TO THE EDITOR—I read with interest the recent article by Wong and Jacobs on the effects of interferon γ (IFN-γ) on Mycobacterium tuberculosis–infected macrophages [1]. I believe their findings are an important contribution to our understanding of the human biology of M. tuberculosis infection. However, I must take issue with their speculation that their work is likely to enable future therapeut...

BACKGROUND Placing inpatients with presumed active pulmonary tuberculosis in respiratory isolation pending results of serial sputum acid-fast bacilli (AFB) smear microscopy is standard practice in high-income countries. However, this diagnostic strategy is slow and yields few tuberculosis diagnoses. We sought to determine if replacing microscopy with the GeneXpert MTB/RIF (Xpert) nucleic acid a...

SETTING Nairobi City Council Chest Clinic, Nairobi, Kenya. OBJECTIVE To determine if under-reading of sputum smears is a contributing factor in the disproportionate increase in smear-negative tuberculosis in Nairobi, Kenya. METHODOLOGY Between October 1997 and November 1998, patients fulfilling the local programme definition of smear-negative presumed pulmonary tuberculosis were enrolled in...

Pulmonary tuberculosis is a global problem requiring 6month MDT-DOTS continuous treatment. This time based treatment along with the combination of VCO nutritional supplement and/or Catfish-extracted albumin has shown a significant benefit on improving immune response, accelerating the conversion of BTA sputum, increasing nutritional states and improving chest X-ray imaging in people with active...

OBJECTIVE 1) To assess the adverse drug reactions (ADRs) of second-line anti-tubercular drugs used to treat Multi-drug resistant Tuberculosis (MDR-TB) in central India on the basis of causality, severity and avoidability scales. 2) To investigate the relationship of MDR-TB (primary or secondary) and the presence of diabetes mellitus (DM) with mean smear conversion time. MATERIAL AND METHODS A...

INTRODUCTION The existing diagnostic algorithms for sputum smear-negative tuberculosis (TB) are complicated, time-consuming, and often difficult to implement. The decision to initiate TB treatment in resource-limited countries is often largely based on clinical predictors. We sought to determine the clinical predictors and accuracy of empiric TB treatment initiation in HIV-infected sputum smear...

Infectivity of Sputum smear positive patients with tuberculosis for household contacts was assessed before diagnosis and during domiciliary treatment. Intracutaneous tuberculin test, sputum and radiological examinations were done in all cases and their house-hold contacts initially; and were repeated for contacts every six months during two years follow-up. Initially 244 (56%) contacts gave pos...

BACKGROUND Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely. OBJECTIVES To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the R...

The aim of this study was to assess the value of examining multiple sputum specimens in the diagnosis of pulmonary tuberculosis (PTB). We analyzed sputum smear and culture results of patients diagnosed with culture-proven PTB during 2002. In 1027 patients, the diagnosis was established by detection of Mycobacterium tuberculosis bacilli in sputum samples. The number of sputum specimens submitted...