Even in this modern era Tuberculosis (TB) poses a serious challenge for the world. Due to emerging of resistance strain and coinfection with Human Immuno Deficiency Virus (HIV)/Acquired Immuno Deficiency Syndrome (AIDS) it is difficult to control the disease. Among the 22 high TB burden countries Pakistan ranks 5th, in case of multi drug resistant its position is 27th. In the year 2013, approximately 12997 incident cases of drug resistant TB in which only 1570 (13%) were registered for treatment. Aim of this study was to find out treatment success rate of pulmonary tuberculosis (PTB) at Tehsil Head Quarter Dargai, Khyber Pakhtunkhwa, Pakistan from 1st January 2011 to 31st December 2014.
The disease still remains a global concern with an increasing rate due to drug-resistant TB. Globally, about 3.3% of new and 20% of formerly treated cases were diagnosed as Multi-drugresistant Tuberculosis (MDR-TB), with the rates remaining almost unchanged in recent years. In 2014, there were approximately 480,000 (range: 360,000–600,000) new cases of MDR-TB worldwide, and roughly 190,000 (range: 120,000–260,000) deaths from MDR-TB. Among patients with pulmonary TB who were diagnosed in 2014, on average 300,000 (range: 220,000–370,000) suffered from MDR-TB. More than half of these patients were from India, China, and Russia. In Iran, there was approximately 0.8% (0.30–1.4%) of new TB cases with MDR-TB in the same year.
Multi-drug-resistant tuberculosis (MDRTB) is a major public health problem due to longer duration of treatment and unfavourable outcome in comparison with sensitive TB. Drug resistant tuberculosis (DRTB) included both multidrug resistant (MDR) and extensively drug-resistant (XDR) TB; MDRTB strains are resistant to Isoniazid and Rifampicin the two most-effective first-line any of the injectables. It is showed PreXDRTB, Diabetes Mellitus Smoking and Drug abuse as independent predictors of failure. These results suggest that strict control of DM, switch over to XDRTB regime from MDRTB regimen in PreXDRTB is warranted, Smoking and drug rehabilitation to be carried out in DRTB patients. Non-communicable disease effect must be studied extensively.
Tuberculosis (TB) is caused by a group of bacteria collectively known as the Mycobacterium tuberculosis complex . The commonest strain of Mycobacterium found among TB patients in Ghana is the M. tuberculosis followed by Mycobacterium africanum and Mycobacterium bovis. M. bovis is virulent for cattle but can infect other animals and humans causing disease and pathology similar to M. tuberculosis , which is naturally pathogenic for man . It has been established that 3% of pulmonary TB in Accra, Ghana is caused by M. boviswhich raises concern about possible aerosol transmission between cattle and human population or within the human population.
Despite rigorous control efforts, the current global estimates indicate that 1/3 of the world’s population has TB infection and 5-10% of these individuals if HIV negative will develop active TB during their lifetime, contributing to a global annual incidence of approximately 9.2 million cases. A study in the Ho district of the Volta Region revealed a prevalence rate of 3.1% bovine TB infection in cattle and 5.9% within a cluster and others have also indicated transmission from humans to animals and vice versa.
In India, pulmonary tuberculosis accounts for 85 percent of cases and extrapulmonary tuberculosis accounts for 15 percent of cases with bone and joint involvement seen in 1 to 3 percent cases. ‘Primary tubercular osteomyelitis’ of sternum is a rare form of extrapulmonary tuberculosis in which tuberculosis is primarily affecting the sternum. It is very rare form of presentation even in the developing countries, where tuberculosis is endemic, with only few cases reported in the literature. Tuberculous sternal involvement is seen in approximately 1% of all skeletal TB cases and approximately 0.3% of all types of osteomyelitis. We report an unusual case of primary manubrio-sternal joint tuberculosis presenting as vague anterior chest wall swelling and pain.
A 45-year-old man presented with 9 months’ history of pain over the center of the anterior aspect of upper chest wall. Pain was insidious in onset. It was localized and used to subside by taking analgesics. It was aggravated by physical activity and coughing. A history of loss of appetite and weight was present.
A 55-year-old male patient, chronic smoker, comes to the hospital with complaints of cough, yellowish expectoration and haemoptysis, accompanied by a sharp, stabbing pain in the right axillary region which is aggravated on taking a deep breath and on coughing. On examination, the trachea is shifted to the right side, a dull note on percussion is heard in the right 2nd-5th intercostal spaces anteriorly, extending to the axilla and right interscapular region. Coarse crepitations, bronchial breath sounds and increased vocal resonance are heard in the same region anteriorly and in the right axilla. A chest radiograph is taken.
This case highlights the difficulties in making a clinical diagnosis in a middle-aged patient with cough and pleuritic chest pain. While a consolidation is apparent on the right side on clinical and radiological examination, the discerning physician will also realize that the trachea is shifted to the same side as the lesion (right side) and the right hemi diaphragm too is significantly elevated.
Tuberculosis (TB) is disproportionately affects the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be catastrophic health expenditure for TB affected households in particularly vulnerable tribal groups (PVTGs).
A survey of pulmonary tuberculosis (PTB) was carried out in Saharia dominated Pohri block of Shivpuri district of Madhya Pradesh state in central India during the period 2013 to 2014. Of 9964 surveyed, 280 PTB cases identified formed the study population for the present study. Among 280 TB patients identified, 220 (79%) cases interviewed at their residence by trained field investigators after obtaining written informed consent.