TAILIEUCHUNG - THE BACTERIOLOGY OF PULMONARY TUBERCULOSIS IN A POPULATION WITH HIGH HUMAN IMMUNODEFICIENCY VIRUS SEROPREVALENCE

Appropriate treatment of smear-positive cases can render most of them noninfectious rapidly, generally within two weeks. Generally, infectivity decreases many fold in the first 2 days in most individuals on standard short course chemotherapy. Therefore, the most effective intervention for reducing infectiousness is treatment of the case, and institution of a mechanism which will guarantee provision of the medications, . the patient will be on DOT. Under these circumstances, it is perfectly reasonable to treat most patients as an outpatient with a plan to ensure treatment completion | INT J TUBERC LUNG DIS 2 4 312-316 1998 IUATLD The bacteriology of pulmonary tuberculosis in a population with high human immunodeficiency virus seroprevalence A. s. Karstaedt N. Jones M. Khoosal H. H. Crewe-Brown Department of Medicine Baragwanath Hospital and Department of Microbiology South African Institute for Medical Research and University of the Witwatersrand Johannesburg South Africa _SUMMARY SETTING A public sector urban university hospital in Soweto South Africa. OBJECTIVE To describe the utility of sputum smear microscopy and the prevalence of Mycobacterium tuberculosis resistance to antituberculosis drugs according to human immunodeficiency virus HIV serostatus in adults. DESIGN A retrospective descriptive study of consecutive cases using a record review. RESULTS We studied 412 adults with culture-proven pulmonary tuberculosis of whom 185 were HIV-seropositive and had a significantly lower sputum smear positivity than HIV seronegatives 68 versus 79 p . Smear positivity was significantly higher in HIV-infected patients with CD4 counts 50 mm3 compared to those with CD4 counts of 201-300 mm3 P . In patients with and those without a history of previous treatment for tuberculosis resistance to one or more antituberculosis drugs was found in and of cases respectively while resistance to both isoniazid and rifampicin multidrug-resistant tuberculosis MDR was found in and of patients respectively. There was no significant difference in resistance between HIV-positive and seronegative patients. CONCLUSION A strong tuberculosis control programme and good surveillance will be required to prevent the further spread of MDR tuberculosis. Surveys such as these are useful for monitoring control programmes. KEY WORDS tuberculosis pulmonary HIV diagnosis resistance THERE IS A WELL DOCUMENTED association between tuberculosis and human immunodeficiency virus HIV infection in .

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