22 research outputs found
Mycobacterium tuberculosis Infection in Young Children: Analyzing the Performance of the Diagnostic Tests
This study evaluated the performance of the Tuberculin Skin Test (TST) and Quantiferon-TB Gold in-Tube (QFT) and the possible association of factors which may modify their results in young children (0-6 years) with recent contact with an index tuberculosis case. Materials and Methods: A cross-sectional study including 135 children was conducted in Manaus, Amazonas-Brazil. The TST and QFT were performed and the tests results were analyzed in relation to the personal characteristics of the children studied and their relationship with the index case. Results: The rates of positivity were 34.8% (TST) and 26.7% (QFT), with 14.1% of indeterminations by the QFT. Concordance between tests was fair (Kappa = 0.35 P<0.001). Both the TST and QFT were associated with the intensity of exposure (Linear OR = 1.286, P = 0.005; Linear OR = 1.161, P = 0.035 respectively) with only the TST being associated with the time of exposure (Linear OR = 1.149, P = 0.009). The presence of intestinal helminths in the TST+ group was associated with negative QFT results (OR = 0.064, P = 0.049). In the TST- group lower levels of ferritin were associated with QFT+ results (Linear OR = 0.956, P = 0.036). Conclusions: Concordance between the TST and QFT was lower than expected. The factors associated with the discordant results were intestinal helminths, ferritin levels and exposure time to the index tuberculosis case. In TST+ group, helminths were associated with negative QFT results suggesting impaired cell-mediated immunity. The TST-&QFT+ group had a shorter exposure time and lower ferritin levels, suggesting that QFT is faster and ferritin may be a potential biomarker of early stages of tuberculosis infection
Plasmodium vivax Malaria in Pregnant Women in the Brazilian Amazon and the Risk Factors Associated with Prematurity and Low Birth Weight: A Descriptive Study
INTRODUCTION: Plasmodium vivax is the most prevalent malaria
species in the American region. Brazil accounts for the higher
number of the malaria cases reported in pregnant women in the
Americas. This study aims to describe the characteristics of
pregnant women with malaria in an endemic area of the Brazilian
Amazon and the risk factors associated with prematurity and low
birth weight (LBW). METHODS/PRINCIPAL FINDINGS: Between December
2005 and March 2008, 503 pregnant women with malaria that
attended a tertiary health centre were enrolled and followed up
until delivery and reported a total of 1016 malaria episodes.
More than half of study women (54%) were between 20-29 years
old, and almost a third were adolescents. The prevalence of
anaemia at enrolment was 59%. Most women (286/503) reported more
than one malaria episode and most malaria episodes (84.5%,
846/1001) were due to P. vivax infection. Among women with only
P. vivax malaria, the risk of preterm birth and low birth weight
decreased in multigravidae (OR, 0.36 [95% CI, 0.16-0.82]; p =
0.015 and OR 0.24 [95% CI, 0.10-0.58]; p = 0.001, respectively).
The risk of preterm birth decreased with higher maternal age (OR
0.43 [95% CI, 0.19-0.95]; p = 0.037) and among those women who
reported higher antenatal care (ANC) attendance (OR, 0.32 [95%
CI, 0.15-0.70]; p = 0.005). CONCLUSION: This study shows that P.
vivax is the prevailing species among pregnant women with
malaria in the region and shows that vivax clinical malaria may
represent harmful consequences for the health of the mother and
their offsprings particularly on specific groups such as
adolescents, primigravidae and those women with lower ANC
attendance
Associação de metemoglobinemia e deficiĂȘncia de glicose-6-fosfato desidrogenase em pacientes com malĂĄria tratados com primaquina
Este estudo teve como objetivo verificar a ocorrĂȘncia de metemoglobinemia em indivĂduos deficientes da glicose-6-fosfato desidrogenase durante o tratamento da infecção malĂĄrica com primaquina. Foram selecionados pacientes com diagnĂłstico para malĂĄria por Plasmodium vivax ou mista V+F (Plasmodium vivax + Plasmodium falciparum), Grupo 1: com 74 indivĂduos com diagnĂłstico clĂnico de metemoglobinemia e Grupo 2: 161 indivĂduos sem diagnĂłstico clĂnico de metemoglobinemia. Quanto Ă deficiĂȘncia da G6PD, nos Grupos 1 e 2, houveram 51,3% (38) e 8,7% (14) de indivĂduos enzimopĂȘnicos, respectivamente, demonstrando atravĂ©s de tais dados, significĂąncia estatĂstica na associação com a metemoglobinemia somente nos indivĂduos do Grupo 1 (p<0,05). A comparação da relação da metemoglobinemia Ă deficiĂȘncia da G6PD mostrou haver uma possĂvel associação de indivĂduos enzimopĂȘnicos desenvolverem metemoglobinemia com maior freqĂŒĂȘncia
Mycobacterium tuberculosis infection in young children: analyzing the performance of the diagnostic tests.
OBJECTIVE:This study evaluated the performance of the Tuberculin Skin Test (TST) and Quantiferon-TB Gold in-Tube (QFT) and the possible association of factors which may modify their results in young children (0-6 years) with recent contact with an index tuberculosis case. MATERIALS AND METHODS:A cross-sectional study including 135 children was conducted in Manaus, Amazonas-Brazil. The TST and QFT were performed and the tests results were analyzed in relation to the personal characteristics of the children studied and their relationship with the index case. RESULTS:The rates of positivity were 34.8% (TST) and 26.7% (QFT), with 14.1% of indeterminations by the QFT. Concordance between tests was fair (Kappaâ=â0.35 P<0.001). Both the TST and QFT were associated with the intensity of exposure (Linear ORâ=â1.286, Pâ=â0.005; Linear ORâ=â1.161, Pâ=â0.035 respectively) with only the TST being associated with the time of exposure (Linear ORâ=â1.149, Pâ=â0.009). The presence of intestinal helminths in the TST+ group was associated with negative QFT results (ORâ=â0.064, Pâ=â0.049). In the TST- group lower levels of ferritin were associated with QFT+ results (Linear ORâ=â0.956, Pâ=â0.036). CONCLUSIONS:Concordance between the TST and QFT was lower than expected. The factors associated with the discordant results were intestinal helminths, ferritin levels and exposure time to the index tuberculosis case. In TST+ group, helminths were associated with negative QFT results suggesting impaired cell-mediated immunity. The TST-&QFT+ group had a shorter exposure time and lower ferritin levels, suggesting that QFT is faster and ferritin may be a potential biomarker of early stages of tuberculosis infection
Mycobacterium tuberculosis Infection in Young Children: Analyzing the Performance of the Diagnostic Tests
This study evaluated the performance of the Tuberculin Skin Test (TST) and Quantiferon-TB Gold in-Tube (QFT) and the possible association of factors which may modify their results in young children (0-6 years) with recent contact with an index tuberculosis case. Materials and Methods: A cross-sectional study including 135 children was conducted in Manaus, Amazonas-Brazil. The TST and QFT were performed and the tests results were analyzed in relation to the personal characteristics of the children studied and their relationship with the index case. Results: The rates of positivity were 34.8% (TST) and 26.7% (QFT), with 14.1% of indeterminations by the QFT. Concordance between tests was fair (Kappa = 0.35 P<0.001). Both the TST and QFT were associated with the intensity of exposure (Linear OR = 1.286, P = 0.005; Linear OR = 1.161, P = 0.035 respectively) with only the TST being associated with the time of exposure (Linear OR = 1.149, P = 0.009). The presence of intestinal helminths in the TST+ group was associated with negative QFT results (OR = 0.064, P = 0.049). In the TST- group lower levels of ferritin were associated with QFT+ results (Linear OR = 0.956, P = 0.036). Conclusions: Concordance between the TST and QFT was lower than expected. The factors associated with the discordant results were intestinal helminths, ferritin levels and exposure time to the index tuberculosis case. In TST+ group, helminths were associated with negative QFT results suggesting impaired cell-mediated immunity. The TST-&QFT+ group had a shorter exposure time and lower ferritin levels, suggesting that QFT is faster and ferritin may be a potential biomarker of early stages of tuberculosis infection
Odds ratio and confidence interal of 95% for the Tuberculosis Skin Test positive results according to time of exposure (months) to index case.
<p>Odds ratio and confidence interal of 95% for the Tuberculosis Skin Test positive results according to time of exposure (months) to index case.</p
Multivariate logistic regression according to factors for positive QFT results stratified by TST results.
<p>TST: Tuberculin Skin Test, QFT: QuantiFERON-TB Gold In-Tube, MTC-score: <i>Mycobacterium tuberculosis</i> contact score, BCG: Bacillus Calmette-Guérin.</p>a<p>logistic regression coefficient related to quantitative variable.</p>b<p>Linear odds ratio; exponential to the regression coefficient.</p