The Problem of Low Efficiency of Treatment of Patients With Pulmonary Tuberculosis

Melnyk, V. M.; Novozhylova, I. A.; Matusevych, V. G.

doi:10.31215/2306-4927-2019-103-1-25-32

Cited by 9 publications

(4 citation statements)

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“…The effectiveness of TB treatment in Ukraine was approximately 55.5% in recent years, while the World Health Organization (WHO) target of the effectiveness of TB treatment was 85.0% 2 . The effectiveness of TB treatment in HIV-infected patients is much lower 3 , and TB remains the cause of more than 50% of all AIDS deaths 4 .…”

Section: Introductionmentioning

confidence: 99%

“…The effectiveness of TB treatment in HIV-infected patients is much lower 3 , and TB remains the cause of more than 50% of all AIDS deaths 4 . Among the leading reasons for the low effectiveness of TB treatment are the late detection of the disease, which is directly related to the deteriorating socio-economic situation in the country, and the low adherence to treatment, which is the reason for frequent interruption of TB treatment 2 . However, in HIV-positive patients, the range of reasons for the low effectiveness of TB treatment is much wider than in HIV-negative patients with TB.…”

Section: Introductionmentioning

confidence: 99%

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Morphological changes of the small intestine mucosa in HIV/Mycobacterium tuberculosis coinfection

Тодоріко¹,

Pidverbetska²,

Шевченко³

et al. 2021

Arch Balk Med Union

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Les changements morphologiques de la membrane muqueuse de l'intestin grêle dans la co-infection VIH/Mycobacterium tuberculosisIntroduction. A ce moment, il n'y a pratiquement pas de données sur les modifications pathomorphologiques de la muqueuse de l'intestin grêle lors de la co-infection VIH/tuberculose, ce qui pourrait être à la base du développement d'une malabsorption. Le but de l'étude est d'étudier les caractéristiques de la structure morphologique de l'intestin grêle dans la tuberculose associée au VIH. Matériaux et méthodes. L'étude prospective pathomorphologique a inclus 24 patients avec co-infection VIH/Mycobacterium tuberculosis (groupe principal) et 20 personnes sans infection par le VIH, de pathologie gastro-intestinale ou de signes morphologiques de tuberculose (groupe témoin). Résultats. L'épaisseur de la petite muqueuse intestinale, la hauteur et la largeur moyennes des villosités

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Morphological changes of the small intestine mucosa in HIV/Mycobacterium tuberculosis coinfection

Тодоріко¹,

Pidverbetska²,

Шевченко³

et al. 2021

Arch Balk Med Union

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“…Prolonged hospital stay, stigmatization of the disease, alcohol and drug abuse, smoking, lack of social and material support, drug-induced side effects, and intoxication play a significant role in the prolongation of the pathological process [8,9]. In case of slow improvement in clinical and radiological study results, persisting bacterial excretion or serious adverse reactions to etiotropic therapy, the duration of the intensive phase of treatment (IP) may be extended to 90 doses by the decision of the Central Medical Advisory Committee (CMAC).…”

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confidence: 99%

Indicators of Clinical, Radiological, and Laboratory Status in Male Patients With Newly Diagnosed Infiltrative Pulmonary Tuberculosis

Kushnir

2021

EUMJ

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Introduction. In Ukraine, despite the free medical care in the field of tuberculosis, the effectiveness of tuberculosis treatment does not meet WHO standards. With the lack of resistance of Mycobacterium tuberculosis to the first-line anti-TB agents, the desired improvement in clinical and radiological results in the first 2 months of treatment is not always possible to achieve. The causes of the poor efficiency remain unknown and require detailed study. The objective was to study clinical, radiological, and laboratory data of male inpatients with newly diagnosed infiltrative pulmonary tuberculosis at the beginning of treatment. Materials and Methods. 133 men with newly diagnosed infiltrative pulmonary tuberculosis sensitive to the first-line anti-TB agents were examined. The data of clinical, radiological, and laboratory parameters were studied; immunological parameters of IL‑4, IL-10, IFN-γ, and data of phagocytic activity of neutrophils were additionally examined. All patients were tested for anxiety and depressive disorders using the State-Trait Anxiety Inventory and Beck Depression Inventory. Results. It was found that at the beginning of treatment, patients with pulmonary destruction cavities had a 2.7-fold higher incidence of intensive bacterial excretion and a 1.6-fold reduction in IFN-γ levels as compared with patients without lung tissue destruction. Men with an extended infiltrative process in the lungs presented with fever and symptoms of intoxication more than 2.5 times more often, with cough – more than 4 times more often, with a history of weight loss – more than 2.9 times more often, with Mycobacterium tuberculosis detected by microscopy – more than 6.2 times more often vs. men with a limited process in the lungs. Conclusions. Patients with newly diagnosed infiltrative pulmonary tuberculosis who had destructive changes in lung tissue and a significant extension of the pathological process were characterized by more pronounced clinical manifestations, intoxication, activation of systemic inflammatory response factors, decreased activity of the cellular immune system, and psychological disorders.

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“…The most important of causes of treatment failure are lack of adherence to treatment [2] and late detection of tuberculosis (when patients are diagnosed with massive bacterial excretion, a generalized process in the lungs and destructions) [3]. Ukrainian scientists mention [4] that changing the structure of clinical forms of tuberculosis toward widespread and acute-progressing forms will further reduce the effectiveness of treatment.…”

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Changes of the pro-hormone levels of vitamin D 25(OH)D in patients with newly diagnosed pulmonary tuberculosis treatment failure

Yasinskyi

Raznatovska

2020

Patologìâ

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A -research concept and design; B -collection and/or assembly of data; C -data analysis and interpretation; D -writing the article; E -critical revision of the article; F -final approval of the articleIn Ukraine the number of patients with newly diagnosed tuberculosis (NDTB) who successfully complete the course of treatment reaches 60-65 % today. This is while the World Health Organization (WHO) criteria for successful treatment of this category of patients is 85 %. Scientists around the world are studying the possible pathogenetic factors of treatment failure of antimycobacterial therapy in patients with tuberculosis. Nowadays, the impact of vitamin D has been widely studied in this area. Studying of the dynamics of this indicator in patients with NDTB with widespread destructive tuberculosis in the lungs and bacterial excretion with the purpose of finding new markers of progression of a specific process and failure of treatment, as well as finding possible ways of additional pathogenetic therapy to accompany patients is actual. This approach will prevent treatment failure and, as a consequence, improve treatment efficiency.Purpose. To determine changes in the pro-hormone levels of vitamin D 25(OH)D in patients with NDTB treatment failure during the intensive phase of antimycobacterial therapy. Materials and methods.A prospective study involving 58 patients with NDTB lungs was performed. The patients were divided into 2 groups: 28 patients with pulmonary NDTB treatment failure were included in the 1 st group (the main group), 30 patients, who subsequently successfully completed the course of treatment were included in the 2 nd group (comparison group). The control group consisted of 29 healthy volunteer-donors. All the patients had been in inpatient treatment in Communal Institution "Zaporizhzhia Regional TB Clinical dispensary" during 2017-2019 years. Scientific medical-laboratory center of Zaporizhzhia State Medical University researched changes of the level of 25(OH)D in the blood serum by method of enzyme linked immunosorbent assay using immunoassay analyser Sirio S with "DIAsource ImmunoAssays S.A." kit (Belgium) (ng/ml). Blood sampling was made after an overnight fast. Blood was collected uniformly throughout the year in all patients and volunteers to avoid the effect of seasonal variability in vitamin D in the blood. Results.While healthy volunteers have a reduction in the level of pro-hormone 25(OH)D only in 51.7 % of cases (deficiency in 13.8 % and insufficiency in 37.9 %), patients with NDTB with generalized specific process in the lungs, the presence of destruction of over 3 cm in diameter and bacterial excretion at the beginning of intensive phase of antimycobacterial therapy (0 doses), have its decrease in 96.5 % (81 % deficiency and 15.5 % insufficiency). 1/3 of patients (35.7 % at the 0 th dose and 32.1 % at the 90 th dose) with tuberculosis treatment failure have pro-hormone levels 25(OH)D less than 7 ng/ml, whereas in patients who successfully completed the course of treatment, this concentratio...

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The Problem of Low Efficiency of Treatment of Patients With Pulmonary Tuberculosis

Cited by 9 publications

References 0 publications

Morphological changes of the small intestine mucosa in HIV/Mycobacterium tuberculosis coinfection

Morphological changes of the small intestine mucosa in HIV/Mycobacterium tuberculosis coinfection

Indicators of Clinical, Radiological, and Laboratory Status in Male Patients With Newly Diagnosed Infiltrative Pulmonary Tuberculosis

Changes of the pro-hormone levels of vitamin D 25(OH)D in patients with newly diagnosed pulmonary tuberculosis treatment failure

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