SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS

Tuberculosis in the SAARC Region: Prioritize control measures, strengthen health facilities

Anup Bastola — Sat, 31 Dec 2022 00:00:00 +0000

Not available.

COVID-19 in Art Naïve HIV Positive Adult: Course of Presentation and Management

Sat, 31 Dec 2022 00:00:00 +0000

During the time of COVID-19 outbreak there is dilemma in diagnosis of acute lung infections. This is further hindered among immunocompromised patients due to bizarre clinical and radiological findings. We report young male severely immunocompromised HIV infected ART naïve patient presenting with acute onset of pneumonia and hypoxemia with SARS CoV-2 PCR positive.

Disseminated Histoplasmosis in HIV-Patient in Nepal: A Case Report

Sat, 31 Dec 2022 00:00:00 +0000

The risk of disseminated Histoplasmosis increases among immunocompromised HIV infected patients. It can clinically present with skin manifestation. We report a forty years HIV infected male with severe immunodeficiency clinically presenting as a disseminated Histoplasmosis with dermatological manifestation and diagnosis.

Tuberculosis Sanatorium of 21st Century Exploring the Admission Pattern and Duration of Stay at TB Sanatorium Bhowali, Uttarakhand, India: A Retrospective Study

Aninda Debnath, Ankit Chandra, Mohd. Maroof, Sadhana Awasthi, Monika Arya — Sat, 31 Dec 2022 00:00:00 +0000

Introduction: With time there have been major changes in the management of TB. No longer TB sanatoriums are preferred. However, in this 21st century, few sanatoriums do exist but are no longer in their original forms, to explore the admission patterns and duration of stay at the TB sanatorium Bhowali, Uttarakhand.

Methodology: We retrieved the data between 1st January 2018 to 31st July 2021 from the inpatient Department (IPD) of TB sanatorium Bhowali. Data were extracted in an extraction sheet and descriptive data analysis was done to see the admission patterns and duration of stay. The place of residence was analysed as per the district-wise distribution.

Results: There were 1247 admissions. These admissions were limited to six states, and the majority were from the state of Uttar Pradesh (50.7%) and Uttarakhand (46.7%). The highest cases were in the year 2018, and during April to July. As per the district-wise distribution, Udham Singh Nagar had the highest proportion of admissions (18.6%), followed by Bareilly (15%), Nainital (11.4%), and Rampur (10.9%). The mean (SD) and median (IQR) duration of stay were 22.7 days (SD–24.7) and 14 (IQR 7– 8) days, respectively. The median duration of stay was significantly higher for females (25.1 days) compared to males (21.6 days).

Conclusion: TB sanatorium Bhowali (Uttarakhand) caters majority of the patients from the neighbouring state of Uttar Pradesh. The admissions were high during the spring and summer seasons. The median duration of hospital stay for patients admitted with TB was two weeks.

Impact of Strategic Adaptations Due to COVID-19 Pandemic on a Capacity Building Program: Insights From a DRTB Program Under NTEP in India

Sat, 31 Dec 2022 00:00:00 +0000

Introduction: India has experienced high burden of drug resistant tuberculosis, under par treatment success rate and very high loss to follow-up despite continuous efforts to develop evidence-based policy to treat DRTB patients. However, it is challenging to translate policies into practice. The goal of this program was to build capacity of the program staff for effective management of DRTB in public sector through workshops, capacity building exercises, creation and dissemination of information, education and communication materials.

Methodology: The program was implemented in seven states; 11 state-level kick-off trainings were planned to reach 660 National TB Elimination Program staffs. Due to COVID-19 pandemic, on-field activities were replaced with virtual trainings with a set of 4-5 webinars per state. Pre and post training assessments were done to evaluate uptake of knowledge. Number of trainings conducted, staff trained and knowledge improvement were the indicators used to assess the outcome.

Results: A total of 34 webinars were conducted on revised Programmatic Management of Drug- Resistant Tuberculosis guidelines and 3000 staff was trained. The program organized three times more training and five times more staff were trained. Although retention of participants and their attention was challenging, transition to virtual platform provided increased coverage and targeted outputs. Proportion of participants answering correctly in pre/post-training assessments, increased from 47% to 65%.

Conclusion: Use of virtual trainings is an efficient high yielding method to build capacity of NTEP staff. Lessons learnt can help improve such interventions, benefit health programs and the end beneficiaries - the patients.

Descriptive Analysis of the Patients with Post COVID Interstitial Lung Diseases in a Tertiary Care Hospital in Central Sri Lanka: An Observational Study

Dushantha Madegedara, Lihini Basnayake, Damith Nissanka Bandara — Sat, 31 Dec 2022 00:00:00 +0000

Background: To date, COVID-19 continues to remain at pandemic proportions. As of March 2022, COVID-19 has caused over 433 million infections and over 5.9 million deaths around the world. Long COVID associated complications were reported worldwide. COVID associated interstitial lung disease is a well-known, recognized long term consequence.

Methodology: A single centre observational study was carried out in the Respiratory Disease Treatment Unit two at National Hospital Kandy, Sri Lanka. Information regarding Demographic, clinical, biochemical and radio graphical characteristics were extracted from the medical records. An interviewer-administered questionnaire was used. Statistical analysis was performed using IBM SPSS statistics data editor.

Results: A total of 53 (13.6%) COVID-19 related ILD cases were analysed. Out of them, 38 (71.7%) were males. The median age was 59 years. The majority of patients (81.1%) were given a history of at least one underlying comorbid disease, while Diabetes Mellitus was the commonest (58.4%). Out of the male patients, 17 (47.3%) had a positive smoking history of varying pack years. Different pathological patterns, geographical and zonal distributions, occasionally asymmetrical patterns were observed in HRCT of patients with COVID-19 related ILD.

Conclusion: The majority of the COVID-19 related ILD patients were males with multiple comorbidities and had a positive smoking history. The progression of the disease is well displayed in the findings of HRCT. Detection of these findings should alert the clinicians to provide prompt and optimized care in order to minimize the morbidity and mortality of COVID-19 related ILD.

Comparison of Genexpert MTB/RIF Assay and AFB Smear Microscopy in Diagnosis of Pulmonary Tuberculosis among HIV Patients at a Tertiary Care Hospital

Najma Bajracharya, Rabin Paudyal, Anup Bastola — Sat, 31 Dec 2022 00:00:00 +0000

Introduction: Tuberculosis (TB) has been the most common acute opportunistic infection in HIV positive patients and accounts for more than half of all AIDS cases in underdeveloped nations. Hence, rapid laboratory diagnosis of M. tuberculosis is needed for vulnerable patients.

Methodology: In this study, 72 sputum samples were collected from ART-naive and patients using ART for 6 months. The samples were tested with the GeneXpert MTB / RIF assay to diagnose TB and drug resistance and AFB smear microscopy as per NTP guidelines.

Results: Among 72 sputum samples studied, males were more diagnosed with TB than females. People aged 25-56 years were more infected with HIV-TB co-infection. Four patients (5.56%) were found to be TB positive with both techniques, 7 (9.72%) were GeneXpert MTB/RIF positive but smear-negative and 61 patients (84.72%) were negative with both methods. The positivity for MTB detected for GeneXpert MTB/RIF method in females was 3 (15%) and the males were 8 (15.38%), while for the ZN staining method the positivity in females was 2 (10%) and the males were 2 (3.85%). The GeneXpert MTB/RIF assay was also capable of detecting TB in smear-negative cases.

Conclusion: This study showed that the GeneXpert MTB/RIF assay is an effective tool for the early diagnosis of TB among HIV patients as compared to AFB smear staining method.