Knowledge of Tuberculosis Among Drug Users)Relationship to Return Rates for Tuberculosis Screening at a Syringe Exchange)

اختصاصی از فی لوو Knowledge of Tuberculosis Among Drug Users)Relationship to Return Rates for Tuberculosis Screening at a Syringe Exchange) دانلود با لینک مستقیم و پر سرعت .

Abstract – Tuberculosis is an important health issue among drug users. We sought to evaluate active
drug users’ (DUs) knowledge of tuberculosis (TB) and to assess the relationship between TB knowledge
and attitudes and tuberculin skin test (TST) return rates at a syringe exchange program. DUs were
recruited at a syringe exchange program in New York City, were interviewed and offered TSTs, and
received $15.00 upon returning for TST reading. The questionnaire evaluated knowledge of TB transmission,
prevention, and treatment. From March 13, 1995 to January 31, 1996, 610 of 650 (94%) of DUs
approached agreed to participate. Of these, 80% had previous TSTs within the past 2 years and 20%
were known to be HIV infected. Almost all knew that TB is contagious and more than two thirds knew that
TB is treatable and that TB preventive therapy existed. However, fewer than half knew that HIV-related
TB could be treated, 30% thought TB could be treated without a medical doctor, and the majority (70%)
thought a reactive TST implied infectivity. The rate of return for TST reading was 93%. In multivariate
analysis, those who knew that HIV-related TB was curable were more likely to return for TST reading
(odds ratio 2.0; 95% confidence interval 1.04 to 3.95; p
5 .03). The high acceptance and return rates
suggest that TB services can be incorporated into syringe exchange programs. However, several important
gaps in TB knowledge existed in this population at high risk of TB, which may impact on adherence
and which support the need for TB education for drug users. © 1999 Elsevier Science Inc. All rights
reserved

Screening for tuberculosis among 2381 household contacts of sputum-smear-positive cases in The Gambia

اختصاصی از فی لوو Screening for tuberculosis among 2381 household contacts of sputum-smear-positive cases in The Gambia دانلود با لینک مستقیم و پر سرعت .

Dolly Jackson-Sillaha, Philip C. Hill a,∗, Annette Foxa, Roger H. Brookesa,
Simon A. Donkora, Moses D. Lugosa, Stephen R.C. Howiea,
Katherine R. Fielding b, Adama Jallowc, Christian Lienhardtd,
Tumani Corraha, Richard A. Adegbolaa, Keith P. McAdama

Summary Contact investigation is a key component of tuberculosis (TB) control in developed,
but not developing, countries. We aimed to measure the prevalence of TB among household
contacts of sputum-smear-positive TB cases in The Gambia and to assess the sensitivity of an
enzyme-linked immunospot (ELISPOT) assay in this regard. Household contacts of adult smearpositive
TB patients were assessed by questionnaire, purified protein derivative (PPD) skin test,
ELISPOT assay, physical examination, chest X-ray and sputum/gastric aspirate. Thirty-three
TB cases were identified from 2174 of 2381 contacts of 317 adult smear-positive pulmonary
TB patients, giving a prevalence of 1518/100 000. The cases identified tended to have milder
disease than those passively detected. The sensitivity of ESAT-6/CFP-10 ELISPOT test as a
screening test for TB disease was estimated as 71%. Fifty-six per cent of contacts with a PPD
skin test result ≥10mm induration had detectable responses to ESAT-6/CFP-10 by ELISPOT; 11%
with a negative PPD skin test (<10mm) had a positive ESAT-6/CFP-10 response. Active screening
for TB among contacts of TB patients may have a role in TB control in The Gambia. These individuals
are a high-risk group, and the disease identified is less advanced than that found through
passive case detection. An ELISPOT assay was relatively insensitive as a screening test for TB.
© 2007 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights
reserved.