Unlabelled: SETTING/OBJECTIVE: We evaluated clinical characteristics, yield of solid vs. liquid culture, polymerase chain reaction (PCR)-based drug-resistance profiles, and clinical outcomes of tuberculosis (TB) inpatients in Lilongwe, Malawi.
Design: We enrolled adult patients admitted to the Bwaila TB Ward from Jan-Aug/2010. Evaluations included questionnaires, clinical exam, chest radiograph, HIV status, CD4 lymphocyte count, plasma HIVRNA and sputum analysis including Auramine-O stain, Lowenstein-Jensen (LJ) and Mycobacterial Growth Indicator Tube (MGIT) culture, and susceptibility testing using the HAIN GenoType® MTBDRplus.
Results: Eighty-eight patients were enrolled (88% re-treatment, 42% smear positive, 93% pulmonary TB, 74% HIV co-infected). At baseline, 44/88 (50%) MGIT and 28 (32%) LJ cultures were positive with a mean time to positivity of 12.1 (Range 1-42) and 21.5 (Range 7-58) days, respectively. Four percent (3/77) of retreatment patients or 8% of the 38 MGIT+ PCR-confirmed retreatment cases had multi-drug resistant tuberculosis (MDR TB). One MDR TB patient was smear negative and only one MDR patient was identified with LJ. Lower mean hemoglobin at admission was associated with mortality (10.5 vs. 7.5; p<0.01; CI 101 9.8-11.0).
Conclusions: The MDR TB burden among the retreatment population in Lilongwe, Malawi is similar to regional estimates by the WHO (7.7% 95% CI 0-18.1). MDR TB patients are not routinely identified with sputum smear or LJ, suggesting more efficient technology should be adopted.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3588213 | PMC |
Publication Analysis
Top Keywords
Similar Publications
Tobacco Smoking in Early Adulthood and Labor Market Performance: The Cardiovascular Risk in Young Finns Study.
Nicotine Tob Res
January 2025
Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
Introduction: Tobacco smoking has been associated with reduced success in the labor market, potentially due to its negative impact on labor productivity, especially in physically demanding jobs, as it affects physical fitness and performance adversely.
Methods: This prospective study used data from the Cardiovascular Risk in Young Finns Study survey, linked to register information on labor market outcomes and education attainment, to examine the association between tobacco smoking and long-term labor market outcomes (earnings and employment, N = 1953). Smoking levels were determined by cigarette pack-years in 2001, as reported in the survey, whereas annual earnings and employment status were tracked from 2001 to 2019.
Comparative Diagnostic Accuracy of ChatGPT-4 and Machine Learning in Differentiating Spinal Tuberculosis and Spinal Tumors.
Spine J
January 2025
Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha 410008, China. Electronic address:
Background: In clinical practice, distinguishing between spinal tuberculosis (STB) and spinal tumors (ST) poses a significant diagnostic challenge. The application of AI-driven large language models (LLMs) shows great potential for improving the accuracy of this differential diagnosis.
Purpose: To evaluate the performance of various machine learning models and ChatGPT-4 in distinguishing between STB and ST.
The impact of tuberculosis-induced hyperglycemia on pulmonary microbiota and airway mucus secretion in individuals not previously diabetic: A systematic review and meta-analysis protocol.
PLoS One
January 2025
Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya.
The lung environment harbours a community of microbes that play a significant role in health and disease, including innate protection against pathogenic microorganisms. Infection with Mycobacterium tuberculosis, psychological stress associated with the tuberculosis (TB) disease, and the metabolites from the rifampicin treatment regimen have been reported to induce hyperglycemia and consequently type 2 diabetes mellitus (T2DM) in individuals not previously diabetic. The high glucose concentration is proposed to alter the composition of the lung microbiota and airway homeostasis, exerting an influence on TB disease and treatment outcomes.
View Article and Find Full Text PDFSix months of chemotherapy using current agents is standard of care for pulmonary, drug-sensitive tuberculosis (TB), even though some are believed to be cured more rapidly and others require longer therapy. Understanding what factors determine the length of treatment required for durable cure in individual patients would allow individualization of treatment durations, provide better clinical tools to determine the of appropriate duration of new regimens, as well as reduce the cost of large Phase III studies to determine the optimal combinations to use in TB control programs. We conducted a randomized clinical trial in South Africa and China that recruited 704 participants with newly diagnosed, drug-sensitive pulmonary tuberculosis and stratified them based on radiographic disease characteristics as assessed by FDG PET/CT scan readers.
View Article and Find Full Text PDFType and physical intensity of occupations at pulmonary TB diagnosis.
IJTLD Open
January 2025
Respiratory Epidemiology & Clinical Research Unit, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Background: Pulmonary TB (PTB) predominantly affects individuals of working age. We sought to characterise the occupations of people newly diagnosed with PTB in Karachi, Pakistan, by type and physical intensity.
Design/methods: We did a secondary analysis of data from a study evaluating the diagnostic accuracy of artificial intelligence-based chest X-ray (CXR) analysis software, where individuals had been evaluated for active PTB using sputum cultures and had provided information on occupation.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!