dados da genotipagem e dos dados epidemiológicos clássicos. Dos 345 pacientes avaliados, 33 (9,6%) apresentavam a doença, sendo 69,7% residentes em Montes Claros e 30,3% em outras cidades do Norte de Minas Gerais. Houve predomínio da TB em indivíduos do sexo masculino (75,8%), da etnia parda (60,6%), de baixa escolaridade (42,4%) e em idade economicamente ativa (78,9%). A maior parte dos casos eram novos (69,7%) e a baciloscopia foi positiva em 75,8% dos pacientes. A taxa de cura foi baixa (30,3%) e a de transferência elevada (30,3%). Os agravos mais evidentes continuam sendo, a co-infecção TB/HIV (6,1%) e o alcoolismo (24,25%). A análise dos 33 isolados clínicos ... / Tuberculosis is a chronic infectious disease caused by the bacillus aerobic Mycobacterium tuberculosis. It causes health problems among millions of people each year, being ranked as the second leading cause of death from infectious disease worldwide. Thus, the aim of this study was to analyze the epidemiology of classical and molecular pulmonary tuberculosis in patients in North of Minas Gerais. We conducted an epidemiological study, an observational, longitudinal, retrospective and quantitative design. The population consisted of patients with suspected pulmonary TB, residents in the north of Minas Gerais patients at the University Hospital Clemente de Faria (HUCF), State University of Montes Claros (UNIMONTES), from January 2011 to December 2012. The clinical samples (sputum or bronchoalveolar lavage) of these patients were analyzed by Ziehl-Neelsen staining and culture by the method of Ogawa-Kudoh. Clinical isolates were subjected to molecular identification, genotyping by Spoligotyping techniques, RDRio, ERIC-PCR and MIRU-VNTR and drug susceptibility testing. The classical and molecular epidemiological correlation was performed using data from genotyping and classical epidemiological data. Of the 345 patients evaluated, 33 (9.6%) had the disease, with 69.7 % living in Montes Claros and 30.3 % in other cities in northern Minas Gerais. There was a prevalence of TB in males (75.8%), of mulattoes (60.6%), low education (42.4 %) and working age (78.9%) . The majority of new cases were (69.7%) and the smear was positive in 75.8 % of patients. The cure rate was low (30.3%) and high transfer (30.3 %). The most obvious grievances remain, the co -infection TB / HIV (6.1%) and alcoholism (24.25%) . Analysis of 33 clinical isolates by Spoligotyping allowed the identification of 22 different genetic profiles (66.7% genetic diversity). Among the genetic profiles found 15 (45.5%) LAM, 04 (18.2 %) belong to T family, 01 families (3.0%) to Haarlen ...
|
10 |
Epidemiologia clássica e molecular da tuberculose pulmonar em pacientes da região norte de Minas Gerais /Prince, Karina Andrade de. January 2013 (has links)
Orientador: Clarice QueicoFujimura Leite / Banca: Fernando Rogerio Pavan / Banca: Daisy Nakamura Sato / Banca: Regiane Prisicila Ratti Sartori / Banca: Carlos Eduardo Mendes D'Angelis / Resumo: A tuberculose (TB) é uma doença infecciosa crônica causada principalmente pelo bacilo aeróbico Mycobacterium tuberculosis. Ela provoca problemas de saúde entre milhões de pessoas a cada ano, sendo classificada como a segunda causa de morte por uma doença infecciosa em todo o mundo. Assim, o objetivo desse estudo foi analisar a epidemiologia clássica e molecular da tuberculose pulmonar, em pacientes do Norte de Minas Gerais. Foi realizado um levantamento epidemiológico, de caráter observacional, longitudinal, retrospectivo e de delineamento quantitativo. A população foi composta por pacientes com suspeita de TB pulmonar, residentes na Região Norte de Minas Gerais, atendidos no Hospital Universitário Clemente de Faria (HUCF) da Universidade Estadual de Montes Claros (UNIMONTES), no período de janeiro de 2011 a dezembro 2012. As amostras clínicas (escarro ou lavado broncoalveolar) destes pacientes foram analisadas, através da técnica de Ziehl- Neelsen e da cultura pela método de Ogawa-Kudoh. Os isolados clínicos obtidos foram submetidos a identificação molecular, a genotipagem pelas técnicas de Spoligotyping, RDRio, ERIC-PCR e MIRU-VNTR e ao teste de susceptibilidade a fármacos. A correlação epidemiológica clássica e molecular foi realizada através dos dados da genotipagem e dos dados epidemiológicos clássicos. Dos 345 pacientes avaliados, 33 (9,6%) apresentavam a doença, sendo 69,7% residentes em Montes Claros e 30,3% em outras cidades do Norte de Minas Gerais. Houve predomínio da TB em indivíduos do sexo masculino (75,8%), da etnia parda (60,6%), de baixa escolaridade (42,4%) e em idade economicamente ativa (78,9%). A maior parte dos casos eram novos (69,7%) e a baciloscopia foi positiva em 75,8% dos pacientes. A taxa de cura foi baixa (30,3%) e a de transferência elevada (30,3%). Os agravos mais evidentes continuam sendo, a co-infecção TB/HIV (6,1%) e o alcoolismo (24,25%). A análise dos 33 isolados clínicos ... / Abstract: Tuberculosis is a chronic infectious disease caused by the bacillus aerobic Mycobacterium tuberculosis. It causes health problems among millions of people each year, being ranked as the second leading cause of death from infectious disease worldwide. Thus, the aim of this study was to analyze the epidemiology of classical and molecular pulmonary tuberculosis in patients in North of Minas Gerais. We conducted an epidemiological study, an observational, longitudinal, retrospective and quantitative design. The population consisted of patients with suspected pulmonary TB, residents in the north of Minas Gerais patients at the University Hospital Clemente de Faria (HUCF), State University of Montes Claros (UNIMONTES), from January 2011 to December 2012. The clinical samples (sputum or bronchoalveolar lavage) of these patients were analyzed by Ziehl-Neelsen staining and culture by the method of Ogawa-Kudoh. Clinical isolates were subjected to molecular identification, genotyping by Spoligotyping techniques, RDRio, ERIC-PCR and MIRU-VNTR and drug susceptibility testing. The classical and molecular epidemiological correlation was performed using data from genotyping and classical epidemiological data. Of the 345 patients evaluated, 33 (9.6%) had the disease, with 69.7 % living in Montes Claros and 30.3 % in other cities in northern Minas Gerais. There was a prevalence of TB in males (75.8%), of mulattoes (60.6%), low education (42.4 %) and working age (78.9%) . The majority of new cases were (69.7%) and the smear was positive in 75.8 % of patients. The cure rate was low (30.3%) and high transfer (30.3 %). The most obvious grievances remain, the co -infection TB / HIV (6.1%) and alcoholism (24.25%) . Analysis of 33 clinical isolates by Spoligotyping allowed the identification of 22 different genetic profiles (66.7% genetic diversity). Among the genetic profiles found 15 (45.5%) LAM, 04 (18.2 %) belong to T family, 01 families (3.0%) to Haarlen ... / Doutor
|
Page generated in 0.0521 seconds