Tuberculosis preventive treatment in a single medical center and evaluation of the results


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Cakar B., Demir N., KARNAK D., Ozkara S.

EXPERIMENTAL AND THERAPEUTIC MEDICINE, cilt.8, sa.6, ss.1874-1878, 2014 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 8 Sayı: 6
  • Basım Tarihi: 2014
  • Doi Numarası: 10.3892/etm.2014.1988
  • Dergi Adı: EXPERIMENTAL AND THERAPEUTIC MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1874-1878
  • Anahtar Kelimeler: tuberculosis, tuberculin skin test, isoniazid, prophylaxis, BCG scar, preventive treatment, TREATMENT COMPLETION, INFECTION, HEPATOTOXICITY
  • Ankara Üniversitesi Adresli: Evet

Özet

The aim of the present study was to evaluate the application of tuberculosis preventive treatment (TB-PT). Demographic data, indications and results for cases that received TB-PT at the Ankara Tuberculosis Control Dispensary No. 7 between 2008 and 2011 were retrospectively evaluated. The 'Prevention with Drugs' registry at the dispensary was used. A total of 463 cases received TB-PT, with the indications including close contact with an active TB case (44%), positive tuberculin skin test (TST) in a child <15 years-old (25%) and immunosuppressive therapy (31%). The immunosuppressed group (n=144) were administered steroids (10%) or tumor necrosis factor (TNF)-alpha inhibitors (90%). Indications of TST conversion and sequela lesions were not observed among the cases. The male/female ratio was 106/98 for cases with TB close contact, 61/54 for TST-positive cases and 85/59 for immunosuppressed cases. The mean ages of these groups were 9 +/- 5.7, 9.5 +/- 3.8 and 38 +/- 14.9 years, respectively. TB-PT was completed in 364 cases (78.6%), and the rate of discontinuation due to adverse effects was 1% for TB close contact and 2% for TST-positive cases, but 5% for immunosuppressed cases. While the percentage of TB close contact cases receiving TB-PT decreased during the four-year study period, the percentage of cases with immunosuppression (in particular patients using TNF-alpha inhibitors) increased. Among the studied cases, only two subjects developed active TB. The first case involved a 1.5-year-old female that had close contact exposure to TB from a parent, while the other case involved a 14-year-old TST-positive male (induration size,16 mm). In conclusion, patients receiving TB-PT should be monitored and/or followed-up carefully to control any side-effects from the treatment and development of active TB.