Tesis sobre el tema "Tuberculosis"
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Couvin, David. "Mise au point, développement et gestion d’une base de données mondiale des génotypes circulants de bacilles tuberculeux : Méthodes moléculaires et outils web pour cartographier, comprendre et maîtriser l’épidémie". Thesis, Antilles-Guyane, 2014. http://www.theses.fr/2014AGUY0791/document.
Texto completoTuberculosis (TB) is a contagious infectious disease caused by mycobacteria belonging to the Mycobacterium tuberculosis complex (MTBC). Despite numerous campaigns of vaccination by the BCG (Bacillus Calmette-Guérin) vaccine, and TB treatments, there was a resurgence of the disease since the 80s. This disruption is due to coinfection with HIV/AIDS, disorganization of health systems and the emergence of bacteria resistant to anti-TB drugs. In this context, a better understanding of the movements and changes of circulating clones of tubercle bacilli would detect faster and more relevant emerging epidemics. The control and monitoring of the disease are essential means to fight against the worldwide spread of tuberculosis. Thus the TB and Mycobacteria unit of the Pasteur Institute of Guadeloupe (IPG) has developed a database of genotypic profiles for the study of global epidemiology of tuberculosis.In this thesis, we discuss the Bioinformatical methods that have been used for the management and development of the 6th version (SITVIT2) of this database of genotypes to better understand the evolution and global dissemination of the tubercle bacillus. The database also includes several molecular markers such as MIRU-VNTRs (mycobacterial interspersed repetitive units- variable number of tandem repeats) and Spoligotype43 allowing a better description and identification of the families of genotypic profiles of Mycobacterium tuberculosis complex. SITVIT2 database is constantly evolving, and it currently contains epidemiological information on 111,635 clinical isolates. This database is available online at the following address: http://www.pasteur-guadeloupe.fr:8081/SITVIT2/. We also developed a database named "SITVITBovis", which is dedicated to bovine tuberculosis. This database will be accessible at: http://www.pasteur-guadeloupe.fr:8081/SITVIT_Bovis/.Alongside the development and management of databases, this work was based on several epidemiological and phylogeographic studies correlating data on drug resistance or demographic characteristics (including sex, age, HIV status, and the origin of the patient). Our research initiative is thus focused to further improve in depth phylogenetic characterization of MTBC lineages, as well as the epidemiological analysis of circulating clones to generate evidence-based geographical mapping of predominant clinical isolates of tubercle bacilli causing the bulk of the disease both at country and regional level. Further superposition of these maps with socio-political, economical and demographical available through Geographic Information Systems (GIS) allows to have a precise view of prevailing disparities at the level of country or sub-region. This thesis represents an important collaboration with several researchers teams also working in the field of molecular epidemiology of tuberculosis.The long-term goal of this work is to further optimize the database structure, and sustain enriching it (including automation and ease of data entry). Optimum performance and accessibility of data in the database would reinforce efforts to control and surveillance of TB in the world
Ferreira, Ester Nogueira Whyte Afonso. "Programa de controle da tuberculose : analise da coorte de tratamento de 2003, Campinas - SP". [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309607.
Texto completoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A distribuição geográfica da tuberculose tem forte relação com os indicadores socioeconômicos das diversas nações. Mesmo com os avanços no conhecimento e com a tecnologia disponível para seu controle, continua sendo grave problema mundial de saúde pública. Objetivo: Analisar a coorte de tratamento dos doentes inscritos no Programa de Controle da Tuberculose (PCT) na cidade de Campinas-SP, em 2003. Métodos: Foram analisados, segundo variáveis demográficas, clínicas e epidemiológicas, 494 doentes de uma coorte de 537 notificados no Sistema de Informação Nacional de Agravos de Notificação. Para determinar as diferenças entre as proporções e calcular as razões de chances (OR) foi utilizado o software Epi 1nfo versão 6. O valor de p foi considerado significativo quando inferior a 0,05. Resultados: Do total de doentes analisados 76,3% eram residentes no município de Campinas. O percentual de casos com a co-morbidade TB/Aids foi de 21,2% para os residentes em Campinas e de 24,8% para os residentes em outros municípios. O risco de adoecer por tuberculose em Campinas foi maior na área com piores níveis socioeconômicos. O sucesso de tratamento do grupo de doentes residentes em Campinas foi de 76,4% entre os que não apresentaram Aids e de apenas 48,8% naqueles com Aids. Os pacientes da forma clínica pulmonar com baciloscopia positiva apresentaram sucesso de 70%. O grupo constituído por pacientes que estavam em retratamento apresentou 2,1 vezes mais insucesso de tratamento comparado aos casos novos (OR = 2,14; IC 1,12 - 4,05). Entre aqueles pacientes com a co-morbidade TB/Aids a chance de insucessotambém foi maior (OR = 3,41; 1C 1,98 - 5,89). A proporção de tratamentos supervisionados foi de 35%. Conclusões: A efetividade do PCT de Campinas apresentou-se abaixo dos 85% proposto pela OMS em todas as estratificações estudadas e a incidência parece estar subdimensionada perante a baixa cobertura de baciloscopias de escarro (43,3%) nos sintomáticos respiratórios, sugerindo problemas na operacionalização do PCT de Campinas. Para melhorar o programa as atividades de busca de casos e as estratégias que asseguram a adesão ao tratamento, incluindo o tratamento supervisionado, devem ser aprimoradas
Abstract: The geographic distribution of tuberculosis has a strong relationship with socioeconomic indicators of different nations. Even with advances in knowledge and available technology for its control, it continues to be a serious worldwide public health problem. Objective: To analyze the treatment cohort of patients enrolled in the Tuberculosis Control Program (TCP) in the city of Campinas, SP, in 2003. Methods: In accordance with demographic, clinical and epidemiological variables, 494 patients IToma 537 cohort, who were notified by the National Disease Reporting Information System, were analyzed. In order to determine the differences among proportions and calculate the odds ratio (aR) the Epi Info version 6 software was used. A p value of less than 0.05 was considered significant. Results: Of the total patients analyzed, 76.3% were resident in the city of Campinas. The percentage of cases with TB/AIDS comorbidity for Campinas residents was 21.2% and for the residents in other cities, 24.8%. The risk for tuberculosis was higher in the areas with worse socioeconomic levels. The successful outcome for the treatment of the group of patients resident in Campinas was 76.4% among those who did not present Aids and only 48.8% for those who presented Aids. Patients with positive baciloscopy presented a success rate of 70%.The group of patients being retreated had a 2.1 times higher rate of unsuccessful treatment when compared to new cases (aR = 2.14; CI = 1.12 - 4.05). Among those patients with the TB/Aids comorbidity the chance of no unsuccessful was also higher (aR = 3.41; IC = 1.98 - 5.89). The proportion of supervised treatment was 35%. Conclusions: The effectiveness of the TCP in Campinas was below the 85% proposed by the WHO in all of the studies strata and the incidence seems to be underdimensioned in face of the low sputum bacilloscopy coverage (43.3%) of those presenting respiratory disease symptoms, which suggests problems in the TCP operation in Campinas. In order to improve the ~program, the activities of case search and supervised treatment should be enhanced.
Mestrado
Saude Coletiva
Mestre em Saude Coletiva
Al-Mouaiad, Al-Azem Assaad. "Epidemiology of tuberculosis in Manitoba, 1992-1997". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape7/PQDD_0002/MQ45018.pdf.
Texto completoMiyata, Marcelo [UNESP]. "Construção de um painel com isolados clínicos de Mycobacterium tuberculosis com genes de resistência a quimioterápicos, para o estudo de novas drogas anti-TB". Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/103867.
Texto completoConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
De acordo com a Organização Mundial de Saúde em 2009, 9,27 milhões de novos casos de tuberculose ocorreram em 2007. Destes novos casos, 4,9% eram multidroga resistentes. Muitas pesquisas são realizadas na procura de novas drogas com atividade contra o bacilo da tuberculose, havendo então a necessidade de se entender os mecanismos de ação destes novos compostos. Este projeto objetivou propiciar ferramentas para compreender um pouco mais sobre os mecanismos de ação de novas drogas. Isolados clínicos de M. tuberculosis foram caracterizados quanto ao seu perfil de susceptibilidade aos fármacos do esquema terapêutico e foram determinadas as mutações responsáveis por estas resistências. Com os isolados caracterizados, foi construído um painel de M. tuberculosis. Pelo REMA, os isolados foram analisados quanto ao seu perfil de susceptibilidade aos fármacos (INH, RMP, STR e ETB) e avaliados quanto à presença de mutações nos genes de resistência (inhA, katG, ahpC, rpoβ, rpsL, rrs e embB) empregando a PCR-SSCP. Pelo REMA foram avaliados 80 isolados clínicos, sendo observada a resistência a INH em 74,7%, a RMP em 51,2%, a STR em 53,7% e ao ETB em 58,7%. Nos isolados resistentes, a porcentagem de mutações encontradas nos genes foi de 20,6% para inhA, 50% para katG, 6,3% para ahpC, 60% para rpoβ, 20% para rpsL e 0% para rrs e embB. Um painel com 12 isolados foi testado frente a três novos compostos, dois derivados de INH (Cu-INH1 e Cu-INH2) e um de RMP (Cu-RMP). Verificou-se que os isolados resistentes a INH foram também resistentes a Cu-INH1 e Cu-INH2. A mesma situação foi verificada em relação à RMP, com o composto Cu-RMP. Provavelmente, estes novos compostos têm os mesmos mecanismos de ação da INH e da RMP, que são os fármacos que lhes deram origem
According to World Health Organization in 2009, 9.27 million new TB cases occurred in 2007. Among these new cases, 4.9% were multidrug resistant. Many surveys are conducted in the search for new drugs with activity against the tuberculosis bacillus, therefore there is a need to understand the action mechanism of these new compounds. This project aimed to provide tools to understand about the action mechanisms of new drugs. M. tuberculosis clinical isolates were analyzed for their susceptibility profile to drugs, mutations responsible for resistance and a panel of these characterized isolates. The isolates were analyzed for susceptibility profile to drugs (INH, RIF, STR and ETB) and evaluated for presence of mutations in the resistance genes (inhA, katG, ahpC, rpoβ, rpsL, rrs and embB) applying the PCR-SSCP. REMA evaluated 85 clinical isolates and the resistance was observed in 74.7% to INH, 51.5% to RIF, 53.7% to STR and 58.7% to ETB. In the resistant isolates, percentage of mutations found in the genes was 20.6% for inhA, 50% for katG, 6.3% for ahpC, 60% for rpoβ, 20% for rpsL and 0% for rrs and embB. A panel of 12 isolates was tested against three new compounds, two INH-derivatives (Cu-INH1 and Cu-INH2) and one RMP-derivative (Cu-RMP). The isolates resistant to INH were also resistant to Cu-INH1 and Cu-INH2 compounds. The same situation was verified in relation to the RMP with the Cu-RMP compound, indicating that probably these three new compounds have the same action mechanism of INH and RMP drugs
Panunto, Alessandra Costa. "Genotipagem utilizando a sequencia de inserção IS6110 e "spoligotyping" de Mycobacterium tuberculosis isolados de pacientes infectados pelo HIV, em Moçambique, Africa". [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310668.
Texto completoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: O M. Avium é um microrganismo oportunista e sua infecção é feeqüentemente encontrada em pacientes com aids no Brasil, apesar do largo uso da quimioterapia antiretroviral altamente efetiva. Este estudo documenta a relevância desse problema. Dentro de uni número significante de pacientes (n=39) infectados com o M. avium, os isolados puderam ser recuperados de uma variedade de espécimes clínicos. Todos os isolados (n=45) foram tipados pela técnica de RFLP usando a seqüência 1S1245. A maioria dos pacientes (n=35) eram infectados pelo HIV. Somente duas cepas não puderam ser tipadas por causa da ausência da seqüência detectável pela 1S1245. Nas 43 cepas restantes os "blots" apresentaram de 6 a 23 bandas. Uma média de 17 seqüências foram observadas para cada cepa. Para alguns pacientes, mais de um isolado pode ser recuperado. Em dois pacientes deste grupo com doença disseminada, o M. avium pode ser recuperado mais de uma vez. De cada paciente, pelo menos duas amostras com diferentes genótipos foram recuperadas de locais estéreis, indicando que eles tinham infecções policlonais. Esses achados têm sido relatados por outros autores. Em um estudo recente, SAAD et aI., 2000, demonstrou que isolados de infecções policlonais e diferentes "fmgerprints" podem apresentar diferentes suscetibilidade antimicrobiano. Quatro "clusters" de pacientes puderam ser identificados. O maior "cluster" foi composto de oito pacientes. Estes resultados indicam que um mecanismo de transmissão recente ocorreu. A fonte de contaminação desses microrganismos não pode ser determinada. Assim, a transmissão pessoa a pessoa não apresentou uma importância significativa na transmissão desse microrganismo. Nós supomos que esses pacientes adquiriram o microrganismo de fontes hospitalares como água, alimento ou mesmo do ambiente
Abstract: not informed.
Doutorado
Ciencias Basicas
Doutor em Clínica Médica
Barco, Patricia. "\"Caracterização molecular de mutações no gene pncA de isolados clínicos de Mycobacterium tuberculosis de origem brasileira\"". Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/9/9136/tde-15082006-201342/.
Texto completoPyrazinamide (Z), a first-line antituberculous drug, is a prodrug that must be activated by bacterial pyrazinamidase (PZase) to the active form pyrazinoic acid, which kills M. tuberculosis. Many studies have shown that mutation in the gene encoding PZase (pncA) is the major mechanism of Z-resistance in M. tuberculosis. Based on this information and taking into consideration the absence of studies concerning Z-resistance in Brazilian M. tuberculosis strains, this study was aimed at characterizing pncA mutations and investigating its correlation with Z-resistance and PZase activity. The molecular characterization carried out by Spoligotyping revealed that all tested strains belong to M. tuberculosis species. The minimal inhibitory concentration (MIC) of Z was determined by three methods: microplate Alamar Blue assay (MABA), broth microdilution method (BMM) and method of proportions on Lowenstein-Jensen medium. The results showed a good association between the 3 methods, and MABA for MIC determination signalized a new and safe option to be used for Z. Most of Z-resistant strains (88%) presented pncA mutations as well as loss of PZase activity. Some exceptions were found since 12% of Z-resistant strains presented neither pncA mutations nor loss of PZase activity, what suggests the existence of another Z-resistance mechanism. Nine of 22 mutations found in pncA gene were described only in this study. During the course of this investigation were identified 5 Z-monoresistant M. tuberculosis strains.
Remualdo, Vanessa Rosália. "Amplificação do DNA de Mycobacterium tuberculosis presente em amostras de esfregaço bucal, pela técnica de reação em cadeia da polimerase (PCR)". Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/23/23141/tde-17062009-170152/.
Texto completoMycobacterium tuberculosis is the causing agent of the tuberculosis, responsible illness for 26% of the prevention deaths in the entire world. In Brazil 85000new cases are notified annually, being esteem 50 million people contaminated by the M. tuberculosis. It is considered priority disease for the control of illnesses for the Health department. For this control, it has to be reliable methods and resources for the ready laboratorial diagnosis. Bacterioscopiv, histological analysis or culture of the microrganism from samples of sputum are techniques normally used. The limitation of these methods is low sensitivity and long-winded 8 weeks. The PCR is one technique of amplification of DNA, that if has shown promising instrument for the diagnosis of the tuberculosis. The M. tuberculosis is a microorganism that has affinity for the cells (intracellular microorganism) and can be present in the cells of the respiratory treat and the oral mucosa. Oral swab, in contrast of sputum, is easily taken, not invasive and offering lesser risks of contamination for other microorganisms. We analyze 80 samples of oral swab of patients with confirmed diagnosis of tuberculosis, of these, 78 (97,4%) had resulted positive in the PCR. We conclude that the oral swab use and the application of the PCR are an effective and trustworthy method for tuberculosis detention of the M. tuberculosis.
Nguyen, Thuy Van. "Utilisation des systèmes de surveillance pour évaluer les aspects particuliers de la tuberculose et de la résistance aux antituberculeux en France". Thesis, Paris 6, 2014. http://www.theses.fr/2014PA066283/document.
Texto completoTuberculosis (TB) remains a major cause of morbidity and mortality worldwide, partly because of drug resistance anf the HIV epidemics. Tuberculous meningitis (TBM) is the most severe form of the tuberculosis disease, and is one of the indicators used for the BCG vaccination policy. Multidrug resistant tuberculosis (MDR-TB), which poses diagnostic and therapeutic problems, has been monitored since 1992 in France. On the opposite, rifampicin mono-resistance (RMR) tuberculosis (TB) which represents a first step toward MDR-TB is rarely studied and the impact of rifampicin mono-resistance on patient’s outcome is unknown in France. Our work was focused on the epidemiology of MTB and the impact of changes in the BCG vaccination strategy. We used two systems implemented for the surveillance of TB in France: a nationwide laboratory network coordinated by the National Reference Centre (NRC) for Mycobacteria and Resistance of Mycobacteria to Anti-tuberculosis Drugs and the mandatory notification system of TB (MNS) coordinated by the National Institute for Public Health Surveillance (Institut de Veille Sanitaire, InVS). The NRC network was also used to evaluate Rifampicin mono-resistant tuberculosis in France. First, we assessed the incidence rate of culture-positive (C+) central nervous system tuberculosis (CNS TB) in France in 2007 (the year of the changing policy on BCG vaccination) and its time trend between 1990 and 2007. In 2007, CNS TB represented less than 1% of all culture-positive TB cases and its incidence was around 0.50 per million inhabitants. The 2007 sensitivity of the NRC was 79.4%. To assess the evolution of C+ CNS TB between 1990 and 2007, we used an average sensitivity derived from the 2000 sensitivity of the NRC (75.6%) and the sensitivity for the year 2007. The average sensitivity was used to correct the number of C+ CNS TB reported in four surveys (1990, 1995, 2000, 2007). There was a major decrease of 62% in the extrapolated number of C+ CNS TB in seventeen years (from 90 to 35 cases), and in the extrapolated incidence rate (from 1.6 to 0.55 cases per million inhabitants) (P < 0.001). Then, we measured the impact of two major changes in BCG vaccination policy in 2006 (disappearance of the multipuncture device for BCG) and 2007 (end of compulsory BCG vaccination) on the epidemiology of TBM in children under 6 years in France between 2000 and 2011. Overall, 10 culture-positive and 17 possible (negative-culture or unknown microbiological result) cases of TBM were identified, with an annual incidence rate varying from 0.16 to 0.66 cases / 10 million inhabitants. In Ile-de-France, where all children are considered “at risk” and therefore should all be vaccinated, and in the other regions where only at-risk children are considered for vaccination since 2007, no statistically significant differences in the annual incidences rates for each one-year age-group cohort could be observed. These results reinforce the 2007 decision to stop universal BCG vaccination. However, a close monitoring of CNS TB in the coming years will be needed to assess the long-term impact of the new vaccination policy. Finally, we built, through the NRC national network of laboratories, a retrospective cohort of RMR TB cases diagnosed between 2005 and 2010. A total of 39 cases with RMR TB were identified (0.12% of all TB culture positive cases). Among all patients, 19 (49%) had a previous history of TB treatment, and 9 (23%) were HIV-coinfected. Data about treatment and outcome were available for 30 of 39 patients and only 20 (67%) were considered as cured. Treatments received both in terms of drugs and duration were heterogeneous. These results suggest the need to improve the management of patients with RMR TB in France
Hill, Véronique. "Phylogéographie mondiale des bacilles tuberculeux : contribution des outils moléculaires et bioinformatiques et caractérisation des lignées génotypiques pour des études épidémiologiques et phylogénétiques". Thesis, Antilles-Guyane, 2012. http://www.theses.fr/2012AGUY0518/document.
Texto completoTuberculosis, very old disease, is more than ever presented on the global health scene with 9 million new cases per year. This disease, which remains a major cause of mortality is one of the most intractable public health and international issues. The various control programs, launched by the World Health Organization (WHO) to prevent and guarantee the cure of tuberculosis patients face difficulties that undermine their effectiveness. Indeed, the expansion of human virus rinimunodéficience (VIII) and its negative influence on susceptibility to tuberculosis, the rapid growth of multidrug-resistant tuberculosis, poverty and population growth, are a set of factors detrimental to application of preventive and curative measures. The difficult economic circumstances undoubtedly leading to accumulation of these factors have a break between rich and poor countries about the impact and the revolution of tuberculosis worldwide. To address the disparity of the results of tuberculosis struggles, the methodologies used in epidemiology of tuberculosis must be part of a process efficiency. Molecular indispensable to the identification and classification of strains belonging to the Mycobacterium tuberculosis complex (MTC) markers each have their own potentials that need to be identified for proper use in epidemiological and phylogenetic studies. The purpose of this thesis is to extract new knowledge of the results of genotyping data stored in databases, knowledge of the polymorphism of genomic carrier to estimate the contribution of each marker in the classification of TCM. The use of different methods of phylogenetic reconstruction and modeling data was essential. In light of the results obtained, the thesis proposes a new classification methodology for a robust recovery phylogeography of TCM in connection with the history of human migration have started in sub-Saharan Africa. Each genotyping method with cost efficiency and equity, should be measured in relation to the resources available and discounts results, it is interesting to strengthen the knowledge of markers and propose alternatives leading to the classification of mycobacteria. Thus, the results obtained in this thesis bring more coherence to the proposed characterization of clones MTC circulating worldwide solutions
Miyata, Marcelo. "Construção de um painel com isolados clínicos de Mycobacterium tuberculosis com genes de resistência a quimioterápicos, para o estudo de novas drogas anti-TB /". Araraquara : [s.n.], 2010. http://hdl.handle.net/11449/103867.
Texto completoAbstract: According to World Health Organization in 2009, 9.27 million new TB cases occurred in 2007. Among these new cases, 4.9% were multidrug resistant. Many surveys are conducted in the search for new drugs with activity against the tuberculosis bacillus, therefore there is a need to understand the action mechanism of these new compounds. This project aimed to provide tools to understand about the action mechanisms of new drugs. M. tuberculosis clinical isolates were analyzed for their susceptibility profile to drugs, mutations responsible for resistance and a panel of these characterized isolates. The isolates were analyzed for susceptibility profile to drugs (INH, RIF, STR and ETB) and evaluated for presence of mutations in the resistance genes (inhA, katG, ahpC, rpoβ, rpsL, rrs and embB) applying the PCR-SSCP. REMA evaluated 85 clinical isolates and the resistance was observed in 74.7% to INH, 51.5% to RIF, 53.7% to STR and 58.7% to ETB. In the resistant isolates, percentage of mutations found in the genes was 20.6% for inhA, 50% for katG, 6.3% for ahpC, 60% for rpoβ, 20% for rpsL and 0% for rrs and embB. A panel of 12 isolates was tested against three new compounds, two INH-derivatives (Cu-INH1 and Cu-INH2) and one RMP-derivative (Cu-RMP). The isolates resistant to INH were also resistant to Cu-INH1 and Cu-INH2 compounds. The same situation was verified in relation to the RMP with the Cu-RMP compound, indicating that probably these three new compounds have the same action mechanism of INH and RMP drugs
Orientador: Clarice Queico Fujimura Leite
Coorientador: Cleslei Fernando Zanelli
Banca: Elsa Mases Mamizuka
Banca: Daisy Nakamura Sato
Banca: Eliana Aparecida Varanda
Banca: Mario Hiroyuki Hirata
Doutor
Pedro, Heloisa da Silveira Paro. "Pesquisa do Mycobacterium sp. em uma população soropositiva para o HIV-1 do Noroeste Paulista /". São José do Rio Preto : [s.n.], 2008. http://hdl.handle.net/11449/94865.
Texto completoBanca: Daisy Nakamura Sato
Banca: Silvia Helena Vendramine
Resumo: São José do Rio Preto (SJRP), localizada na região Noroeste do Estado de São Paulo, Sudeste do Brasil, é considerada Município prioritário pelo Programa Nacional de Controle da Tuberculose e da AIDS. O objetivo deste trabalho foi avaliar retrospectivamente pacientes infectados pelo HIV com pelo menos um isolamento de Mycobacterium sp., atendidos em unidades de saúde de referência de SJRP e região, bem como descrever seus aspectos clínicos e sócio-demográficos. Foram avaliados no período de janeiro de 2000 a dezembro de 2006, 198 indivíduos soropositivos para o HIV com culturas positivas no Instituto Adolfo Lutz de SJRP. Houve uma correlação positiva entre a tuberculose e o registro de detenção (p=0.021). O uso do tabaco reduziu o tempo de vida entre o diagnóstico e o óbito (p=0.05). Houve associação entre o isolamento de M. tuberculosis (MT) e os níveis de linfócitos TCD4+ bem como o achado difuso para RX de tórax (p=0.014 e 0.000, respectivamente). Aproximadamente 11% de todas as cepas de MT mostraram resistência a pelo menos uma droga, enquanto 3.1% foram multiresistentes. Micobactérias não tuberculosas (MNT) totalizaram 35.19% de todos os isolamentos e a maioria das espécies pertence ao complexo Mycobacterium avium (MAC; 22.3%), seguido por M. fortuitum (5.2%) e M.gordonae (3.1%). Conclui-se que a população HIV estudada tem alta prevalência de colonização por MNT. Em um país com extensão continental como o Brasil, o conhecimento das diferenças regionais na distribuição de MNT em populações infectadas pelo HIV pode contribuir para o controle e tratamento dessas infecções oportunistas.
Abstract: São José do Rio Preto city (SJRP), Northwestern São Paulo State, Southeast Brazil, is considered "priority" by the National Programs of Tuberculosis and AIDS Control. Our purpose was to retrospectively evaluate Mycobacterium sp. isolated from HIV-infected patients attending the HIV/TB reference health care units from SJRP and region, as well as to describe their clinical and socio-demographic aspects. One hundred and ninetyeigth HIV-seropositive individuals provided 287 positives cultures from January 2000 to December 2006. There was a positive correlation between tuberculosis and prison record (p=0.021) and tobacco use reduced the mean lifetime from tuberculosis diagnosis to obit (p = 0.05). TCD4+ levels and a diffuse chest X-ray finding were associated to Mycobacterium tuberculosis (MT) isolation (p = 0.014 and 0.000, respectively). Approximately eleven percent of all MT strains showed resistance to at least one drug while 3.1% were multidrug resistant. Non-tuberculous mycobacteria (NTM) totalized 35.19% of all species and the most frequently isolated ones were Mycobacterium avium complex (MAC; 22.3%), M. fortuitum (5.2%) and M. gordonae (3.1%). We conclude that the HIV-infected population studied has a high prevalence of NTM colonization. In a wide country like Brazil, regional differences on NTM distribution in HIV-infected individuals must be further evaluated in order to improve control and treatment of these opportunistic infections.
Mestre
Derntl, Alice Moreira. "Implicações epidemiológicas do tempo de sintomatologia na busca passiva de casos de tuberculose pulmonar". Universidade de São Paulo, 1987. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-03082016-181659/.
Texto completoThis work presents the results of the study of causes that interfere with the passive search of pulmonary tuberculosis cases in the population. Three hundred and fifty infection spreading and non infection spreading subjects who looked up the Pinheiros Public Health Center in the city of São Paulo throughout 1985 were interviewed. Information obtained regarding intervening time between perception of any symptom by the study population and its arrival at the Health Center was studied. The results obtained point ot to the fact that a good deal of responsability for the delay in the provision of correct care lies with the professionals of the anterior instances attended by the population before looking up the Health Center. Other factors related to the area of human behaviour and socio-economic aspects were also identified as probable causes of the delay in obtaining adequate health care. It is concluded that the population has little or no knowledge whatsoever regarding the health care function of the Health Center, save it being free of charge. This group of factors resulted in a symptomatology time span that varied from less than three weeks to twenty-four months with a higher concentration rate comprised between three weeks and twelve months meaning a larger infection spreading risk in the community.
Díaz, Alicia, Doelia Sandobal y Dalinda Tejero. "Tuberculosis". Bachelor's thesis, Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería, 2006. http://bdigital.uncu.edu.ar/8909.
Texto completoFil: Díaz, Alicia. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
Fil: Sandobal, Doelia. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
Fil: Tejero, Dalinda. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
Béguec, Caroline Allix. "Marqueurs génétiques du complexe Mycobacterium tuberculosis: études phylogénétiques et épidémiologiques de la tuberculose". Doctoral thesis, Universite Libre de Bruxelles, 2006. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210747.
Texto completoBarbosa, Luiza de Marilac Meireles. "Epidemiologia da tuberculose: morbidade e mortalidade no CearÃ, no perÃodo de 1992 a 1996". Universidade Federal do CearÃ, 1997. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=10477.
Texto completoTuberculosis is a disease associated with strong social determinants. Until the 70âs tuberculosis morbidity rates steadily decreased world-wide. Since the 80âs however, an increase was observed in all continents, including the developed countries, where this disease was a problem amenable of eradication. This increase in the incidence was explained by the spread of both, poverty and AIDS epidemics. Tuberculosis is one of the infectious and communicable diseases more frequent in Ceara. The aim of this study was to describe the patterns of tuberculosis morbidity and mortality in Ceara in the 1992-1996 period. An analysis of the stateâs demographic background is also presented, in an attempt to explain the fairly high rates. Demographic and surveillance data from IBGE and State of Ceara Secretariat for Health were used. The main results were: 1) the mortality rate was 2.69/ 100,000 with a falling trend. 2) 21,033 incidence cases were notified, with a incidence rate of 64.03/ 100,000; 3) the age group 20 to 29 years was the most affected, while the persons above 50 years old showed the highest risk; 4) a declining trend of pulmonary involvement was observed. The results confirm tuberculosis as one of the most important endemic disease in Ceara, being necessary the urgent implementation of strong public health initiatives in order to achieve its control.
Wolfart, Marilei. "Mycobacterium tuberculosis : Prevalência de cepas resistentes em indivíduos HIV-positivos". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2003. http://hdl.handle.net/10183/4522.
Texto completoKruger, Clarissa. "Non-tuberculous mycobacteria in tuberculosis epidemic settings in South Africa". Thesis, Cape Peninsula University of Technology, 2007. http://hdl.handle.net/20.500.11838/1489.
Texto completoNon-tuberculous mycobacteria (NTM) are often isolated from Human Immunodeficiency Virus (HIV) infected individuals, but there is very little information documented about the prevalence of NTM in community settings. An increase in NTM infection is also noted in HIV-negative people. Although it is as yet unknown whether the organisms cause desease in HIV-negative individuals or whether they are merely commensal organisms, their affect on HIV-positive individuals is unquestionable.
Sousa, Flávio Antunes de. "Pesquisa de tuberculose do trato genitourinário em pacientes com antecedente de Tuberculose". Universidade Federal do Amazonas - Instituto Nacional de Pesquisas da Amazônia, 2009. http://tede.ufam.edu.br/handle/tede/3655.
Texto completoCoordenação de Aperfeiçoamento de Pessoal de Nível Superior
Statistical data from the Ministry of Health shows that, from the different ways of Extrapulmonary Tuberculosis, the Genitourinary Tract has the fifth place in terms of incidence in Brazil (BRASIL SINAN 2003). In 1996, Wyner (1996) related that 1/6 (one sixth) of the Pulmonary Tuberculosis patients present concomitantly tuberculosis injuries in other organs or tissues and, 20% of them are developed in the urogenitary tract , being the kidneys the most affected organs by this sort of disease. As a consequence of kidney injury, 5 to 10% of patients present arterial hypertension, 25% present unilateral reduction of renal function, and in some cases, total kidney loss. In the state of Amazonas, the coefficient of incidence of all forms of disease, has been the 1st or 2nd in Brazil, for the last 10 years, however, it is still unknown if there is concomitancy of Pulmonary Tuberculosis and Urogenitary Tuberculosis, since these patients are diagnosed for its pulmonary form and never examined for the kidney disease concomitancy. In this sense, the present work aims at verify if patients with Pulmonary Tuberculosis background, diagnosed in 2006, above 60 years old, or, that had disease relapse in that year, independently of age, present radiological alterations compatible to Urinary Tuberculosis, seeking to propose changes on the diagnose approach and follow up of the disease. The expected casualties for the disease study, was of 296 patients, corresponding to 16, 13% of the total patients notified in 2006. The patients were selected in the data bank of Tuberculosis Programme Control of the state of Amazonas. After selection, correspondence (letter) was sent containing the research objective and requesting presentation at the Health Unit for orientation. To all patients who had turned up and through a Term of Free and Clarified Permission (TCLE), according to norms and approval by the Ethics Committee for Research in Human Beings (CEP), detailed information was given about the research and the activities developed towards the realization of the objective. In those patients who accepted taking part and being examined, an anamnese was carried out directed to the signs and clinical pulmonary and urological symptoms as well as physical exam. From those that remained in the study after the criteria of inclusion and exclusion, was requested an EAS, abdomen tomography, micro bacterial exams and PCR for M. Tuberculosis for the region IS6110. In a total of 254 possible patients, 35 participated effectively in the study. 29 patients did the EAS, the abdomen tomography and molecular and micro bacterial exams. The EAS didn t show hematuria in the exams (35), the abdomen tomography didn t emphasize suggestive alterations of genitourinary tuberculosis. The micro bacterial exams were negative for the research of BK, a female patient presented positive culture for M. intracellular. This patient did treatment for pulmonary tuberculosis 6 times. The PCR was positive for Genitourinary Tuberculosis in a male patient.
Dados estatísticos do Ministério da Saúde mostram que das formas de tuberculose extra-pulmonar, a do trato geniturinário ocupa o quinto lugar em incidência no Brasil (BRASIL-SINAN 2003). Em 1996, Wyner (1996) relatou que 1/6 (um sexto) dos pacientes com tuberculose pulmonar apresentam concomitantemente lesões tuberculosas em outros órgãos ou tecidos e desses, 20% as desenvolvem no trato urogenital, sendo os rins o órgão mais acometido nessa forma da doença. Como conseqüência das lesões renais de 5 a 10% dos pacientes apresenta hipertensão arterial, 25% apresentam diminuição unilateral da função renal, e em alguns casos pode se ter a perda total do rim. No Estado do Amazonas, o coeficiente de incidência de todas as formas da doença tem sido o 1º ou 2º do Brasil nos últimos 10 anos, porém, se desconhece se existe concomitância de Tb pulmonar e Tb urogenital, visto que esses pacientes são diagnosticados por sua forma pulmonar e nunca examinados sobre a concomitância da doença renal. Nesse sentido o presente trabalho pretende verificar se pacientes com histórico de tuberculose pulmonar diagnosticados no ano de 2006, com mais de 60 anos de idade ou que tiveram recidiva da doença no referido ano e independente da idade, apresentam alterações radiológicas compatíveis com tuberculose urinária, visando propor mudanças na abordagem do diagnóstico e acompanhamento da doença. A casuística prevista para o estudo foi de 296 pacientes, correspondendo a 16,13% do total de pacientes notificados no ano de 2006. Os pacientes foram selecionados no banco de dados do Programa de Controle da Tuberculose do Estado do Amazonas. Após seleção, foi encaminhada correspondência (carta) contendo o objetivo da pesquisa e solicitando o comparecimento a Unidade de saúde para orientação. A todos os pacientes que compareceram e por meio de Termo de Consentimento Livre e Esclarecido (TCLE), conforme normas e aprovação por Comitê de Ética em Pesquisas com Seres Humanos (CEP), foram fornecidas informações detalhadas sobre a pesquisa e as atividades que foram executadas para a concretização do objetivo. Nos que aceitaram participar ou serem examinados foi efetuada anamnese direcionada para os sinais e sintomas clínicos pulmonares e urológicos e exame físico. Dos que permaneceram no estudo após os critérios de inclusão e exclusão, foi solicitada a realização de um EAS, uma tomografia de abdômen, exames micobacteriológicos e PCR para M. Tubercujlosis para a região IS6110. Do total de 254 pacientes possíveis, 35 pacientes participaram efetivamente do estudo. Um total de 29 pacientes realizaram o EAS, a tomografia de abdômen e os exames micobacteriológicos e moleculares. O EAS não mostrou hematúria nos exames realizados (35), a tomografia de abdômen não evidenciou alterações sugestivas de Tb genitourinária. Os exames micobacteriológicos foram negativos para pesquisa de BK, uma paciente apresentou cultura positiva para M. intracellulare.Essa paciente fez tratamento para Tb pulmonar 6 vezes. O PCR foi positivo para Tb genitourinária em um paciente.
Meneses, Rosângela Palheta de Oliveira. "Prevalência da tuberculose resistente na Bahia". Instituto de Saúde Coletiva, 2010. http://repositorio.ufba.br/ri/handle/ri/16410.
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Introdução: Este estudo analisou o perfil da resistência aos medicamentos contra a tuberculose, a partir da participação do estado da Bahia no II Inquérito Nacional de Resistência a Drogas em Tuberculose realizado nos anos 2006 e 2007. Método: Estudo transversal, do tipo descritivo, exploratório, realizado em 16 municípios do estado da Bahia. Foram incluídos os sintomáticos respiratórios que tiveram tuberculose confirmada por baciloscopia e cultura e foram notificados no SINAN. Foi estimada a prevalência de resistência (primária, adquirida, multirresistência, monorresistência a Isoniazida) e analisadas associações segundo sexo, idade, raça/cor, escolaridade e comorbidades. Resultados: Entre os 687 casos de tuberculose estudados e com informações disponíveis no SINAN, 67,1% eram do sexo masculino; 52,4% estavam na faixa etária ≥25 e < 45 anos, 87,3% eram não brancos (562/644) e as comorbidades identificadas foram 20,8% HIV+, 1,2% com Aids, 17,2% com problemas de alcoolismo, 4,4% com diabetes e 1,5% com doença mental. Verificou-se que a resistência primária foi 10,59% e a resistência adquirida foi 16,44%. A multirresistência (MR) global foi observada em 1,3% dos pacientes, a MR primária de 0,81%, a MR adquirida de 5,47% e a monorresistência a isoniazida foi 3,8%. Considerações Finais: Concluiu-se que a multirresistência aos tuberculostáticos na Bahia é baixa, entretanto as prevalências da resistência primária e da resistência adquirida são altas. A análise destes resultados poderá colaborar na definição de estratégias para o efetivo controle da doença no estado e sugere-se que novas investigações busquem identificar os fatores que contribuem para a resistência primária, indicador da ocorrência da transmissão da TBMR na comunidade.
Introduction: This study analyzed the profile of drug resistance for tuberculosis in Bahia, from participation in the Second National Survey of Drug Resistance in Tuberculosis held in years 2006 and 2007 with the participation of 16 municipalities, including the capital. Method: Cross sectional, descriptive, exploratory, conducted in 16 counties of the state of Bahia. We included symptomatic patients who had TB confirmed by sputum smear and culture were reported in SINAN. It was estimated the prevalence of resistance (primary, acquired, multidrug resistance, a single drug isoniazid) and analyzed associations by gender, age, race, education, and comorbidities. Results: Among 687 cases of tuberculosis studied and information available from SINAN, 67.1% were male, 52.4% were aged ≥ 25 and <45 years, 87.3% were non-whites (562 / 644) and comorbidities identified HIV were 20.8%, 1.2% with AIDS, 17.2% with alcohol abuse, 4.4% to 1.5% with diabetes and mental illness. It was found that the primary resistance was 10.59% and 16.44% was acquired resistance. The multidrug resistance (MDR) rate was observed in 1.3% of patients, the primary of 0.81% MR, MR gained 5.47% and single drug isoniazid was 3.8%. Conclusion: We concluded that the multiresistance to antitubercular drugs in Bahia is low, however the prevalence of primary resistance and acquired resistance are high. Analysis of these results may assist in developing strategies for effective disease control in the state and it is suggested that further research can identify factors that contribute to primary resistance, indicating the occurrence of transmission of MDR-TB in the community.
Pedro, Heloisa da Silveira Paro [UNESP]. "Pesquisa do Mycobacterium sp. em uma população soropositiva para o HIV-1 do Noroeste Paulista". Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/94865.
Texto completoSão José do Rio Preto (SJRP), localizada na região Noroeste do Estado de São Paulo, Sudeste do Brasil, é considerada Município prioritário pelo Programa Nacional de Controle da Tuberculose e da AIDS. O objetivo deste trabalho foi avaliar retrospectivamente pacientes infectados pelo HIV com pelo menos um isolamento de Mycobacterium sp., atendidos em unidades de saúde de referência de SJRP e região, bem como descrever seus aspectos clínicos e sócio–demográficos. Foram avaliados no período de janeiro de 2000 a dezembro de 2006, 198 indivíduos soropositivos para o HIV com culturas positivas no Instituto Adolfo Lutz de SJRP. Houve uma correlação positiva entre a tuberculose e o registro de detenção (p=0.021). O uso do tabaco reduziu o tempo de vida entre o diagnóstico e o óbito (p=0.05). Houve associação entre o isolamento de M. tuberculosis (MT) e os níveis de linfócitos TCD4+ bem como o achado difuso para RX de tórax (p=0.014 e 0.000, respectivamente). Aproximadamente 11% de todas as cepas de MT mostraram resistência a pelo menos uma droga, enquanto 3.1% foram multiresistentes. Micobactérias não tuberculosas (MNT) totalizaram 35.19% de todos os isolamentos e a maioria das espécies pertence ao complexo Mycobacterium avium (MAC; 22.3%), seguido por M. fortuitum (5.2%) e M.gordonae (3.1%). Conclui-se que a população HIV estudada tem alta prevalência de colonização por MNT. Em um país com extensão continental como o Brasil, o conhecimento das diferenças regionais na distribuição de MNT em populações infectadas pelo HIV pode contribuir para o controle e tratamento dessas infecções oportunistas.
São José do Rio Preto city (SJRP), Northwestern São Paulo State, Southeast Brazil, is considered “priority” by the National Programs of Tuberculosis and AIDS Control. Our purpose was to retrospectively evaluate Mycobacterium sp. isolated from HIV-infected patients attending the HIV/TB reference health care units from SJRP and region, as well as to describe their clinical and socio-demographic aspects. One hundred and ninetyeigth HIV-seropositive individuals provided 287 positives cultures from January 2000 to December 2006. There was a positive correlation between tuberculosis and prison record (p=0.021) and tobacco use reduced the mean lifetime from tuberculosis diagnosis to obit (p = 0.05). TCD4+ levels and a diffuse chest X-ray finding were associated to Mycobacterium tuberculosis (MT) isolation (p = 0.014 and 0.000, respectively). Approximately eleven percent of all MT strains showed resistance to at least one drug while 3.1% were multidrug resistant. Non-tuberculous mycobacteria (NTM) totalized 35.19% of all species and the most frequently isolated ones were Mycobacterium avium complex (MAC; 22.3%), M. fortuitum (5.2%) and M. gordonae (3.1%). We conclude that the HIV-infected population studied has a high prevalence of NTM colonization. In a wide country like Brazil, regional differences on NTM distribution in HIV-infected individuals must be further evaluated in order to improve control and treatment of these opportunistic infections.
POULET, SYLVIE. "Organisation genomique de mycobacterium tuberculosis et epidemiologie moleculaire de la tuberculose". Paris 6, 1994. http://www.theses.fr/1994PA066674.
Texto completoMachado, Tao. "Tuberculose pleural no Estado de Roraima no período de 2005-2013: perfil epidemiológico e qualidade diagnóstica". Universidade Federal de Roraima, 2014. http://www.bdtd.ufrr.br/tde_busca/arquivo.php?codArquivo=266.
Texto completoA tuberculose está entre as dez principais causas de morte no mundo e o Brasil é um dos 22 países que concentram 80% da carga mundial da doença. A apresentação pleural, objeto central do presente estudo, é a mais comum forma extrapulmonar em indivíduos HIV soronegativos e sempre aparece como diagnóstico diferencial a ser considerado nos portadores de derrames pleurais no País. O diagnóstico de tuberculose pleural fundamenta-se principalmente na identificação do agente Mycobacterium tuberculosis no exame direto ou cultura do líquido pleural ou dos fragmentos de tecido pleural, assim como na presença de granuloma na análise histopatológica dos mesmos. O objetivo principal deste trabalho é conhecer a qualidade dos diagnósticos e o perfil epidemiológico dos portadores de tuberculose pleural no estado de Roraima visando embasar tecnicamente o fomento e aplicação de políticas públicas para o enfrentamento da doença em questão. O presente estudo foi desenhado como uma pesquisa quali-quantitativa do tipo corte transversal para avaliar os critérios diagnósticos utilizados e seus determinantes da apresentação pleural da doença no estado de Roraima, localizado na Região Norte do Brasil, dentro dos limites da Amazônia Legal, local que possui extensa diversidade sociocultural e ambiental. Trata-se de um estudo observacional, retrospectivo e descritivo baseado na revisão de dados secundários do SINAN, incluindo todos os casos notificados como portadores de tuberculose pleural de 2005 a 2013 no referido Estado. Dos 1.395 casos de tuberculose notificados no período, 8,3% foram da apresentação pleural, totalizando 38,9% das formas extrapulmonares na amostra. A taxa de incidência desta apresentação não acompanhou a tendência decrescente da forma pulmonar da doença no período. A prevalência de diagnósticos de qualidade encontrada foi de 28,5% (IC95%: 20,4 a 37,6%), e, em análise univariada nenhuma variável explicativa dentre as características demográficas e clínicas possíveis de serem apuradas no banco de dados tiveram impacto significativo na qualidade dos diagnósticos. A principal conclusão do estudo remete à necessidade de uma política de referenciamento específica a nível estadual no intuito de facilitar o acesso aos métodos diagnósticos preconizados pelo Programa Nacional de Controle da Tuberculose disponíveis no sistema de saúde.
Tuberculosis is among the ten main causes of death in the world and Brazil is one of 22 countries that account for 80 % of the global burden of disease. Pleural presentation, the main object of this study, is the most common extrapulmonary TB form in HIV-seronegative individuals and always appears as a differential diagnosis to be considered in patients with pleural effusions. The main objective was to know the quality of diagnoses and the epidemiological profile of patients with pleural tuberculosis in the state of Roraima aiming to offer a technical foundation to public policies destined to fight the disease. The diagnosis of pleural tuberculosis is based primarily on the identification of Mycobacterium tuberculosis on direct examination or culture of pleural fluid or pleural tissue fragment, as well as in the presence of granuloma on histopathological analysis of the tissue sample. The present study was designed as a qualitative and quantitative transversal research to evaluate the diagnostic criteria being used and the determinants of pleural disease presentation in the state of Roraima, located in northern Brazil, within the limits of the Amazon, and with extensive socio-cultural and environmental diversity. This is an observational, retrospective and descriptive study based on a review of secondary SINAN data, including all cases of pleural tuberculosis reported from 2005 to 2013. Of 1.395 reported cases of tuberculosis in the period, 8.3% were of pleural presentation, totaling 38.9% of extrapulmonary cases in the sample. The incidence rate of this presentation did not follow the downward trend of pulmonary tuberculosis in the period. The prevalence of quality diagnosis was found to be 28.5 % (95% CI: 20.4 to 37.6 %), and in a univariate analysis, no variable among the possible clinical and demographic characteristics searched in the data basis had significant impact in the quality of the diagnosis. The main conclusion of the study indicates the need for a specific referral policy at a state level in order to facilitate access to diagnostic methods recommended by the National Tuberculosis Control Programme available in the health system.
AlcÃntara, Cid Carlos Soares de. "Fatores associados ao diagnÃstico de tuberculose pulmonar entre suspeitos da doenÃa na rotina de unidades de saÃde de Fortaleza, CE". Universidade Federal do CearÃ, 2010. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=5815.
Texto completoTuberculosis (TB) is a disease that has challenged mankind since antiquity. It was believed that with the new technology, infectious diseases would be easily tracked and banned. The reality has been presented differently, despite advances in knowledge of tuberculosis and technology available for its control, the current picture is far from the targets set by governments. It is essential to the study of factors associated with pulmonary tuberculosis, since they are present in the prime-infeccÃÃo in relapse and multi-drug resistant pulmonary TB. Knowledge of data related to TB in the general population and specific groups at risk for TB are crucial to assess the epidemiological reality of our environment allowing proper organization of prevention and care activities. OBJECTIVE: To investigate factors associated with the diagnosis of TB, the frequency and characteristics of pulmonary tuberculosis with respiratory symptoms in three routine health services in Fortaleza. Cross-sectional study of quantitative accomplished through the application of a questionnaire in patients from three health units of Fortaleza. Respondents were divided on outcome of patients with tuberculosis and non tuberculosis outcome. We studied the influence of sociodemographic factors, housing conditions, behavioral factors, antecedents related to TB infection and clinical outcome for tuberculosis. RESULTS: The rate of pulmonary TB patients with respiratory symptoms among the study sample was 41.2%, but this data can not be extrapolated, the socio demographic and clinical outcome independently associated with TB were cough, fever and weight loss considering the level of six percent of significance. The main method used to assist diagnosis of TB in patients suspected of units studied in Fortaleza was the chest radiograph. The susceptibility profile of Mycobacterium tuberculosis showed 8.82 percent of MDR strains and sensitivity to isoniazid, rifampin, ethambutol and streptomycin from 88.23 percent in the samples taken and can not be extrapolated. If all TSA excluded from the hospital and found only Messejana TSA health posts, the resistance value reduces to a case of MDR 28 to TSA made, representing 3.6% of the sample, most patients with pulmonary TB had AFB positive only a cross, which may mean duration of disease not so long.
Prince, Karina Andrade de [UNESP]. "Epidemiologia clássica e molecular da tuberculose pulmonar em pacientes da região norte de Minas Gerais". Universidade Estadual Paulista (UNESP), 2013. http://hdl.handle.net/11449/108419.
Texto completoA tuberculose (TB) é uma doença infecciosa crônica causada principalmente pelo bacilo aeróbico Mycobacterium tuberculosis. Ela provoca problemas de saúde entre milhões de pessoas a cada ano, sendo classificada como a segunda causa de morte por uma doença infecciosa em todo o mundo. Assim, o objetivo desse estudo foi analisar a epidemiologia clássica e molecular da tuberculose pulmonar, em pacientes do Norte de Minas Gerais. Foi realizado um levantamento epidemiológico, de caráter observacional, longitudinal, retrospectivo e de delineamento quantitativo. A população foi composta por pacientes com suspeita de TB pulmonar, residentes na Região Norte de Minas Gerais, atendidos no Hospital Universitário Clemente de Faria (HUCF) da Universidade Estadual de Montes Claros (UNIMONTES), no período de janeiro de 2011 a dezembro 2012. As amostras clínicas (escarro ou lavado broncoalveolar) destes pacientes foram analisadas, através da técnica de Ziehl- Neelsen e da cultura pela método de Ogawa-Kudoh. Os isolados clínicos obtidos foram submetidos a identificação molecular, a genotipagem pelas técnicas de Spoligotyping, RDRio, ERIC-PCR e MIRU-VNTR e ao teste de susceptibilidade a fármacos. A correlação epidemiológica clássica e molecular foi realizada através dos dados da genotipagem e dos dados epidemiológicos clássicos. Dos 345 pacientes avaliados, 33 (9,6%) apresentavam a doença, sendo 69,7% residentes em Montes Claros e 30,3% em outras cidades do Norte de Minas Gerais. Houve predomínio da TB em indivíduos do sexo masculino (75,8%), da etnia parda (60,6%), de baixa escolaridade (42,4%) e em idade economicamente ativa (78,9%). A maior parte dos casos eram novos (69,7%) e a baciloscopia foi positiva em 75,8% dos pacientes. A taxa de cura foi baixa (30,3%) e a de transferência elevada (30,3%). Os agravos mais evidentes continuam sendo, a co-infecção TB/HIV (6,1%) e o alcoolismo (24,25%). A análise dos 33 isolados clínicos ...
Tuberculosis is a chronic infectious disease caused by the bacillus aerobic Mycobacterium tuberculosis. It causes health problems among millions of people each year, being ranked as the second leading cause of death from infectious disease worldwide. Thus, the aim of this study was to analyze the epidemiology of classical and molecular pulmonary tuberculosis in patients in North of Minas Gerais. We conducted an epidemiological study, an observational, longitudinal, retrospective and quantitative design. The population consisted of patients with suspected pulmonary TB, residents in the north of Minas Gerais patients at the University Hospital Clemente de Faria (HUCF), State University of Montes Claros (UNIMONTES), from January 2011 to December 2012. The clinical samples (sputum or bronchoalveolar lavage) of these patients were analyzed by Ziehl-Neelsen staining and culture by the method of Ogawa-Kudoh. Clinical isolates were subjected to molecular identification, genotyping by Spoligotyping techniques, RDRio, ERIC-PCR and MIRU-VNTR and drug susceptibility testing. The classical and molecular epidemiological correlation was performed using data from genotyping and classical epidemiological data. Of the 345 patients evaluated, 33 (9.6%) had the disease, with 69.7 % living in Montes Claros and 30.3 % in other cities in northern Minas Gerais. There was a prevalence of TB in males (75.8%), of mulattoes (60.6%), low education (42.4 %) and working age (78.9%) . The majority of new cases were (69.7%) and the smear was positive in 75.8 % of patients. The cure rate was low (30.3%) and high transfer (30.3 %). The most obvious grievances remain, the co -infection TB / HIV (6.1%) and alcoholism (24.25%) . Analysis of 33 clinical isolates by Spoligotyping allowed the identification of 22 different genetic profiles (66.7% genetic diversity). Among the genetic profiles found 15 (45.5%) LAM, 04 (18.2 %) belong to T family, 01 families (3.0%) to Haarlen ...
Moraes, Eloise Brasil de. "Epidemiologia molecular e estudo da diversidade genética da tuberculose no Estado de São Paulo". Botucatu, 2016. http://hdl.handle.net/11449/144231.
Texto completoResumo: Tuberculosis (TB) is a major cause of mortality, and Mycobacterium tuberculosis (M. tuberculosis), the causative agent. The study of molecular epidemiology associated with classical epidemiology, provides an understanding of the spread of M. tuberculosis and ads in epidemiological investigation, determining outbreaks and risk factors for transmission in the population. This study aimed to provide a more accurate view of the molecular epidemiology and genetic diversity of M. tuberculosis by MIRU-VNTR technique and get a better understanding of the relevance of the epidemiological and clinical potential of RDRio genotype in municipalities in the state of São Paulo, investigating possible associations with clinical and epidemiological data. Besides this study investigate possible transmission between contacts of patients with TB. Heterogeneity was observed in both regions that were grouped independently in phylogenetic analysis. Nevertheless some specific isolated from both regions showed high genetic similarity. When investigated epidemiological data of these patients 30% were from prisons. This suggests a recent transmission process within the penitentiaries to the general community between these two regions. Although the clustering rate found to be low, we noted in cluster formation the presence again of patients sharing the same genetic profile in different penitentiaries suggesting once more a transmission between distinct prision units. Regarding RDRio deletion was found h... (Resumo completo, clicar acesso eletrônico abaixo)
Mestre
Prince, Karina Andrade de. "Epidemiologia clássica e molecular da tuberculose pulmonar em pacientes da região norte de Minas Gerais /". Araraquara, 2013. http://hdl.handle.net/11449/108419.
Texto completoBanca: Fernando Rogerio Pavan
Banca: Daisy Nakamura Sato
Banca: Regiane Prisicila Ratti Sartori
Banca: Carlos Eduardo Mendes D'Angelis
Resumo: A tuberculose (TB) é uma doença infecciosa crônica causada principalmente pelo bacilo aeróbico Mycobacterium tuberculosis. Ela provoca problemas de saúde entre milhões de pessoas a cada ano, sendo classificada como a segunda causa de morte por uma doença infecciosa em todo o mundo. Assim, o objetivo desse estudo foi analisar a epidemiologia clássica e molecular da tuberculose pulmonar, em pacientes do Norte de Minas Gerais. Foi realizado um levantamento epidemiológico, de caráter observacional, longitudinal, retrospectivo e de delineamento quantitativo. A população foi composta por pacientes com suspeita de TB pulmonar, residentes na Região Norte de Minas Gerais, atendidos no Hospital Universitário Clemente de Faria (HUCF) da Universidade Estadual de Montes Claros (UNIMONTES), no período de janeiro de 2011 a dezembro 2012. As amostras clínicas (escarro ou lavado broncoalveolar) destes pacientes foram analisadas, através da técnica de Ziehl- Neelsen e da cultura pela método de Ogawa-Kudoh. Os isolados clínicos obtidos foram submetidos a identificação molecular, a genotipagem pelas técnicas de Spoligotyping, RDRio, ERIC-PCR e MIRU-VNTR e ao teste de susceptibilidade a fármacos. A correlação epidemiológica clássica e molecular foi realizada através dos dados da genotipagem e dos dados epidemiológicos clássicos. Dos 345 pacientes avaliados, 33 (9,6%) apresentavam a doença, sendo 69,7% residentes em Montes Claros e 30,3% em outras cidades do Norte de Minas Gerais. Houve predomínio da TB em indivíduos do sexo masculino (75,8%), da etnia parda (60,6%), de baixa escolaridade (42,4%) e em idade economicamente ativa (78,9%). A maior parte dos casos eram novos (69,7%) e a baciloscopia foi positiva em 75,8% dos pacientes. A taxa de cura foi baixa (30,3%) e a de transferência elevada (30,3%). Os agravos mais evidentes continuam sendo, a co-infecção TB/HIV (6,1%) e o alcoolismo (24,25%). A análise dos 33 isolados clínicos ...
Abstract: Tuberculosis is a chronic infectious disease caused by the bacillus aerobic Mycobacterium tuberculosis. It causes health problems among millions of people each year, being ranked as the second leading cause of death from infectious disease worldwide. Thus, the aim of this study was to analyze the epidemiology of classical and molecular pulmonary tuberculosis in patients in North of Minas Gerais. We conducted an epidemiological study, an observational, longitudinal, retrospective and quantitative design. The population consisted of patients with suspected pulmonary TB, residents in the north of Minas Gerais patients at the University Hospital Clemente de Faria (HUCF), State University of Montes Claros (UNIMONTES), from January 2011 to December 2012. The clinical samples (sputum or bronchoalveolar lavage) of these patients were analyzed by Ziehl-Neelsen staining and culture by the method of Ogawa-Kudoh. Clinical isolates were subjected to molecular identification, genotyping by Spoligotyping techniques, RDRio, ERIC-PCR and MIRU-VNTR and drug susceptibility testing. The classical and molecular epidemiological correlation was performed using data from genotyping and classical epidemiological data. Of the 345 patients evaluated, 33 (9.6%) had the disease, with 69.7 % living in Montes Claros and 30.3 % in other cities in northern Minas Gerais. There was a prevalence of TB in males (75.8%), of mulattoes (60.6%), low education (42.4 %) and working age (78.9%) . The majority of new cases were (69.7%) and the smear was positive in 75.8 % of patients. The cure rate was low (30.3%) and high transfer (30.3 %). The most obvious grievances remain, the co -infection TB / HIV (6.1%) and alcoholism (24.25%) . Analysis of 33 clinical isolates by Spoligotyping allowed the identification of 22 different genetic profiles (66.7% genetic diversity). Among the genetic profiles found 15 (45.5%) LAM, 04 (18.2 %) belong to T family, 01 families (3.0%) to Haarlen ...
Doutor
Costa, Silvana Monteiro. "Conhecimento dos clientes com tuberculose pulmonar e seus familiares sobre adesão ao tratamento, e fatores associados, no município do Rio Grande/RS". reponame:Repositório Institucional da FURG, 2007. http://repositorio.furg.br/handle/1/2870.
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Este estudo transversal objetivou determinar a prevalência de conhecimento sobre adesão ao tratamento da tuberculose que os clientes com tuberculose pulmonar e seus familiares possuem acerca desta doença e fatores associados. Foram entrevistados os portadores de tuberculose atendidos no PCT(Programa de Controle da Tuberculose) do município do Rio Grande-RS e seus familiares com idade igual ou superior a 15 anos, totalizando 150 clientes, sendo 68 portadores de tuberculose e 82 familiares dos mesmos. A prevalência de conhecimento encontrada foi de 60,0%. A análise multivariada mostrou que o conhecimento sobre adesão esteve associado com a condição de ser portador de tuberculose (razão de prevalência: 1,64; intervalo de confiança de 95%:1,25-2,15) e com o fato de já ter existido um caso da doença na família (razão de prevalência: 1,33; intervalo de confiança de 95%:1,04-1,70). Constata-se que o conhecimento sobre adesão é baixo; evidenciando-se assim, a necessidade de ações educativas direcionadas aos enfermos, familiares e comunidade.
This cross sectional study aimed at the determination of the prevalence of the knowledge about the adherence to the tuberculosis treatment that clients suffering of pulmonary tuberculosis and their families have concerning this disease and associated factors. Tuberculosis clients who receive health care from PCT (Tuberculosis Control Program) in Rio Grande-RS and their family members(15 years old or more) were interviewed. The final number was 150 clients: 68 tuberculosis clients and 82 family members. The prevalence of the knowledge was 60.0%. The multivariate analysis has showed a meaningful association between the adherence knowledge and the condition of being a tuberculosis client (prevalence ratio: 1.64, confidence intervals 95%: 1.25-2.15) and with the fact of the existance of one case in the family (prevalence ratio: 1.33; confidence intervals 95%: 1.04-1.70). It is observed that the adherence knowledge is low, making it clear the need for educational actions for sick people, family members and the community.
Este estudio transversal tuvo por objetivo determinar la prevalencia del conocimiento sobre la adherencia al tratamiento de la tuberculosis que los clientes con tuberculosis pulmonar y sus familiares poseen acerca de esta enfermedad y factores asociados. Fueron entrevistados los portadores de tuberculosis atendidos en el PCT (Programa de Control de la Tuberculosis) del municipio de Rio Grande-RS y sus familiares con edad igual o superior a 15 años, totalizando 150 clientes, siendo 68 portadores de tuberculosis y 82 familiares de los mismos. La prevalencia del conocimiento encontrado fue de 60,0%. El análisis multivariado mostró que existe una asociación significativa con el conocimiento sobre la adherencia y la condición de ser portador de tuberculosis (razón de prevalencia: 1,64; intervalo de confianza de 95%:1,25-2,15) y con el hecho de haber sucedido un caso de tuberculosis en la familia (razón de prevalencia: 1,33; intervalo de confianza de 95%:1,04-1,70). Se comprueba que el conocimiento sobre la adherencia es bajo, evidenciando así, la necesidad de acciones educativas direccionadas a los enfermos, a los familiares y a la comunidad.
Napoli, Allan Eurípedes Rezende [UNESP]. "Perfil epidemiológico da tuberculose urogenital no Distrito Federal, Brasil, em nove anos (2001 a 2009)". Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/99199.
Texto completoFundação de Ensino e Pesquisa em Ciências da Saúde (FEPECS)
A tuberculose (TB) permanece como a enfermidade infecciosa que mais dano tem causado à espécie humana ao longo de toda a sua história. O objetivo deste estudo transversal foi conhecer o perfil epidemiológico da tuberculose urogenital no Distrito Federal, Brasil, no período de nove anos. Foi realizado estudo descritivo de todos os pacientes diagnosticados com tuberculose urogenital no período de 2001 a 2009, notificados pelo Sistema de Informação de Agravos de Notificação (SINAN) e residentes no Distrito Federal. Dos 44 casos estudados, a faixa etária de maior acometimento foi entre 41 a 60 anos (59,1%), sexo feminino (68,2%). Quanto à escolaridade, observou-se grau superior em 40,9% dos casos e médio em 18,2%. A renda familiar foi superior a cinco salários mínimos em 47,7% dos casos. Em 65,9% dos casos havia história de contato com tuberculose e 88,6% dos pacientes apresentavam teste tuberculínico reator. O estudo concluiu que o perfil epidemiológico da tuberculose urogenital no Distrito Federal, Brasil, não está diretamente relacionado às condições socioeconômicas e culturais precárias, conforme a literatura indica
Tuberculosis (TB) remains the infectious disease that has caused more damage to the human race throughout its history. The objective of this survey was to know the epidemiological profile of urogenital tract tuberculosis in Distrito Federal, Brazil, in the period of nine years. Descriptive study was conducted of all patients diagnosed with urogenital tuberculosis in the period 2001 to 2009, reported by the Information System for Notifiable Diseases (SINAN) and resident in Distrito Federal. Of 44 cases studied, the major age range was between 41 to 60 years (59.1%) and female (68.2%). As for education, higher degree was observed in 40.9% of the cases and high school, in 18.2%. Family income was more than five minimum wages in 47.7% of the cases. In 65.9% of the cases there was a history of contact with tuberculosis patients and 88.6% of the patients had tuberculin skin test reactor. The study concluded that the epidemiological profile of urogenital tuberculosis in Distrito Federal, Brazil, is not directly related to the precarious socioeconomic and cultural conditions, according to the literature indicates
Knowling, William Ronald. "Ignorant, dirty, and poor, the perception of tuberculosis in Newfoundland, 1908-1912". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq23151.pdf.
Texto completoCerqueira, Danuza Firmino. "O vínculo no processo de atenção à tuberculose no munícipio de Ribeirão Preto - SP (2006-2007)". Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-07072008-113607/.
Texto completoTuberculosis is a priority for the Brazilian Ministry of Health given its considerable impact on the population and great importance for public health. Aware its treatment and control actions have been inserted in the context of primary health care in Brazil, we proposed to analyze the establishment of bonding in the TB care process in Ribeirão Preto, Sao Paulo, in the period of July, 2006 to July, 2007. A quantitative approach based on the dimension was used. Indicators were based on the instruments of quick evaluation of organization and performance of PHC services. The population under study was composed of TB patients diagnosed in the health public services of Ribeirão Preto. Data were kept in an electronic worksheet in the Microsoft Office Excel 2003 and then transferred to the Statistics 7.0 Statsoft. Frequency tables to quantify results observed and verify possible inconsistencies in the database such as, errors in data entry or missing answers, were used. In order to compare units regarding variables, analysis of variance and F test were performed. To those variables that met assumptions of independence, homoscedasticity and normality, Bartlett\'s test was applied. Tukey\'s test with correction for samples of different sizes was applied to those variables that presented differences between health units. For those analyses that indicated violation of criteria for the use of ANOVA, the non-parametric Kruskall-Wallis test was used and for those variables that presented differences between health units, the Dunn (z-prime) test was performed. In all tests, the level of statistical significance adopted was 5% (Callegari-Jacques, 2003). The interviewees reported that they are always attended by the same professional during appointments (99%) and are able to solve doubts with the same professional (98%). The fact the teams are the same in the TCP favors the establishment of bonding because the patient has a professional as reference and seek this person to clarify doubts and talk about concerns. A large percentage of the interviewees in the outpatients clinics A and B, reported they always/almost always seek for the doctor for other needs, such as basic food package and transport aid, 35% and 23% in each outpatient clinic, respectively. More than 60% of patients interviewed in the outpatients clinics A, B and C report never/almost never seek for the nurse, more than 50% of patients reported they never/almost never seek for the nursing auxiliary for other needs. Only in the clinic D, 73% of patients seek for the nursing auxiliary. Such results were expected due several PCT factors: spontaneous demand - the patient, most of the time, does not need to be refereed by another unit to be attended; there is no delay in attendance or for appointments; exams results are delivered fast and team is fixed.
Vendramini, Silvia Helena Figueiredo. "O tratamento supervisionado no controle da tuberculose em Ribeirão Preto sob a percepção do doente". Universidade de São Paulo, 2001. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-19022003-171830/.
Texto completoThis study aimed to analyze the perception of tuberculosis patients under supervised treatment (ST) in a District Health Unit in the City of Ribeirão Preto - SP. A qualitative analysis was selected as the methodological approach. The study population consisted of 7 tuberculosis patients participating in the Tuberculosis Control Program under the a regimen of supervised treatment. The patients' medical records, the Epidemiological Form of Disease Notification and semi-structured interviews were used as instruments for data collection. The following were used as guiding questions: "the significance of tuberculosis" and "the supervised treatment in the patient's life". The Content Analysis technique - Thematic Modality - was used for data analysis. The main thematic unit "Supervised treatment in tuberculosis: the patients perception" was found from the following meaning units: the focus of ST as a therapeutic action (medication ingestion and the weaknesses and strengths of ST); and the Singularities of patients under supervised treatment (The perception of the disease, Living with the disease, The consequences of ST on the patient's life). The following were perceived by patients as strengths in the disease and treatment process: the provision of free medication; the availability of other forms of incentive such as the basic food basket and transportation vouchers; supervision through home visits allowed the link between health workers, the patients and their families. The weaknesses of ST were perceived as: the surveillance of medication ingestion and the dependence on the visiting hours for medication ingestion. The social actors involved in the treatment, such as the family and the health care team (in the visiting figure), were recognized as a factor of adherence to the treatment.
Spies, Fernanda Sá. "Determinação do custo biológico em isolados de Mycobacterium tuberculosis com mutações nos genes rpsL, rrs, gidB, rpoB e katG". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/33219.
Texto completoSince few drugs are active against the Mycobacterium tuberculosis, it is very important to know the mechanisms that lead to resistance and, although much has been learned about the resistance, there are still some antimicrobials where it is not fully understood. The acquisition of antimicrobial resistance in bacteria is often associated with a loss in fitness and it is very important to have the fitness determined in the population, since it can influence the future of the multidrug isolates epidemic. Mutations related to streptomycin-resistance in the rpsL and rrs genes are well known and can explain about 70% of the phenotypic resistance. Mutations in the gidB gene were described recently as being associated with resistance to low concentrations of streptomycin in strains of M. tuberculosis. In this study, mutations in gidB occurred in 27% of streptomycin-resistant strains without mutations in the rrs and rpsL genes. Two mutations were considered polymorphisms, gidB16 (16G allele) was found exclusively in Latin American Mediterranean genotype, while gidB92 (92C allele) was associated with Beijing lineage in another population. The fitness of 21 multidrug resistant strains of M. tuberculosis was studied by the method of quantitative resazurin reduction assay and fitness of 78 strains was studied by growth curves in mycobacterial growth indicator tube and competition assays using some selected strains. In general, analyzing the growth curves in both studies the strains with the mutations rpsL K43R and rpoB S531L grew better or with no difference from the susceptible strain, on the other hand, strains with mutations in rpoB-but not S531L and with mutations in more than one gene grew, on average, more slowly than susceptible ones. Regarding the different lineages from the first study, strains classified as Latin American Mediterranean grew faster in the parameter of the lag phase, but with no difference in the logarithmic phase. In the second study, the outcome was different, non- Latin American Mediterranean strains grew faster on average, but with no statistical difference from Latin American Mediterranean strains, and also grew well in the competition assays. The fitness of the clinical isolates studied is very heterogeneous, possibly because these isolates present varying degrees of drug resistance, different mutations in the genes analyzed and even different genotypes. In both studies we can say that the frequently mutations found in clinical isolates are the mutations related with no fitness cost or that generate little fitness cost.
Zozio, Thierry. "Etude de la structure des populations de bacilles tuberculeux circulant sur les trois continents Asie, Afrique, Amérique : description de nouveaux clones et familles génotypiques ayant émergé au cours de l'évolution du complexe Mycobacterium tuberculosis". Antilles-Guyane, 2010. http://www.theses.fr/2010AGUY0385.
Texto completoTuberculosis is an infectious disease caused by Mycobacterium tuberculosis (MTB). Every year it kills 2 million people worldwide, affecting mostly developing countries. Despite many efforts, tuberculosis is gaining ground in various parts of the world. Co-infection HIV/TB and the emergence of TB strains resistant to treatment amplifies the problem. The various studies conducted in this thesis aims at describing populations of Mycobacterium tuberculosis, using different techniques of molecular genotyping, on four regions: Northern Europe with Kaliningrad, the Middle East with Turkey , West Africa with the Gambia and the Caribbean with the Dominican Republic. Since the ancestor of the MTB Complex, the selection pressures encountered led to the diversity of Iineages currently observed in the world. Studies in this thesis, have resulted in the identification of new clones emerging genotypic and families, and to situate them in the phylogeny of MTBC. These studies target territories over or near the birthplace of MTB( (Egypt, Turkey and Saudi Arabia in particular). This approach allowed us to better characterize the overall phylogeny of MTBC. Thus, these results will help the development of control programs more suited to the structural reality of people from BK currently circulating in the study areas, and provide new information about the phylogenetic evolution of the MTBC. Considering the current situation and the inventory made in this report, tuberculosis should be placed at the center of global health concerns
COVRE, L. P. "AVALIAÇÃO DO PAPEL DE RECEPTORES TIPO TOLL 2 e 4 NA RESPOSTA IMUNE DE INDIVÍDUOS, SADIOS REATIVOS OU NÃO AO TESTE TUBERCULÍNICO, FRENTE AO DESAFIO in vitro COM Mycobacterium tuberculosis". Universidade Federal do Espírito Santo, 2013. http://repositorio.ufes.br/handle/10/4571.
Texto completoAcredita-se que indivíduos PPD+ representam um dos maiores reservatórios de transmissão da tuberculose, pois podem sofrer uma reativação da tuberculose latente e transmitir silenciosamente o bacilo Mycobacterium tuberculosis (Mtb) para seus contactantes. Em relação aos casos de tuberculose ativa existentes, sabe-se que a maioria é devido à reativação da infecção latente. Portanto a latência ainda é um grande obstáculo para alcançar o controle da tuberculose. A capacidade de controlar a infecção pelo Mtb está correlacionada com as funções imunológicas do hospedeiro. Os receptores Tipo Toll, principalmente TLR2 e TLR4, podem exercer participação direta a respeito dessa função imune, visto que possuem capacidade de iniciarem e direcionarem tanto a resposta inata quanto a adaptativa. Dessa forma, o objetivo deste estudo foi avaliar o papel de receptores do tipo Toll 2 e 4 na resposta imune de indivíduos sadios reativos ou não ao teste tuberculínico (PPD+ e PPD-) frente ao desafio in vitro com Mycobacterium tuberculosis. Para isso, foram arrolados 13 indivíduos PPD+ e 11 indivíduos PPD-, nos quais avaliamos: 1) a frequência de células T reguladoras, 2) a atividade microbicida, e o 3) perfil de citocinas e óxido nítrico, após a infecção com o Mtb com ou sem o bloqueio dos receptores TLR2 e TLR4. Observamos que indivíduos PPD+ apresentaram maior frequência de células T reguladoras e carga bacilar que o grupo PPD- e que os receptores TLR2 e TLR4 possuem papel distinto na ativação da resposta imune. O bloqueio do receptor TLR2 reduziu a frequência de células T reguladoras e a capacidade microbicida do grupo PPD+. Por outro lado o bloqueio do receptor TLR4 aumentou a capacidade microbicida dos grupos PPD+ e PPD-, o que pode estar associado à redução na produção da citocina IL10. Dessa forma, nossos dados sugerem que a pré-exposição ao Mtb e/ou micobactérias ambientais, apesar de levar a uma memória imunológica nos indivíduos PPD+, não influencia na capacidade de eliminação do patógeno por esse grupo. Diversos mecanismos podem estar associados a essa dificuldade na eliminação do Mtb sendo a imunorregulação provocada pelo aumento de células T reguladoras um desses mecanismos. Além disso, observamos que os receptores TLR 2 e TLR4 possuem capacidade de modular a resposta imune contra o Mtb e podem ser futuros alvos para tratamentos anti-TB e quimioprofilaxia da TB latente. Palavras-chave: Mycobacterium tuberculosis, tuberculose latente, Purified Protein Derivative, PPD, células T reguladoras, receptores tipo Toll.
Remus, Natascha. "Genetic epidemiologic of the response to Mycobacterium tuberculosis : investigation of clinical and immunological phenotypes". Paris 5, 2008. http://www.theses.fr/2008PA05T042.
Texto completoTuberculosis (TB) remains a major global public health threat and host genetic factors are known to modulate the outcome of exposure to M. Tuberculosis. We studied the genes NRAMP1, which has been associated with TB susceptibility in several ethnic groups, and IL12RB1, that plays a major role in Mendelian Susceptibility to Mycobacterial Disease (MSMD) and found no evidence for association with pulmonary TB in an adult Moroccan population. Thus, complex susceptibility to TB disease in this population seems to be governed by other mechanisms than Mendelian susceptibility in children, which might explain the different clinical presentations and physiopathological pathways in these different age groups. We then analysed familial correlations of the immune response to infection studying the tuberculin skin test (TST) size and IFNy-production of PBMC's after stimulation with mycobacterial antigens in a population from a low to moderate incidence region near Paris (Val de Marne). We observed strong familial correlations for the TST, and after restriction of the study population to non-infected individuals, correlations for the ESAT6 trait were borderline significant (p=0. 047). These studies have both scientific implications, as they will enhance understanding of immune mechanisms controlling infection, and medical implications, as they will open the way for new preventive and therapeutic strategies
Machado, Kim Vinícius Amaral. "Infecção latente por mycobacterium tuberculosis". Universidade Federal do Amazonas, 2013. http://tede.ufam.edu.br/handle/tede/3420.
Texto completoCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Exposure to Mycobacterium tuberculosis can trigger three distinct events in the human body, which are: elimination of bacilli; latent infection, where there is infection control, but not its elimination; or development of tuberculosis, when the immune response is insufficient to contain the infection. Undergraduate nursing students can become exposed to these bacteria, due to their curricula activities. The purpose of this study was to identify latent tuberculosis infection and its associated risk factors among undergraduate nursing students according to their college year. This is an epidemiological, cross-sectional, case detection study with primary collection of data on knowledge and situation of latent tuberculosis infection among first and last year undergraduate nursing students from the Federal University of Amazonas and the University of the State of Amazonas in which were conducted test release interferon-gamma (Quantiferon TB Gold in Test) and Tuberculin Test to detect TB infection . Data were analyzed using the Statistical Package program for the Social Sciences in univariate approaches for describing the distribution of variables, and bivariate approaches to identify how variables relate to each other and the associated risk factors within latent tuberculosis infection . The first year students test results showed positive in four cases simultaneously, while the last year students results detected both positive results in a single individual. The total of 38 positive test results was obtained in correspondence to 33 students at both universities. Statistically significant differences were detected between the first and last year students, and the age group with positive result for Tuberculin Test as well as latent infection, use of Tuberculin Test to guide treatment, sharing environments with patients and mandatory reporting of case tuberculosis situation with first or last year students. Data from this study allowed a profile analysis of the students and compared it between the groups of first and last years. We suggest Nursing Schools better preparation for learning more accurately about tuberculosis.
A exposição ao Mycobacterium tuberculosis pode desencadear três eventos distintos no organismo humano, quais sejam: eliminação dos bacilos; infecção latente, onde há controle, mas não eliminação da infecção; ou adoecimento por tuberculose, quando a resposta do sistema imune é insuficiente para conter a infecção. Entre estudantes de enfermagem estas ocorrências são possíveis, visto as situações de contágio aos quais são expostos em atividades curriculares. O objetivo deste trabalho foi identificar infecção latente por tuberculose e seus fatores associados em acadêmicos do curso de graduação em enfermagem, conforme a situação de iniciante ou finalista. Trata-se de um estudo epidemiológico, transversal, de detecção de caso, com coleta primária de dados sobre conhecimentos e situação de infecção latente por tuberculose de acadêmicos iniciantes e finalistas dos cursos de enfermagem da Universidade Federal do Amazonas e da Universidade do Estado do Amazonas, nos quais foram realizados Ensaios de Liberação de Interferon-gama (Quantiferon-TB Gold In Test) e Prova Tuberculínica a fim de detectar infecção por tuberculose. Os dados foram analisados no Programa Statistical Package for the Social Sciences (SPSS) em abordagens univariadas para descrição da distribuição das variáveis, e bivariadas para identificar como as variáveis se relacionam entre si e os fatores associados à infecção latente por tuberculose. Nos estudantes iniciantes, o resultado dos dois exames foi simultaneamente positivo em quatro casos, e nos finalistas detectamos ambos os resultados positivos em um único indivíduo. No total obtivemos 38 exames positivos correspondentes a 33 estudantes de enfermagem, em ambas as instituições. Detectamos diferenças estatisticamente significativas entre as variáveis de situação no curso (iniciante ou finalista) e faixa etária com o resultado positivo de Prova Tuberculínica, bem como infecção latente, uso de Prova Tuberculínica para guiar tratamento, compartilhamento de ambientes com pacientes e notificação compulsória de caso de TB com situação de iniciante ou finalista do curso. Os dados deste estudo permitiram uma análise do perfil dos estudantes e de comparação entre os grupos de iniciantes e finalistas. Sugerimos às escolas de enfermagem melhor preparação para facilitar no processo de aprendizado um conhecimento mais acurado sobre TB.
Dunsford, Deborah. "Seeking the prize of eradication : a social history of tuberculosis in New Zealand from World War Two to the 1970s /". e-Thesis University of Auckland, 2008. http://hdl.handle.net/2292/2932.
Texto completoFelix, Alvina Clara. "Estudo da resposta imunológica de anticorpos IgG, IgM e IgA, subclasses de IgG (IgG1 e IgG3) e avidez de IgG, por Western Blotting, em amostras de soros de pacientes com tuberculose pulmonar e comparação de resultados com métodos microbiológicos e dosagem de interferon-gama". Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5134/tde-21072011-135809/.
Texto completoDespite the recommendations of the World Health Organization, during the Ministerial meeting held in Amsterdam, Holland in 2000, tuberculosis continues at an important increasing rate, affecting mostly developing countries and people with severe compromised immune systems, especially those infected with human acquired immunodeficiency virus. The methods used for diagnosis are the same used for many years, whose limitations prevent the rapid action of countries health programs that seek to stop the chain of disease transmission. Continuing a line of research of the Laboratory of Seroepidemiology and Immunobiology of IMTSP using the method of Western blotting, in this study we tried to broaden the knowledge of the immune response of antibodies in patients with pulmonary tuberculosis, clinical and laboratory defined by evaluating the participation of IgG, IgA and IgM, IgG subclasses (IgG1 and IgG3) and immunoglobulin IgG avidity in serum samples collected in the beginning and end of treatment. Our results showed that the immunoglobulin IgG was best immunological marker when compared with the results of microbiological methods and determination of interferon gamma, QuantiFERON TB Gold. The proteins fractions that showed better diagnosis performance were 38 and 30 KDa
Umubyeyi, Nyaruhirira Alaine. "Apport de la microbiologie dans la prise en charge thérapeutique de la tuberculose au Rwanda". Doctoral thesis, Universite Libre de Bruxelles, 2007. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209231.
Texto completoMEDEIROS, Nilma Maria Pôrto De Farias Cordeiro De. "Caracterização da tuberculose resistente no estado da Paraíba entre 2003 e 2013". Universidade Federal de Pernambuco, 2015. https://repositorio.ufpe.br/handle/123456789/17759.
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A tuberculose (TB) é a doença mais comum da humanidade. Atualmente, a Organização Mundial de Saúde estimou nove milhões de novos casos e um milhão e meio de mortes decorrentes da doença. A rápida expansão da resistência aos fármacos antituberculose tem prejudicado o controle global da TB, constituindo um grave problema de Saúde Pública. No Brasil, a semelhença de outros países endêmicos, tem-se observado uma variabilidade na prevalência de resistência e no estado da Paraíba (PB) não há dados recentes e concisos. Dessarte, esse estudo objetivou verificar a prevalência de resistência do Mycobacterium tuberculosis aos fármacos do esquema de primeira linha do tratamento da TB utilizados no Brasil e a frequência de fatores de risco - sexo, idade, tratamento prévio e ingesta alcóolica - em pacientes adultos com diagnóstico de TB pulmonar resistente (TBP), atendidos em serviço de referência na PB durante o período de 01 de janeiro de 2003 a 31 de dezembro de 2013. Para obtenção dos dados, utilizou-se formulário padronizado, preenchido, retrospectivamente, a partir das informações contidas nos prontuários dos pacientes atendidos no período do estudo. Foram notificados 69 casos, com prevalência de 0,5%. Evidenciou-se 17,4% de mono, 14,5% de poli e 68,1% de multirresistência. A resistência à isoniazida (INH) mostrou-se importante, tanto isolada, quanto em associações; bem como e, principalmente, a TB multirresistente (TBMR). Perante os fatores de risco, o sexo masculino (73,9%), a faixa etária de 40 a 49 anos (46,4%), a realização de tratamento prévio (98,5%) e a ingesta alcóolica (57,4%) foram os de maior ocorrência. Todavia, não expressaram significância estatística no estudo realizado tendo a PB como cenário. O desfecho foi a cura para 44,9% dos casos; no entanto, o abandono ao tratamento foi considerável, principalmente para a TBP monorresistente (33,3%). As características sociodemográficas compreenderam: a cor da pele parda (68,5%), o estado civil casado (50,9%), o nível de instrução até o fundamental (67,3%) e a procedência do interior da PB (78,2%). Quanto à coinfecção com HIV/AIDS, ocorreu em 14,5%; no entanto, nesse grupo a TBMR, também, foi mais frequente. Desta feita, mais estudos são imprescindíveis no intuito de investigar genotipicamente a resistência da TB no estado da PB, visto que alguns estudos genéticos têm reportado mutações em cepas resistentes à rifampicina (RMP), estando associada a maior transmissibilidade e a resistência à INH tem sido associada com mutações de vários genes. Assim, correlacionando com outros estados e países a fim de colaborar com o enfrentamento da doença na busca do controle e cura extensiva a todos. Por outro lado, há necessidade de fortalecimento das ações do programa de controle da TB, tanto em nível estadual, quanto nos municípios.
Tuberculosis (TB) is the most common disease of humanity. Currently, the World Health Organization estimated nine million new cases and a million and a half deaths from the disease. The rapid spread of resistance to antituberculosis drugs has undermined the global TB control, constituting a serious public health problem. In Brazil, as other endemic countries, it has been observed variability in the prevalence of resistance and the state of Paraíba (PB) no recent and accurate data. Thus, this study aimed to determine the prevalence of resistance of the Mycobacterium tuberculosis to first-line drugs in TB treatment regimen used in the Brazil and frequency of risk factors - gender, age, prior treatment and alcoholic intake - in adults patients diagnosed with resistant pulmonary TB (PTB), treated on reference service in PB during the January 1, 2003 to December 31, 2013. To obtain the data, it used standardized form filled out retrospectively from the information contained in the medical records of patients seen during the study period. Were reported 69 cases, with a prevalence of 0.5%. Revealed a 17.4% to mono, 14.5% to poly and 68.1% to multidrug resistance. The isoniazid (INH) resistance was found to be important, both isolated, as in associations; as well as, and especially multidrug resistant TB (MDR-TB). In view of the risk factors, males (73.9%), the age group 40 -49 years (46.4%), the realization of previous treatment (98.5%) and alcoholic intake (57.4%) were the most frequent. However, did not express statistical significance in the study with the PB as a scenario. The outcome was the cure for 44.9% of cases; however, abandon to treatment was significant, particularly for mono resistant PTB (33.3%). The sociodemographic characteristics included: dark brown skin (68.5%), married status (50.9%), level of education up to primary (67.3%) and the origin from the interior of PB (78.2%). The co-infection with HIV/AIDS occurred in 14.5%; however, this group the MDR-TB also was more frequent. This time, more studies are essential in order to investigate genotypically the TB resistance in the state of PB, as some genetic studies have reported mutations in strains resistant to rifampicin (RMP) and are associated with increased transmissibility and INH resistance has been associated with mutations multiple genes. Thus, correlating with other states and countries to collaborate with coping with the disease in the search of control and extensive cure to all. On the other hand, there is need to strengthen the actions of the TB control program at the state level and in the municipalities.
Temoteo, Rayrla Cristina de Abreu. "Adesão ao tratamento da tuberculose: Aspectos da vulnerabilidade individual e social". Universidade Estadual da Paraíba, 2015. http://tede.bc.uepb.edu.br/tede/jspui/handle/tede/2319.
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The Directly Observed Treatment objective of strengthening TB treatment adherence, reducing cases of abandonment and increasing the likelihood of cure. The individual and social vulnerability elements can interfere with adherence to this treatment, contextualized in the environment in which the patient is inserted. OBJECTIVE: Analyze the adhesion potential to tuberculosis treatment related to aspects of individual and social vulnerability, in Campina Grande - Paraíba. MATERIAL AND METHOD: Descriptive and analytical study with cross-cut with a quantitative approach. Held in Campina Grande, Paraiba, 2015. They were included as research participants tuberculosis cases treated, diagnosed from September 2014 to February 2015. Performed descriptive analyzes (absolute frequencies, relative rather boxplot graphics), to view the dispersion of data and factor analysis of multiple correspondence, to highlight similarities between data. RESULTS: The lower potential for adherence to tuberculosis treatment evidenced by unfavorable answers to questions such as: impact of tuberculosis on work, conception of causality of health-disease and work process (employment status). Established diagnosis in more than 30 days lack of support treatment at work (or unemployment), negative reaction to the diagnosis, negative impact on the life and lack of family support, were also aspects which have worsened the vulnerability to non-adherence to treatment tuberculosis. CONCLUSIONS: The success of this treatment is conditional on the complexity of each case, considering the family, professional and social (individual and social vulnerabilities). The intersectoral actions aimed at finding facilities in the resolution of this problem.
Elementos de vulnerabilidade individual e social podem interferir na adesão ao tratamento da tuberculose (TB), contextualizados no ambiente o qual o doente está inserido. Os marcadores de adesão, por sua vez, detectam precocemente vulnerabilidades na adesão ao tratamento de doentes com TB, por meio de escores, apresentando forte potencialidade para o monitoramento dessa adesão no âmbito da Atenção Primária à Saúde (APS), aprimorando a vigilância de pessoas com TB. OBJETIVO: Verificar aspectos de vulnerabilidade individual e social relacionados ao diagnóstico e a potencialidade de adesão ao tratamento da tuberculose, em Campina Grande – Paraíba. MATERIAL E MÉTODO: Estudo descritivo, com recorte transversal, de abordagem quantitativa realizado com 39 doentes com tuberculose, em tratamento há no mínimo 30 dias, no município de Campina Grande, no ano de 2015. Foram incluídos como participantes da pesquisa casos de tuberculose em tratamento, diagnosticados no período de setembro de 2014 a fevereiro de 2015. Realizadas análises descritivas (frequências absolutas, relativas, e gráficos boxplot), para visualizar a dispersão dos dados e análise fatorial de correspondência múltipla, para evidenciar similaridades entre os dados. RESULTADOS: O menor potencial para adesão ao tratamento da tuberculose foi evidenciado por respostas desfavoráveis a quesitos como: impacto da tuberculose sobre o trabalho, concepção sobre a causalidade do processo saúdedoença e trabalho (condição empregatícia). Diagnóstico estabelecido em período superior a 30 dias, falta de apoio ao tratamento no trabalho (ou desemprego), reação negativa diante do diagnóstico, impacto negativo sobre a vida e falta de apoio familiar, foram também aspectos que podem potencializar a vulnerabilidade a não adesão ao tratamento da tuberculose. CONCLUSÃO: O sucesso do tratamento está condicionado à complexidade de cada caso, considerando o ambiente familiar, profissional e social (vulnerabilidades individual e social). A intersetorialidade das ações visa encontrar facilidades na resolução dessa problemática. A utilização do instrumento foi importante para evidenciar marcadores em baixo potencial de vulnerabilidade à adesão ao tratamento da tuberculose, evidenciando quais deles necessitam de intervenção, recomendando-se sua utilização na APS para o monitoramento da adesão ao tratamento da TB.
Kipp, Aaron M. Van Rie Annelies. "Tuberculosis stigma, AIDS stigma, and tuberculosis control in southern Thailand". Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2009. http://dc.lib.unc.edu/u?/etd,2833.
Texto completoTitle from electronic title page (viewed Jun. 4, 2010). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology in the School of Public Health." Discipline: Epidemiology; Department/School: Public Health.
Aznar, Ruiz de Alegria Maria Luisa. "Tuberculosis multirresistente en un área rural de Angola". Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/669704.
Texto completoMultidrug-resistant TB (MDR TB) is caused by bacillus Mycobacterium tuberculosis (MTB) resistant to rifampin (RIF) and isoniazid (INH). In 2017, more than 160,000 cases of MDR TB were reported, and only 25% of them started treatment with second-line drugs. However, it’s estimated that about 558,000 cases developed RIF-resistant TB, of which 82% had MDR TB. There are numerous barriers that justify the differences between reported cases and estimated cases, such as the difficulty of access to health systems, the lack of diagnostic tools and the poor case notification. In Angola, the prevalence of MDR TB was unknown since there was no appropriate method for diagnosis. The realization of the projects related to this thesis revealed the first cases of the country. The papers that compose this thesis were inspired by the results of a first study carried out by our group in which a high proportion of failure was observed among patients diagnosed with TB who started treatment with first-line drugs. These data suggested that one of the causes of the high percentage of failures was the presence of MDR TB in the area. To corroborate this hypothesis, the first rapid molecular diagnosis equipment for detection of both MTB and resistance to RIF (Xpert MTB / RIF) was installed in the country, which allowed to know the prevalence of this disease, and to initiate the appropriate treatment with second-line drugs in patients infected with MDR TB strains. The first of the studies that compose this thesis describes the prevalence of MDR TB found in Cubal, which is much higher than the estimated by WHO for Angola (8% in patients not previously treated for TB and 71.1% in patients who had received treatment for TB previously), as well as factors related to the development of MDR TB. The second study describes the clinical characteristics and microbiological outcomes of patients diagnosed with MDR TB who were treated with a standardized second-line regimen, observing that more than 80% of the patients experienced adverse effects related to second-line drugs and that only 54% of cases achieved treatment success. The conclusions of this thesis have been enormously valuable to know that MDR TB is a very important problem in the country. Based on the results observed in the articles described in this thesis, Angola's national TB control program (PNLT) has installed new Xpert MTB / RIF devices in the country and the treatment guidelines have been modified, considering the regimen for MDR TB and starting the process for the performance of an epidemiological study to know the prevalence of MDR TB nationwide.
Mathys, Vanessa. "Contribution à la compréhension des mécanismes moléculaires de résistance de mycobacterium tuberculosis aux agents anti-tuberculeux". Doctoral thesis, Universite Libre de Bruxelles, 2009. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210242.
Texto completoLa sélection de mutants résistants se produit chez le patient lorsque les taux d’antibiotiques présents dans le corps sont sub-thérapeutiques ou lorsque la thérapie est inappropriée. Un des facteurs favorisant est l’exceptionnelle durée de la chémothérapie. Le besoin de maintenir des taux élevés d’antibiotiques pendant des mois, combiné avec la toxicité inhérente des agents, résultent en une observance incomplète du traitement par le patient et le risque d’acquérir des résistances. La résistance aux antibiotiques chez M. tuberculosis résulte d’altérations dans des gènes chromosomiques spécifiques. Les causes génétiques de la résistance ont été définies pour certains antibiotiques bien que plusieurs inconnues persistent.
Le présent travail a consisté en l’étude du problème de la résistance aux antibiotiques anti-tuberculeux par différentes approches :l’analyse génétique des mécanismes de résistance, l’évaluation de l’activité thérapeutique de nouvelles molécules et la caractérisation du profil de résistance de souches cliniques.
L’acide p-aminosalicylique (PAS) est un antibiotique bactériostatique de deuxième ligne dont le mécanisme d'action sur le bacille tuberculeux est incompris. Récemment, en utilisant la mutagenèse par transposon, la résistance au PAS fut associée à des mutations de la thymidylate synthase encodée par le gène thyA. Suite à cette découverte, nous avons entrepris une étude moléculaire de souches cliniques et de mutants spontanés résistants au PAS. Des mutations du gène thyA furent identifiées chez seulement 37% des souches. En tout, vingt-quatre mutations différentes furent identifiées dans le gène thyA. Les séquences nucléotidiques de cinq autres gènes de la voie de synthèse du folate et de la thymine (dfrA, folC, folP1, folP2, et thyX) ainsi que de 3 gènes encodant des N-acétyltransférases (nhoA, aac1 et aac2) furent également analysées mais aucune mutation associée à la résistance au PAS n’a pu être mise en évidence. L’utilisation de techniques bioinformatiques de prédiction structurelle révèle que les mutations identifiées affectent soit la structure soit le site fonctionnel de ThyA. L’étude des profils de croissance des organismes résistants au PAS nous permit de constater que les organismes porteurs d’une mutation de la protéine ThyA présentent un profil de croissance constant en présence de concentrations croissantes de PAS. Les organismes résistants au PAS possédant une protéine ThyA sauvage répondent, quant à eux, aux concentrations croissantes de PAS de façon dose-dépendante, indiquant que le(s) mécanisme(s) alternatif(s) de résistance au PAS est (sont) dose-dépendant(s).
La thymidylate synthase est également une des cibles du 5-fluorouracil (5-FU), l’agent chimiothérapeutique le plus largement utilisé pour le traitement du cancer colorectal avancé. Etant donné l’augmentation du nombre de souches résistantes de M. tuberculosis, de nouveaux composés anti-tuberculeux sont nécessaires de façon urgente. Ici, nous avons évalué l’efficacité in vitro et in vivo du 5-FU sur M. tuberculosis. La concentration minimale inhibitrice du 5-FU fut déterminée sur une collection de souches cliniques sensibles et multi-résistantes ainsi que sur des mutants spontanés résistants au PAS. Tous les isolats montrèrent une sensibilité au 5-FU à des concentrations allant de 0.4 à 1.8 µg/ml, et ce indépendamment de leur profil de sensibilité/résistance aux agents anti-tuberculeux actuels. Les études in vivo du 5-FU (sur un modèle murin de tuberculose active) montrèrent une efficacité de celui-ci durant les deux premières semaines de traitement puis une perte d’activité à la troisième semaine, vraisemblablement engendrée par les effets secondaires du 5-FU.
L’éthionamide (ETH) est un autre antibiotique de deuxième ligne dont l’utilisation est limitée aux tuberculoses multi-résistantes étant donné les effets secondaires qu’il engendre. Ces dernières années, les études ont montré que l’ETH est un pro-médicament, transformé en forme active par l’enzyme monooxygénase EthA dont l’expression est contrôlée par le répresseur transcriptionnel EthR. Notre étude décrit l’élaboration d’inhibiteur d’EthR capable d’augmenter la sensibilité de M. tuberculosis à l’ETH suite à l’amélioration de son activation. Les composés synthétisés et sélectionnés pour leur capacité à inhiber l’interaction EthR-ADN furent co-cristallisés avec EthR. Les structures tridimensionnelles des complexes furent utilisées pour la synthèse d’analogues capables d’améliorer la puissance de l’ETH en culture. Les molécules les plus prometteuses furent testées sur un modèle murin de tuberculose. Pour un des inhibiteurs d’EthR testés, nous avons montré que sa co-administration avec l’ETH permet une réduction de la dose d’ETH utilisée de 3 fois, pour l’obtention d’une même réduction de charge mycobactérienne pulmonaire. Ce travail démontre la possibilité d’augmenter l’index thérapeutique de l’éthionamide en agissant pharmacologiquement sur le mécanisme régulateur de son activation.
Dans certaines régions du monde, le problème de la multi-résistance devient très présent. Nous avons étudié l’état de la situation à Mourmansk (Fédération russe), une région à haute incidence de tuberculose. La résistance aux antibiotiques et l’épidémiologie moléculaire de la tuberculose furent étudiées sur des isolats collectés en 2003 et 2004 dans cette région. Une extrêmement haute prévalence de tuberculose multi-résistante (MDR-TB) fut constatée à la fois pour les nouveaux cas (primaires) (26%) et les cas précédemment traités (72.9%). Le typage des souches MDR primaires révèle une appartenance au génotype Beijing pour la plupart des isolats (79.8%) et l’homogénéité génétique des souches suggère une transmission active au sein de la population. L’analyse moléculaire des gènes impliqués dans la résistance à l’INH et à la RIF montre la présence des mutations katG codon 315 et rpoB codon 531 chez, respectivement, 98,2% et 76,3% des isolats MDR-TB primaires. La haute fréquence de ces mutations « communes » suggère la possible utilisation de tests moléculaires ciblant spécifiquement ces mutations pour détecter rapidement la plupart des cas de MDR-TB.
Nos travaux illustrent les différentes voies à suivre pour maitriser le problème de la résistance aux antibiotiques :l’élucidation des mécanismes de résistance, le développement de nouveaux médicaments et la détection rapide des cas de résistance.
Doctorat en Sciences biomédicales et pharmaceutiques
info:eu-repo/semantics/nonPublished
Mendes, Natália Helena [UNESP]. "Genotipagem por Spoligotyping e MIRU de Mycobacterium tuberculosis provenientes de pacientes com tuberculose pulmonar". Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/94816.
Texto completoUniversidade Estadual Paulista (UNESP)
O estudo da epidemiologia molecular através de diferentes técnicas vigentes revolucionou a compreensão da epidemiologia da tuberculose. A técnica Spoligotyping tem sido extensamente aplicada no estudo da epidemiologia molecular da tuberculose, para abordar estrutura populacional do M. tuberculosis, atentando para identificar principais linhagens e distribuições geográficas. Por outro lado, técnicas moleculares para diferenciar cepas de M. tuberculosis, tais como RFLP e MIRU possibilitam agrupar isolados clínicos de M. tuberculosis provenientes de pacientes que apresentam ligações epidemiológicas, identificando cadeias de transmissão e discriminando os isolados a nível clonal. A presente dissertação objetivou utilizar as técnicas de Spoligotyping e MIRU, para compreender um pouco mais sobre a tuberculose de uma metrópole, avaliando isolados provenientes do Ambulatório do Instituto Clemente Ferreira (referência no tratamento de tuberculose) na cidade de São Paulo. Os isolados clínicos de pacientes atendidos no período de agosto de 2006 a julho de 2008 foram reidentificados pela técnica molecular de PCR, e as cepas identificadas como de M. tuberculosis foram submetidas à genotipagem pelas técnicas de Spoligotyping e MIRU. Foi confirmada a identificação de M. tuberculosis em 93 isolados clínicos pela técnica de PCR-IS6110. No Spoligotyping, do total de 93 isolados, 21 amostras (22,6%) revelaram spoligotipos ainda não descritos na base de dado mundial (SpolDB4, SITVIT e Spotclust) e 51 (54,8%) estavam envolvidos em 12 cluster, 7 diferentes famílias e 36 spoligotipos. A família mais freqüente foi a LAM (26 isolados), seguida de T (24 isolados) e Haarlem (11 isolados), que juntos representaram 65,4% de todos os isolados. Essas 3 famílias representam os genótipos mais freqüentemente encontrados na África, América Central, América do Sul e Europa. Seis SITs...
The molecular epidemiology study using different techniques has improved the epidemiology of tuberculosis understanding. The Spoligotyping technique has been widely applied in the study of molecular epidemiology of tuberculosis, to address population structure of M. tuberculosis, focusing on the identification of the main lines and geographic distributions. Furthermore, molecular techniques used to differentiate strains of M. tuberculosis, such as RFLP and MIRU can be used for clustering clinical isolates of M. tuberculosis from patients with epidemiological links, identifying chains of transmission and discriminating isolates at the clonal level. In this work the techniques of Spoligotyping and MIRU were used to understand a little more about tuberculosis in a metropolis, assessing isolates from the Ambulatory Clemente Ferreira Institute (reference in the treatment of tuberculosis) in São Paulo. Clinical isolates from patients treated between August 2006 and July 2008 were re-identified by the molecular technique of PCR, were strains identified as M. tuberculosis were evaluated through genotyping the use of Spoligotyping and MIRU techniques. By PCR-IS6110 the identification of M. tuberculosis was confirmed in 93 clinical isolates. The total of 93 isolates, 21 samples (22.6%) in Spoligotyping showed spoligotypes have not yet been described in the world’s data base (SpolDB4, SITVIT and Spotclust) and 51 (54.8%) were involved in 12 clusters, seven different families and 36 spoligotypes. The most frequent family was the LAM (26 isolates), followed by T (25 isolates) and Haarlem (11 isolates), which together accounted 65,4% of all isolates. These three families represent the most frequently genotypes found in Africa, Central America, South America and Europe. Six SITs accommodated 51.4% (37/72) of all isolates identified in SpolDB4 (SIT53, SIT50, SIT42, SIT60, SIT17 and SIT1). By technique... (Complete abstract click electronic access below)
Nunes, Elizabete Abrantes. "Tuberculose pulmonar e infecção pelo virus da imunodeficiencia humana (HIV) : aspectos epidemiologicos e clinicos em Moçambique". [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308973.
Texto completoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A tuberculose, a resistência aos medicamentos antituberculose e o HIV são hoje em dia três grandes endemias, com tendências similares e com prejuízos incalculáveis para a humanidade, em particular nos países de baixos recursos. Obiectivos do trabalho: Determinar o padrão de resistência aos medicamentos antituberculose, em pacientes HIV positivos, portadores de doença pulmonar por micobactéria tuberculosa e micobactéria não tuberculosa na região de Maputo e a prevalência de MOTT nesta população. População e métodos: estudo elaborado em dois hospitais da cidade de Maputo, Moçambique. Foram estudados 503 doentes com tuberculose pulmonar e HIV+. Obteve-se 282 amostras da expectoração e ou lavagem brônquica nas quais foi solicitado; baciloscopia, cultura de BK, cultura de micobactérias nào tuberculosas e teste de sensibilidade para os antibacilares. Foram também avaliadas as características clínicas, radiográficas, a contagem de CD4 e o perfil hematológico. Resultados: Em 229 (98,7%) dos isolados, o M tuberculosis foi a principal micobactéria identificada. As micobactérias não tuberculosas, surgiram em apenas 3 (1,3%) casos, identificadas na expectoração e com clínica compatível. Dos 282 doentes, 232 (82%) apresentaram sensibilidade aos medicamentos antituberculose (MAT) e 50 (17%) resistência a qualquer MAT. Quanto ao padrão de resistência 27 (13,6%) eram casos novos e 21 (26,6%) casos previamente tratados. Resistências mais observadas a qualquer MAT, foram de 13,6% nos CN e 26,6% nos PT. As resistências gerais aos diferentes MAT foram: 10 H- 14,9%, 20 S- 7,8%, 30 R - 6,4%. A resistência à R foi aumentada tanto nos CN como nos PT. A tuberculose multiresistente combinada, foi de 5,7%, sendo nos CN, 3% e PT, 11,4%. Factores de risco de resistência e de TB-MR, foram identificados: tratamento anterior de TB e CD4<200. Estes doentes apresentaram mediana de CD4 de 151 cels/mm3, mediana de Hgb de 7,8g1dl e de CTL 1140. Do ponto de vista radiológico o padrão atípico foi o mais frequente e cavidades foram observadas num grupo reduzido, predominando nos PT e nos casos que apresentaram poliresistência aos MAT.O sarcoma de kaposi pulmonar surgiu em 4,8% dos doentes e as infecções fiíngicas/bacterianas em 27,9% Conclusões: A tuberculose multiresistente (TB-:MR)apresentou níveis elevados pelo que se deve reduzir o risco de transmissão da TB com medidas de controle da transmissão nosocomial e na comunidade e ampliar a DOTS estratégia a um maior número de população. Face à resistência elevada à H, aconselhamos a introdução de um 30MAT na fase de manutenção no regime de tratamento dos CN, teste de sensibilidade aos MAT no início dos retratamentos. A profilaxia com H em HIV+ na prevenção de TB e tratamento de infecção latente deverá ser analisada com cuidado devido á elevada resistência à H. Uso de cotrimoxazol para redução das causas de morte associadas ao HIV!TB. Tratamento antiretroviral e aconselhamento para teste voluntário de HIV em todos os doentes TB
Abstract: Tuberculosis, multidrug-resistant tuberculosis and mv are, today, the three greatest endemics with similar trends and immeasurable impairment to humanity,particularin low resources countries. Obiectives: Determine the resistance pattern to anti-tuberculosis drugs (ATD) in mv positive patients with pulmonary disease by mycobacteria tuberculosis and mycobacteria non tuberculosis in the Maputo region and the prevalence of MOTT in this population. Population and methods: the study was conducted in 503 patients with pulmonary tuberculosis and mv positive in two hospitaIs of Maputo City, Mozambique. Two hundred and eighty two (282) sputum samples and/or bronchial wash were submitted for testing of baciloscopy, BK culture, MOTT and Drug Susceptibility Testing (DST) for ATD. Clinical and radiographic characteristics, CD4 counting and hematological profile were also evaluated. Results: M tuberculosis was the main organism identified in 229 (98,7%) of the isolated samples. Non-tuberculosis mycobacteria were identified in sputum of only 3 (1,3%) of the cases with compatible clinic. Drug sensitivity was observed in 232 (82%) patients and resistance in 50 (17%) of the 282 sampled cases. In relation to the drug resistance pattems, 27 (13,6%) were in New Cases (NC) and 21 (26,6%) in Previously Treated cases (PT). More observed resistance to ATD was recorded in 13,6% in NC and 26,6% in PT. General resistant to different ATD was: 1° H- 14,9%, 2° S- 7,8%, 3° R- 6,4%. The resistance to R increased both in the NC as in PT. Overall, the MDR-TB was 5,7%, being 3% in NC and 11,4% in PT. The risk factors identified for resistance and MDR-TB were: previous treatment to TB and CD4 <200. These patients presented a median CD4 of 151 cells/mm3, a median of Hgb of 7,8 g/dl and of CTL 1140. From a radiological point ofview, the atipic pattem was the most frequent and cavities were observed in a small group predominant1yin PT and in-the cases that presented poliresistance to ATD. The pulmonary Kaposi sarcoma was observed in 4,8% ofthe patients and the fungall bacterial infections in 27,9%. Conclusions: The high levels of MDR-TB recorded in this study suggests that the risk of TB transmission should be reduced through control measures of nosocomial transmission and in the community and amplify the DOTS strategy to a greater population number. As a result of the high resistance to H, it is advised to introduce one of the 3o ATDin the maintenance phase of the treatment regime of NC, and sensitivity tests to ATD in the beginning of retreatment. Prophylaxis with H in HIV positive for TB prevention and latent infection treatment should be analyzed carefully, due to the high resistance to H. The use of cotrimoxazol to reduce the death causes associated to lllV/TB. Anti-Retroviral Treatment (ATRV) is important and also counceling for HIV voluntary testing in all TB patients
Doutorado
Clinica Medica
Doutor em Clínica Médica
Ducati, Rodrigo Gay. "Especificidade de substrato e mecanismo cinético da enzima fosforilase de nucleosídeos purínicos de Mycobacterium tuberculosis". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/17043.
Texto completoHuman tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a public health threat worldwide, resisting through the historic attempts of humanity on defeating consumption. The emergence of drug-resistant strains has led to an urgent need for the development of new anti-TB compounds. These chemotherapic agents can be designed based on metabolic pathways which are essential for the pathogen. There is a continuous requirement for studies on mycobacterial metabolism, as an attempt to identify enzymes of biological significance, as these might represent promising targets for the development of new anti-TB agents. M. tuberculosis purine nucleoside phosphorylase (MtPNP), a key enzyme of the purine salvage pathway, has been recently proposed to be essential for mycobacterial survival. It has been suggested that this enzyme may play a role in the latency process. However, there has been no report on MtPNP enzyme mechanism and substrate specificity. In the present work, we demonstrate that MtPNP is more specific to 2'-deoxyguanosine (2dGuo) and does not catalyze the phosphorolysis of adenosine. Initial velocity, product inhibition and equilibrium binding data suggest that MtPNP catalyzes 2dGuo phosphorolysis by a steady-state ordered bi bi kinetic mechanism, in which inorganic phosphate binds first followed by 2dGuo binding to form the catalytically competent ternary complex, and ribose 1-phosphate is the first product to dissociate followed by guanine. Pre-steady-state kinetic data indicate that product release is the ratelimiting step for MtPNP-catalyzed reaction. The results described here should be useful to the design of MtPNP inhibitors with potential action against M. tuberculosis.
Bhargava, Anurag. "Nutrition and Tuberculosis". Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=110718.
Texto completoLa tuberculose représente toujours un problème de santé publique majeur dans les pays en voie de développement. Pour complémenter les stratégies traditionnelles de contrôle, la prise en charge des déterminants sociaux et autres facteurs de risques constitue une avenue à explorer. La malnutrition est un phénomène biologique complexe comprenant une importante dimension sociale qui, de par son effet délétère sur les mécanismes d'immunité cellulaire, est un facteur de risque pour le développement de la tuberculose et en augmente la mortalité. En Inde, le pays portant le plus lourd fardeau de tuberculose (et de tuberculose multirésistante), la malnutrition est le facteur de risque principal, et le bilan nutritionnel est le pire au monde. Cependant, il existe peu de données analysant le lien entre l'état nutritionnel et les issues cliniques reliées à la tuberculose dans les pays comme l'Inde, et encore moins d'études ont abordé l'impact d'interventions nutritionnelles sur la prévention de la tuberculose.Nous avons analysé le parcours de 1965 patients atteints de tuberculose pulmonaire diagnostiqués par le biais d'un programme communautaire d'un hôpital rural de l'Inde centrale. Chez ces patients, la malnutrition était sévère, hautement prévalente, et persistait malgré une thérapie anti-tuberculeuse. De plus, la malnutrition était associée avec un risque de 2 à 4 fois plus accru de mortalité. Nous avons également procédé à une ré-analyse des données de la cohorte du village de Papworth, dans lequel une intervention expérimentale portant sur la modification de certains aspects sociaux pour prévenir la tuberculose, incluant un apport nutritionnel adéquat, a été étudiée entre 1918 et 1943 chez plus de 300 enfants ayant été en contact avec la tuberculose. Bien que l'incidence de l'infection par la tuberculose n'a pas été modifiée par ces interventions, le développement de la tuberculose active a été presque entièrement enrayé chez les enfants nés dans le village, alors que ceux qui y sont arrivés après la naissance ont bénéficié d'une protection substantielle. Les impacts de la prise en charge de la malnutrition sur les issues cliniques reliées à la tuberculose demeurent toutefois en grande partie inconnus. Étant donné les bénéfices potentiels reliés à des interventions ciblant ce problème dans des pays comme l'Inde, il est urgent de considérer ces avenues comme des priorités de recherche.
Campos, S., M. Dorival, M. Ormeño, C. Rojas, C. Tanta y V. Tarazona. "Tuberculosis pulmonar infantil". Universidad Peruana de Ciencias Aplicadas - UPC, 2010. http://hdl.handle.net/10757/272516.
Texto completoСміянов, Владислав Анатолійович, Владислав Анатольевич Смиянов, Vladyslav Anatoliiovych Smiianov, Світлана Володимирівна Павличева, Светлана Владимировна Павлычева, Svitlana Volodymyrivna Pavlycheva, Ольга Іванівна Сміянова, Ольга Ивановна Смиянова, Olha Ivanivna Smiianova y A. V. Kovchun. "History of tuberculosis". Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/27490.
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