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Vol 47  No 3 July 2000 ISSN 0019-5707 |
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| Tuberculin sensitivity in BCG vaccinated children and its implications for ARI estimation: -V.K.Chadha,P.S.Jagannath and H.Satyanarayana To study the tuberculin sensitivity patterns among BCG vaccinated and unvaccinated children and possibility of estimating annual risk of infection (ARI) among BCG vaccinated children , a total of 11132 children (5107 aged 0-4 years and 6205 aged 5 -9 years) were tested using 1TU of PPD RT 23 with Tween 80. Children with BCG scar comprised 68.2% of the test read population aged 0-4 years and 47.5% of those aged 5-9 years. Overall 68.9% of the children with BCG scar had either no test reaction or reaction less than 10mm in size. In the 0-4 year age group a bimodal distribution of reaction sizes was observed among the unvaccinated children, but not so in the vaccinated children. in the 5-9 year age group, the distribution were bimodal in both the vaccinated as well as unvaccinated children. The mode on the right side of the distribution was at 25mm in the vaccinated as well as unvaccinated 5-9 years old children. Based on this mode, the prevalence of infection was estimated to be 8.08% and 8.6% among the vaccinated and unvaccinated respectively. The respective A.R.I rates were 1.12% and 1.19%. This study indicates that in the event of non availability of a sufficient number of unvaccinated children for estimation of ARI,tuberculin surveys may be conducted among the 5-9 year aged including vaccinated children.
Tuberculosis in North Arcot district of Tamilnadu A sample survey: -Manjula Datta,P.G.Gopi,B.N.Appegowda,K.R.Bhima Rao and B.N.Gopalan A sample survey was carried out in North Arcot district of TamilNadu with the objective of finding out the prevalence of bacteriologically positive and radiologically active pulmonary tuberculosis among persons aged 15 years and above using two screening methods viz , elicitation of suggestive symptoms and chest Xray examination . Another objective was to estimate the prevalence of tuberculosis infection in children aged below 10 years. A population of 105339 persons was registered in a random sample of 35 villages from the rural areas and 102 town streets from the urban sector. All children aged 0-9 were tuberculin tested with 1TU RT23. Persons aged 15 years and above were screened for suggestive symptoms,and one third of the sample was screened by Xray of chest as well.. Sputum specimens from the symptomatics and/orXray abnormals were subjected to bacteriological examination. The prevalence of infection among "below 10 years old" children without BCG scar was 6.7%. The prevalence of disease by sputum smear and/or culture among symptomatics was 4.3 per thousand in population aged 15 years and above. The prevalence rate of bacteriolgical positives based on symptoms and Xray screening, in one third sample was 7.9 per thousand. The prevalence of Xray positive cases was 17.0 per 1000. Information available from similar studies in the country has been reviewed.
Treatment outcome in Tuberculosis patients placed under directly observed treatment short course(DOTS) A cohort study: -S.l Chadha and R.P.Bhagi The study was carried out to evaluate treatment outcome in tuberculosis patients under DOTS. The 639 subjects in the cohort comprised 432 males and 207 females. The patients were diagnosed and administered standard regimens of antituberculosis drugs as prescribed under DOTS guidelines. along with lesions of the radiological assessment. The sputum conversion rate was 92.6% and 76.9% in category I and II patients respectively. Defaulter rate was 7.7%,treatment failure rate was 1.6%;three fourth patients were asymptomatics and 95% had gained weight ranging from 1 Kg to 5 Kg. The radiological lesions showed significant improvement in 76.3% patients.
Report on Revised National Tuberculosis control programme:Urban pilot project in Lucknow: -S.K.Srivastava,R.K.Ratan,P.Srivastava and R.Prasad. A total of 1529 patients of tuberculosis(new smear positive,retreatment smear positive,new smear negative and extra pulmonary) were provided service in the urban pilot project area of Lucnow under the Revised National Tuberculosis control programme. from september 1995 to December 1997. Diagnosis, treatment and follow up of patients were done as per guidelines of RNTCP. The case finding efficiency for new smear positive cases was 65.1% using Styblo model and assuming ARI of 1.7%. Sputum conversion rates at the end of 3months for new and retreatment smear positive were 92.9% and 81.9% respectively. Treatment success rate (cure/treatment completion) in new smear positive and retreatment group were 89.8% and 74.9% respectively. Overall treatment success rate for all types of cases was 88.9%. Overall failure and death rates were 0.8% and 3.3.% respectively. Supervised chemotherapy and emergence of drug resistance in cases of relapse.: -B.N.Panda,J.Jena,,S.P.Rai and R.S Chaterjee In the armed forces fully supervised short course chemotherapy is being followed for the initial intensive phase of tuberculosis since 1981. Generally relapse rate with such SCC has been less than 2%. In this retrospective analysis ,we have studied the pattern of drug resistance with Mycobacterium tuberculosis isolates obtained from cases of relapse after supervised SCC and compared with that in new cases. Pattern of drug resistance was analysed in 4346 newly registered cases of pulmonary tuberculosis and 79 culture positive relapses at a respiratory diseases centre. Overall drug resistance in new cases was 12.8% compared with 41.5% in relapses.:Polyresistance excluding combined Rifampicin and INH resistance was 3.7% and 11.7%. and MDR-TB (resistance to Rifampicin and INH , with or without resistance to other drugs) was 1.8% and 13.2% respectively. Inspite of supervised chemotherapy,under Armeed Forces setup MDR-TB was observed very frequently among the relapses. Scelerosing mediastinitis with oesophageal involvement in miliary tuberculosis- A case report -Neil Sahasrabudhe,Ashwini Sathe,Anita Kavatkar,and M.V.Jadhav Scelerosing mediastinitis with superior venacaval compression and oesophageal involvement in a patient of disseminated miliary tuberculosis is reported because of its clinical importance Concomitant Endobronchial tuberculosis,Myocarditis and congestive heart failure -Nagina Agarwal and S.K.Sharma A rare case of endobronchial as well as myocardial tuberculosis,which presented as acute congesive heart failure is being reported. The patient gradually improved on antituberculosis drug therapy, steroids,digoxin,enalapril and diuretics. The presence of myocardial tuberculosis without pericardial or endbronchial involvement or miliary dissemination is considered extraordinary. The above are only abridged summaries.You may please refer the original articles for detailsBesides the above Volume 47:3(July 2000) issue features Tuberculosis:Triumph and Tragedy the text of oration of Dr.M.M.Singh delivered at the 54 th national conference of Tuberculosis and Chest diseases held at Patna and a leading article "Role of Human Leukocyte antigen (HLA) and nonHLA genes in susceptibilty or resistance to pulmonary tuberculosis" by P.Selvaraj from Tuberculosis Research centre (ICMR)Chennai. The summaries of the papers presented at the 54th national conference on Tuberculosis and Chest diseases are also featured. |
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