Gambaran Berat Jenis Urin Pada Pasien Tuberkulosis Paru Dewasa Di Rsup Prof. Dr. R. D. Kandou Manado

: Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium Tuberculosis. Drugs that given to the TB patients such as isoniazid, pyrazinamide, ethambutol, streptomycin, and rifampicin. Rifampicin and streptomycin can damage the kidneys and can changes in the urine specific gravity. This study aims to describe the specific gravity of urine in adult pulmonary TB patients in the department of Prof. Dr. R. D. Kandou Manado. This research uses descriptive observational method by means of random consecutive sampling to obtain data on the weight of the urine in adult pulmonary TB patients conducted in October-November 2016 in the department Prof. Dr. R. D. Kandou Manado. The sample used is a urine sample from pulmonary TB patient with inclusion criteria. The result of urine specific gravity test that obtained from 30 patients with pulmonary tuberculosis, 27 patients (90%) with the results of 1010-1025, 1 patient (3.33%) with the results of the urine specific gravity ≤1.005, and 2 patients with the results of the urine specific gravity ≥ 1030. outpatients have an average urine specific gravity higher than inpatients. Overview urine specific gravity in this study largely still in the normal range

Rapid Molecular Diagnosis of Extra-Pulmonary Tuberculosis by Xpert/RIF Ultra

Rapid detection of Mycobacterium tuberculosis complex and determination of drug resistance are essential for early diagnosis and treatment of tuberculosis (TB). Xpert MTB/RIF Ultra (Xpert Ultra), a molecular test that can simultaneously identify M. tuberculosis complex and resistance to rifampicin directly on clinical samples, is currently used. Xpert Ultra represents a helpful tool for rapid pulmonary TB diagnosis, especially in patients with paucibacillary infection. The aim of this review is to provide an overview of the diagnostic performance of Xpert Ultra in detection of extra-pulmonary tuberculosis

Determinants of Multidrug-Resistant Pulmonary Tuberculosis in Indonesia: A Spatial Analysis Perspective

Tuberculosis is caused by Mycobacterium Tuberculosis (MT). MT usually attacks the lungs and causes pulmonary-tuberculosis. Tuberculosis cases in Indonesia keep increasing over the years. The presence of Multidrug-Resistant Tuberculosis (MDR-TB) has been one of the main obstacles in eradicating tuberculosis because it couldn’t be cured using standard drugs. In fact, the success rate of MDR-TB treatment in 2019 at the global level was only 57 percent. Research on MDR-TB can be related to the spatial aspect because this disease can be transmitted quickly. This study aims to obtain an overview and model the number of Indonesia’s pulmonary MDR-TB cases in 2019 using the Geographically Weighted Negative Binomial Regression (GWNBR) method. The independent variables used in the model are population density, percentage of poor population, health center ratio per 100 thousand population, the ratio of health workers per 10 thousand population, percentage of smokers, percentage of the region with PHBS policies, and percentage of BCG immunization coverage. The finding reveals that the model forms 12 regional groups based on significant variables where GWNBR gives better results compared to NBR. The significant spatial correlation implies that the collaboration among regional governments plays an important role in reducing the number of pulmonary MDR-TB

Effect of Omega-3 Addition on Sputum Conversion, Body Mass Index, Interleukin-6, and Lymphocyte Monocyte Ratio in the Treatment of Pulmonary Tuberculosis

This research aims to investigate the impact of omega-3 supplementation on sputum conversion, body mass index (BMI), interleukin-6 (IL-6) levels, and lymphocyte-monocyte ratio (LMR) in patients with pulmonary tuberculosis (TB). Tuberculosis is a significant health problem in Indonesia, with high incidence and mortality rates. Omega-3 fatty acids are known to have anti-inflammatory effects and may enhance the immune response, potentially supporting tuberculosis (TB) therapy. The research methods included bacteriological examination of the sputum, measurement of BMI, IL-6 levels, and MLR in patients who received additional Omega-3 compared to the control group. The results are expected to provide an overview of the effectiveness of Omega-3 as a supportive therapy in treating TB, as well as its contribution to improving patients' nutritional status and immune response. This research is expected to serve as a reference for developing more effective and affordable tuberculosis therapies

Health Concerns in Cambodia Compounded by Historical and Rural Setbacks

Cambodia is a country in the Greater Mekong Subregion of Southeast Asia. The Khmer Rouge genocide in the mid 1970s produced significant setbacks in the nation’s healthcare system. While much progress has been made, rural areas still lack access to medical professionals, facilities, and equipment. Three of the most problematic diseases in Cambodia have been malaria, HIV, and tuberculosis. Due to the inadequacies of rural healthcare, treatment-resistant varieties of malaria and tuberculosis have become a serious concern for both the nation and Southeast Asia as a whole. The question of how to best provide aid to these isolated communities is characterized by complex and multifaceted discussions that seek to bring Cambodia to a place of greater health

Interactions between Type 1 Interferons and the Th17 Response in Tuberculosis: Lessons Learned from Autoimmune Diseases

textabstractThe classical paradigm of tuberculosis (TB) immunity, with a central protective role for Th1 responses and IFN-γ-stimulated cellular responses, has been challenged by unsatisfactory results of vaccine strategies aimed at enhancing Th1 immunity. Moreover, preclinical TB models have shown that increasing IFN-γ responses in the lungs is more damaging to the host than to the pathogen. Type 1 interferon signaling and altered Th17 responses have also been associated with active TB, but their functional roles in TB pathogenesis remain to be established. These two host responses have been studied in more detail in autoimmune diseases (AID) and show functional interactions that are of potential interest in TB immunity. In this review, we first identify the role of type 1 interferons and Th17 immunity in TB, followed by an overview of interactions between these responses observed in systemic AID. We discuss (i) the effects of GM-CSF-secreting Th17.1 cells and type 1 interferons on CCR2+ monocytes; (ii) convergence of IL-17 and type 1 interferon signaling on stimulating B-cell activating factor production and the central role of neutrophils in this process; and (iii) synergy between IL-17 and type 1 interferons in the generation and function of tertiary lymphoid structures and the associated follicular helper T-cell responses. Evaluation of these autoimmune-related pathways in TB pathogenesis provides a new perspective on recent developments in TB research

Simulating Alternative Tuberculosis Diagnosis Methods in Underdeveloped Countries

Tuberculosis is the deadliest infectious disease in the world; it is especially rampant in underdeveloped countries because they do not have the infrastructure, technology, or funding to properly combat the infection. However, the development of portable point-of-care diagnosis machines can reverse this epidemic as they far surpass conventional laboratory identification. The question now is where to place these machines, which is a difficult decision with a lack of data. Therefore, a flexible simulation model is created to test the implementation of these machines with different countries and configurations. The simulation tests the baseline model and three proposed implementations of the machines. Initial analysis indicates these machines can reduce the average diagnosis period of patients by a factor of one-hundred. Furthermore, a fractional factorial design was conducted to test the sensitivity of each variable to determine which data needs to be collected before making any decisions. The model is built to be accessible and flexible allowing for the model to be expanded upon in future research

MTBVAC: A Tuberculosis Vaccine Candidate Advancing Towards Clinical Efficacy Trials in TB Prevention

Tuberculosis (TB) remains a major global health burden, causing more than 10 million new cases and 1.6 million deaths each year. Currently, the only approved TB vaccine in use in humans, is the one hundred years old vaccine, BCG, an attenuated vaccine derived from an isolate of Mycobacterium bovis that causes TB in cattle. BCG shows a variable efficacy in preventing pulmonary forms of the disease in humans, so new vaccines are needed to help stop TB transmission. Among the 15 diverse TB vaccine candidates in clinical trials, MTBVAC is the only one based on rational attenuation of a human clinical isolate of Mycobacterium tuberculosis, which contains the largest number of antigens of the TB vaccine candidates in the pipeline. MTBVAC was designed and constructed as a response to the need to confer a better TB protection in terms of pulmonary disease prevention in newborns, adolescents, and adults. This review aims to provide an overview of the preclinical and clinical development of MTBVAC to the present. We will focus on the clinical development of MTBVAC, and we will compare it with other TB vaccine candidates currently in Phase 3 efficacy trials

How can mathematical models advance tuberculosis control in high HIV prevalence settings?

Existing approaches to tuberculosis (TB) control have been no more than partially successful in areas with high human immunodeficiency virus (HIV) prevalence. In the context of increasingly constrained resources, mathematical modelling can augment understanding and support policy for implementing those strategies that are most likely to bring public health and economic benefits. In this paper, we present an overview of past and recent contributions of TB modelling in this key area, and suggest a way forward through a modelling research agenda that supports a more effective response to the TB-HIV epidemic, based on expert discussions at a meeting convened by the TB Modelling and Analysis Consortium. The research agenda identified high-priority areas for future modelling efforts, including 1) the difficult diagnosis and high mortality of TB-HIV; 2) the high risk of disease progression; 3) TB health systems in high HIV prevalence settings; 4) uncertainty in the natural progression of TB-HIV; and 5) combined interventions for TB-HIV. Efficient and rapid progress towards completion of this modelling agenda will require co-ordination between the modelling community and key stakeholders, including advocates, health policy makers, donors and national or regional finance officials. A continuing dialogue will ensure that new results are effectively communicated and new policy-relevant questions are addressed swiftly

Optimal Control of Tuberculosis: A Review

We review the optimal control of systems modeling the dynamics of tuberculosis. Time dependent control functions are introduced in the mathematical models, representing strategies for the improvement of the treatment and cure of active infectious and/or latent individuals. Optimal control theory allows then to find the optimal way to implement the strategies, minimizing the number of infectious and/or latent individuals and keeping the cost of implementation as low as possible. An optimal control problem is proposed and solved, illustrating the procedure. Simulations show an effective reduction in the number of infectious individuals.Comment: This is a preprint of a paper whose final and definite form will be published in the volume 'Mathematics of Planet Earth' that initiates the book series 'CIM Series in Mathematical Sciences' (CIM-MS) published by Springer. Submitted Aug 2013; Revised and Accepted June 201