Diagnostic performance of GeneXpert MTB/RIF assay compared to conventional Mycobacterium tuberculosis culture for diagnosis of pulmonary and extrapulmonary tuberculosis, Nepal

Chaudhary, Raina; Bhatta, Sabita; Singh, Apoorv; Pradhan, Manoj; Shrivastava, Brijendra; Singh, Y I; Sah, Ranjit; Fathah, Zareena; Mehta, Rachana; Mandegary, Ali; Rodríguez‐Morales, Alfonso J.; Dhama, Kuldeep

doi:10.52225/narraj.v1i2.33

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…GenExpert sputum and stool examinations were negative although it has relatively high sensitivity and specificity. 16 Cancer antigen 125 (Ca125) is found in the epithelium of the respiratory tract and female reproductive tract and can be elevated in both benign and malignant conditions including ovarian cancer. 17 It has been reported to be increased in peritonitis.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis challenges of a patient with peritoneal tuberculosis masquerading as ovarian malignancy: a case report

Bimantoro

Maimunah

2022

Bali Med J.

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Background: Peritoneal tuberculosis (PTB) could mimic advanced ovarian cancer cases, making its diagnosis challenging. Comprehensive and conscientious examinations for diagnosis are needed to differentiate such cases to avoid inappropriate treatment. We report a problematic diagnosis of PTB that mimic ovarian malignancy. Case Presentation: A 20-year-old female patient with history of multiple rehospitalizations, presented with complaints of abdominal pain, nausea/vomiting, low-grade fever, and weight loss in the last five months. In the first admission, patient was suspected with malignant ovarian cyst due to clinical features of malignancy with normal chest X-ray, abdominal USG suggested ovarian cyst in both ovaries, high levels of Ca125. However abdominal CT-scan showed thickening in peritoneum which suggested PTB. The patient was planned for urgent laparotomy while waiting for GenExpert result. On the second admission, patient presented with recurrent abdominal pain, GenExpert sputum and stool showed negative result, and planned for surgery but the patient refused. On the last admission, patient diagnosed with impending bowel obstruction and underwent abdominal CT-scan with contrast showed diffuse multiloculated cystic lesion in cavum pelvic and multiple prominent mesenteric lymph nodes that suggested abdominal TB with abscess in cavum pelvic. Exploratory laparotomy revealed conglomeration, pus and tubercles in the peritoneum. A TB was confirmed based on pathology and microbiology examination from tissue biopsy and pus. Conclusion: We reported patients with PTB with unspecific clinical symptoms which suspected as ovarian malignancy. This study highlights the challenges in diagnosing PTB and therefore PTB could be considered a differential diagnosis in patients suspected of ovarian malignancy in the TB endemic countries.

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Section: Discussionmentioning

confidence: 99%

Diagnosis challenges of a patient with peritoneal tuberculosis masquerading as ovarian malignancy: a case report

Bimantoro

Maimunah

2022

Bali Med J.

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“…By administering TNFi, patients should be closely monitored for signs of reactivation of latent TB 21 and the TB could be diagnosed with GeneXpert MTB/ RIF assay. 23 The patient intended to return to Papua following the second Etanercept injection. TNFi therapy would be continued in Papua, and an internist would oversee and assess treatment progress, pharmacological side effects, and the risk of LTBI reactivation.…”

Section: Case Reportmentioning

confidence: 99%

TNF-α inhibitor administration in psoriatic arthritis patient with latent tuberculosis and cardiovascular disease as an extra articular manifestation

Nurrakhmadaniyah

Rahmawati

2022

Bali Med J.

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Introduction: Psoriatic arthritis is a spondyloarthropathy subtype with a broad clinical spectrum and diverse symptoms. The use of biological disease-modifying antirheumatic medications (DMARDs), such as TNF inhibitors is recommended as pharmacological therapy for PSA in cases of axial involvement and high disease activity level. Since Indonesia has the second-highest tuberculosis (TB) cases globally, and patients receiving TNF inhibitors have an elevated risk of latent TB reactivation, evaluation of latent TB before starting TNFi is necessary and challenging. Case Presentation: A 63-year-old male psoriatic arthritis patient with bilateral hip joint osteoarthritis, bilateral knee effusions and bilateral frozen shoulder. The patient also had coronary heart disease with a history of underwent coronary artery bypass graft (CABG), diabetes mellites type 2 and confirmed latent TB. Psoriatic arthritis had high activity based on the Bath Ankylosing Spondylitis Disease Activity (BASDAI) score and Ankylosing Spondylitis Disease Activity Score (ASDAS). TNF inhibitor treatment started a month after latent TB treatment. The patient responded satisfactorily to the TNFi treatment, as demonstrated by clinical evaluation and decreased disease activity. Latent TB treatment was continued for up to six months, followed by latent TB activity monitoring during TNFi administration to prevent latent TB reactivation. Conclusion: This case highlights the challenges in management of axial psoriatic arthritis patients with high disease activity, concomitant latent TB infection, and early extra-articular symptoms of cardiovascular disease.

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“…Asia and Africa contributed to nearly 44% of global TB cases [1,2]. During the past decades, the incidence and mortality have persistently declined due to the use of new anti-TB drug regimens, the increasing number of cases identified, and the improvement of anti-TB treatment coverage [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitudes of Indonesian General Practitioners Towards the Isoniazid Preventive Therapy Program in Indonesia

Winardi

Nalapraya

Sarifuddin³

et al. 2022

J Prev Med Public Health

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Objectives: The Indonesian Ministry of Health launched isoniazid preventive therapy (IPT) in 2016, with general practitioners (GPs) at the frontline of this program. However, the extent to which GPs have internalized this program remains uncertain. The aim of this study was to identify the knowledge and attitudes of GPs towards the IPT program in Indonesia.Methods: This study used an online, self-administered questionnaire distributed via e-mail and social messaging services. A logistic regression model was employed to identify the explanatory variables influencing the level of knowledge and attitudes toward IPT among GPs in Indonesia. An empirical analysis was conducted separately for each response variable (knowledge and attitudes).Results: Of the 418 respondents, 128 (30.6%) had a good knowledge of IPT. Working at a public hospital was the only variable associated with good knowledge, with an adjusted odds ratio (aOR) of 1.69 (95% confidence interval [CI], 1.02 to 2.81). Furthermore, 279 respondents (66.7%) had favorable attitudes toward IPT. In the adjusted logistic regression analysis, good knowledge (aOR, 0.55; 95% CI, 0.34 to 0.89), 1-5 years of work experience (aOR, 2.09; 95% CI, 1.21 to 3.60), and having experienced IPT training (aOR, 0.48; 95% CI, 0.25 to 0.93), were significantly associated with favorable attitudes.Conclusions: In general, GPs in Indonesia had favorable attitudes toward IPT. However, their knowledge of IPT was limited. GPs are an essential element of the IPT program in the country, and therefore, adequate information dissemination to improve their understanding is critical for the long-term viability and quality of the IPT program in Indonesia.

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Diagnostic performance of GeneXpert MTB/RIF assay compared to conventional Mycobacterium tuberculosis culture for diagnosis of pulmonary and extrapulmonary tuberculosis, Nepal

Cited by 8 publications

References 9 publications

Diagnosis challenges of a patient with peritoneal tuberculosis masquerading as ovarian malignancy: a case report

Diagnosis challenges of a patient with peritoneal tuberculosis masquerading as ovarian malignancy: a case report

TNF-α inhibitor administration in psoriatic arthritis patient with latent tuberculosis and cardiovascular disease as an extra articular manifestation

Knowledge and Attitudes of Indonesian General Practitioners Towards the Isoniazid Preventive Therapy Program in Indonesia

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