SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS <p>The official peer-reviewed journal of SAARC TB and HIV/AIDS Centre. Full text articles available.</p> SAARC Tuberculosis and HIV/AIDS Centre (STAC) en-US SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 1818-9741 <p>Copyright © SAARC Tuberculosis and HIV/AIDS Centre (STAC), all rights reserved, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without prior permission of the STAC.</p> Common Disease with Uncommon Presentation: Spina Ventosa <p><strong>Introduction: </strong>Tuberculosis of short tubular bones of hand and foot is called tuberculousdactilitis or “spinaventosa”. This is uncommon type of osteoarticular tuberculosis more often seen in children than adults. This report describes tuberculosis affecting third metacarpal bone in a 25-year-old male patient presenting with a firm, painless, progressively increasing swelling over the dorsum of left hand. Diagnosis was made by cytological examination of aspirate from the affected area.</p> R. Dixit M. Goyal K. Pawar V. Chandra Copyright (c) 2019 SAARC Tuberculosis and HIV/AIDS Centre (STAC) 2019-12-31 2019-12-31 17 2 29 31 10.3126/saarctb.v17i2.49112 Editorial Vol.17(2) <p>No abstract available.</p> Ramesh Kumar Kharel Copyright (c) 2019 SAARC Tuberculosis and HIV/AIDS Centre (STAC) 2019-12-31 2019-12-31 17 2 10.3126/saarctb.v17i2.49107 Diagnostic Yield of Bronchoalveolar lavage Xpert MTB/RIF Assay (Gene Xpert ® in Sputum Smear Negative Pulmonary Tuberculosis Patients – A One Year Cross Sectional Study <p><strong>Introduction: </strong>Tuberculosis remains a major public health issue and is one of the top ten causes of death worldwide. Seven countries worldwide account for 64% of the total incidence and India leading the count. Only about 50-60% of the cases are sputum smear positive, while rest are sputum scare or smear negative cases. Since December 2010, WHO has recommended the use of Xpert MTB/RIF assay due to its high-quality performance, as compared to microscopy in the diagnosis of tuberculosis. The present study was done to evaluate the early diagnosis of sputum smear negative pulmonary tuberculosis patients using Xpert MTB/RIF assay test in broncho-alveolar fluid and to evaluate prevalence of rifampicin resistance in these patients.</p> <p><strong>Methods: </strong>This was a one year cross section study conducted in a tertiary care hospital. A total of 143 suspected cases of pulmonary tuberculosis patients who were sputum smear negative were included in the study. All patients underwent bronchoscopy and the BAL specimen was subjected for Xpert MTB/RIF assay, smear by ZN staining and AFB Culture using MGIT 960 medium. The sensitivity and specificity of the Xpert MTB/RIF assay was compared to AFB culture which is considered as the gold standard method for diagnosing TB was calculated.</p> <p><strong>Results: </strong>Majority of the patients were males (74.83%) and under the age group of 30 years (26.57%). Out of 143 suspected, the final diagnosis of PTB was done in 93 patients. Out of 93 cases of PTB, 87(93.5%) patients were Xpert MTB/RIF assay positive, 80(86.0%) were AFB culture positive and 39(41.9%) patients were AFB smear positive. The sensitivity and specificity of BAL Xpert MTB/RIF assay was 92.5% and 79.37% respectively (p &lt;0.0001).</p> <p><strong>Conclusion: </strong>The Xpert MTB/RIF assay is more sensitive and specific than smear microscopy for the diagnosis of PTB in sputum smear negative on specimens obtained from broncho-alveolar lavage (BAL).</p> G. S. Gaude S. Samskruti J. Hattiholi B. Patil Copyright (c) 2019 SAARC Tuberculosis and HIV/AIDS Centre (STAC) 2019-12-31 2019-12-31 17 2 1 7 10.3126/saarctb.v17i2.49108 Impact of Education and Media Exposure on Tuberculosis Related Awareness among Indian Adults: A Study Based on NFH-3 <p><strong>Introduction: </strong>Lack of awareness about a contagious disease like pulmonary tuberculosis (TB) among the general population may be a hindrance to early prevention of infection and timely care-seeking, besides being a stigma fuelling factor. The objective in this study is to identify the roles of education and media exposure on correct knowledge regarding the route of TB transmission across selected low awareness geographical regions of India, one of the 30 high TB burden countries according to the WHO.</p> <p><strong>Methods: </strong>The study is based on NFHS 3 (2005-06) unit level data on adult men and women using basic statistical tools and logistic regression analysis.</p> <p><strong>Results: </strong>Adults of both sexes in the northern, central and eastern regions of India are found to have lower than all India share of correct knowledge about the route of TB transmission. Education seems to be positively impacting correct knowledge among women in all three regions and among men, only in the East. Good exposure to mass media significantly raises the probability of correct knowledge among both genders in the east while leaving no impact in the north and central regions.</p> <p><strong>Conclusion: </strong>Adoption of a more holistic approach in fighting TB is the need of the hour. Besides addressing the medical aspect of the disease, region-specific deeper socio-economic factors like education and media exposure that can potentially impact disease related knowledge and awareness need to be incorporated in attempts to control TB particularly in a high endemic country like India.</p> P. Barman Copyright (c) 2019 SAARC Tuberculosis and HIV/AIDS Centre (STAC) 2019-12-31 2019-12-31 17 2 8 14 10.3126/saarctb.v17i2.49109 Assessment of Health-Related Quality of Life among Tuberculosis Patients with and without Diabetes in Western Region of Nepal <p><strong>Introduction: </strong>Currently Tuberculosis is a great public health importance globally especially in developing countries due to the converging epidemics of communicable diseases. Quality of life is important for people with diabetes and TB and their health care providers for several reasons. Objective of the study was to assess status of quality of life among tuberculosis patients with and without diabetes.</p> <p><strong>Methods: </strong>This research was health facility based cross sectional study and carried out among TB patients registered under directly observed treatment short course therapy and receiving treatment from health facilities of Western Region of Nepal. Interview schedule was used to collect the data. Quality of life was assessed by using Nepali version of WHOQOL-BREFF questionnaires. Data was entered in Epi Data software and analysis was performed with the help of the statistical package for social science version 20.</p> <p><strong>Results: </strong>A total 390 TB patients were participated in this study. The overall prevalence of diabetes mellitus among TB patient was 10.8%. More than half of participants were 15-40 years of age. WHOQOL-BREF measure overall quality of life of TB patients was 68.82±10.79 and it was poor levels of quality of life. Among different socio-demographic variables such as older people, married and illiterate participants had poor QOL than others. HRQoL is affected by age, sex and marital status. TB with diabetes patients had lesser overall quality of life (88.1%) than the TB without diabetes patients (94.4%).</p> <p><strong>Conclusion: </strong>The finding suggests that to improving for TB Patients of Health literacy and counselling are promoted to achieve optimum levels of QOL.</p> D. K. Yadav N. Shrestha R. K. Yadav S. C. Gurung Copyright (c) 2019 SAARC Tuberculosis and HIV/AIDS Centre (STAC) 2019-12-31 2019-12-31 17 2 15 21 10.3126/saarctb.v17i2.49110 The Prevalence and Determinants of Active Tuberculosis among Diabetes Patients in Tertiary Care Hospitals of Nepal 2018 <p><strong>Introduction: </strong>Researches implicated diabetes as independent risk factor for multi-drug resistant tuberculosis and unfavorable outcome of treatment. There is no data to address the association between diabetes mellitus (DM) and tuberculosis (TB) in Nepal. Thus we assessed the burden and demographics of active tuberculosis among diabetic patients attending tertiary care hospitals in Nepal.</p> <p><strong>Methods: </strong>A cross-sectional study was conducted in adult DM patients attending seven tertiary care hospitals representing five development region of the country. Relevant data were collected and participants were screened for active TB (symptom screening and microbiological diagnosis).</p> <p><strong>Results: </strong>Among the 520 enrolled DM patients screened, 23 had active TB. The prevalence was 4.42% (CI 2.96 - 6.54). The positive cases had older age group with the mean age of 59.73 ± 17.36 years with male predominance of 78% (18/23). Among the 23 positive cases, only two (8.69 %) had extra pulmonary TB. Diabetic control had significant (p=0.006) relationship to develop Tuberculosis. The comorbid conditions e.g., Hypertension (OR 13, 95% CI: 4.54 to 37.14); diabetic nephritis (OR 9.25, 95% CI: 2.03 to 42.20); and Diabetic neuropathy (OR 26.66, 95% CI: 5.16 to 137.71) are significant risk factors to develop tuberculosis among the diabetes patients. There were no significant differences in occupation, literacy rate, tobacco or alcohol consumption, HbA1c levels between TB and non-TB participants.</p> <p><strong>Conclusion: </strong>The prevalence of tuberculosis among diabetic patients is low in Nepal. This is the result of tertiary care hospital outdoor patients only, thus representativeness was compromised. Thus to assess the magnitude of comorbidities, mandatory screening in all level were recommended.</p> R. K. Kharel R. Sultana R. P. Bichaa R. P. Pant A. P. Weerakoon K. B. Karki Copyright (c) 2019 SAARC Tuberculosis and HIV/AIDS Centre (STAC) 2019-12-31 2019-12-31 17 2 22 28 10.3126/saarctb.v17i2.49111