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Yogendra Shah
Yogendra Shah

This document contains two abstracts from the 14th International Congress on Infectious Diseases. The first abstract reports on a study that found a high prevalence of pulmonary tuberculosis among Bhutanese refugees in Nepal. Medical screening of over 23,000 refugees found a prevalence of bacteriologically confirmed TB of 644 per 100,000, much higher than previous estimates. Sputum culture detected more cases than smear testing alone. Drug resistance testing found some multi-drug resistant and mono-resistant cases. The second abstract examines tobacco use among newly diagnosed TB patients in North Malaysia. It found smoking prevalence of 40.27% current and 13.95% former smokers. A survey found patients had deficiencies in tobacco knowledge but

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e150 14th International Congress on Infectious Diseases (ICID) Abstracts 33.008 33.009 Prevalence of bacteriologically con鍖rmed pulmonary tuberculosis in the Bhutanese refugees in Nepal. Results of active case 鍖nding Newly diagnosed tuberculosis patients and tobacco use in North Malaysia: The prevalence of tobacco use, knowledge, and attitudes O. Gorbacheva , A.K. Mishra, D. Shapovalov, S. Sudtasay A. Awaisu 1, , M.H. Nik Mohamed 2 , N. Mohamad Noordin 3 , A.R. Muttalif 4 , A. Ahmad Mahayiddin 5 , A. Saad 6 , S. Muhammadu Gobir 7 International Organization for Migration, Jhapa, Nepal Background: Approximately 100,000 Bhutanese refugees live in camps in southeastern Nepal. Since December 2007 the International Organization for Migration (IOM) in Nepal has conducted medical screening of Bhutanese refugees prior to resettlement in USA, Canada, Australia, New Zealand, Denmark and Norway. Screening for TB included both sputum smears and cultures. The estimated prevalence of all forms of TB was 243 per 100,000 in Nepal (WHO, 2006), and 217 per 100,000 in Bhutanese refugee camps prior to resettlement (UNHCR, 2007). Methods: Depending on the age group and speci鍖c instructions of the resettlement countries, suspected TB cases were identi鍖ed with the combination of the medical history, physical examination, CXR and TST. Suspected cases were referred for microbiological examination of three sputum samples by both acid-fast bacilli staining and liquid culture for TB. Drug susceptibility testing (DST) was performed on all new positive cultures. If smears or cultures were positive, or if clinical and radiological 鍖ndings were consistent with active TB, directly observed treatment was performed. Results: From December 13, 2007 to July 31, 2009, IOM Nepal conducted medical examinations of 23,459 refugees, of which 2,391 (10.2%) were suspected TB cases. Prevalence of bacteriologically con鍖rmed (positive sputum smears or/and cultures) was 644 per 100,000. Prevalence of smearpositive cases was 230 per 100,000. Compared with culture, sensitivity of sputum smears was only 32%. DST yielded 2% MDR TB among culture con鍖rmed cases; 5% with resistance to more than one drug, but not MDR TB; 3% INH monoresistant TB; 3% PZA mono-resistant TB. Conclusion: Results of this cross-sectional study show high prevalence of infectious pulmonary TB among the Bhutanese refugees in Nepal. These results highlight the increase in case detection when sputum culture is performed, which can detect TB cases with low bacillary load. We identi鍖ed prevalence of pulmonary TB at least 2.7 times greater than previously reported prevalence of all forms. This points out the bene鍖t for wider use of sputum culture to detect infectious TB in high burden countries. A signi鍖cant proportion (13%) of cases with drug resistance highlights the need for DST to direct TB therapy. doi:10.1016/j.ijid.2010.02.1814 1 Universiti Sains Malaysia, Penang, Penang, Malaysia International Islamic University Malaysia, Kuantan, Pahang DM, Malaysia 3 National Institute of Health, Ministry of Health, Kuala Lumpur, Kuala Lumpur, Malaysia 4 Penang Hospital, Penang, Penang, Malaysia 5 Institut Perubatan Respiratori, Wilayah Persekutuan Kuala Lumpur, Kuala Lumpur, Malaysia 6 Universiti Putra Malaysia, Serdang, Selangor DE, Malaysia 7 Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia 2 Background: Suf鍖cient evidence concludes that tobacco smoking is strongly linked to tuberculosis (TB). It was suggested that a considerable proportion of the global burden of TB may be attributable to smoking. This study aimed to document the prevalence of smoking among newly diagnosed TB patients and to learn about their tobacco use knowledge and attitudes. Methods: Data on smoking prevalence were obtained based on reviews of routinely collated data from January through December 2008 in the state of Penang. The study setting comprised of 鍖ve chest clinics located within Penang and Wilayah Persakutuan Kuala Lumpur health districts, Malaysia. A validated 58-item questionnaire was used to assess the tobacco use knowledge and attitudes of those TB patients who were smokers. Results: Smoking status was determinant in 817 of 943 new cases of TB during study period. Of this, it was estimated that the prevalence rates of current and exsmoking among TB patients was 40.27% (329/817) and 13.95% (114/817), respectively. Of 86 cigarette smokers who were eligible for a larger project, 93% responded to the survey. The mean (賊SD) total score of tobacco use knowledge items was 4.23 賊 2.66 (maximum possible score = 11). More than half of the participants (51.3%) were moderately dependent on nicotine and less than half (47.5%) had knowledge about the body system on which cigarette smoking has the greatest negative effect. The majority wrongly believed that smokeless tobacco can increase athletic performance (60%) and that it is a safe and harmless product (46.2%). However, an overwhelming proportion (>80%) of the patients believed that: tobacco use is dangerous to health and that smokers are more likely to die from heart disease when compared with nonsmokers. The use of smokeless tobacco was moderately prevalent among the participants with 28.8% reporting ever snuffed, but the use of cigar and pipe was uncommon. Conclusion: Smoking prevalence rate was high among patients with TB in Malaysia. These patients generally had de鍖ciencies in knowledge of tobacco use and its health dangers, but had positive attitudes against it. Efforts should be

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1 s2.0-s1201971210018540-main

  • 1. e150 14th International Congress on Infectious Diseases (ICID) Abstracts 33.008 33.009 Prevalence of bacteriologically con鍖rmed pulmonary tuberculosis in the Bhutanese refugees in Nepal. Results of active case 鍖nding Newly diagnosed tuberculosis patients and tobacco use in North Malaysia: The prevalence of tobacco use, knowledge, and attitudes O. Gorbacheva , A.K. Mishra, D. Shapovalov, S. Sudtasay A. Awaisu 1, , M.H. Nik Mohamed 2 , N. Mohamad Noordin 3 , A.R. Muttalif 4 , A. Ahmad Mahayiddin 5 , A. Saad 6 , S. Muhammadu Gobir 7 International Organization for Migration, Jhapa, Nepal Background: Approximately 100,000 Bhutanese refugees live in camps in southeastern Nepal. Since December 2007 the International Organization for Migration (IOM) in Nepal has conducted medical screening of Bhutanese refugees prior to resettlement in USA, Canada, Australia, New Zealand, Denmark and Norway. Screening for TB included both sputum smears and cultures. The estimated prevalence of all forms of TB was 243 per 100,000 in Nepal (WHO, 2006), and 217 per 100,000 in Bhutanese refugee camps prior to resettlement (UNHCR, 2007). Methods: Depending on the age group and speci鍖c instructions of the resettlement countries, suspected TB cases were identi鍖ed with the combination of the medical history, physical examination, CXR and TST. Suspected cases were referred for microbiological examination of three sputum samples by both acid-fast bacilli staining and liquid culture for TB. Drug susceptibility testing (DST) was performed on all new positive cultures. If smears or cultures were positive, or if clinical and radiological 鍖ndings were consistent with active TB, directly observed treatment was performed. Results: From December 13, 2007 to July 31, 2009, IOM Nepal conducted medical examinations of 23,459 refugees, of which 2,391 (10.2%) were suspected TB cases. Prevalence of bacteriologically con鍖rmed (positive sputum smears or/and cultures) was 644 per 100,000. Prevalence of smearpositive cases was 230 per 100,000. Compared with culture, sensitivity of sputum smears was only 32%. DST yielded 2% MDR TB among culture con鍖rmed cases; 5% with resistance to more than one drug, but not MDR TB; 3% INH monoresistant TB; 3% PZA mono-resistant TB. Conclusion: Results of this cross-sectional study show high prevalence of infectious pulmonary TB among the Bhutanese refugees in Nepal. These results highlight the increase in case detection when sputum culture is performed, which can detect TB cases with low bacillary load. We identi鍖ed prevalence of pulmonary TB at least 2.7 times greater than previously reported prevalence of all forms. This points out the bene鍖t for wider use of sputum culture to detect infectious TB in high burden countries. A signi鍖cant proportion (13%) of cases with drug resistance highlights the need for DST to direct TB therapy. doi:10.1016/j.ijid.2010.02.1814 1 Universiti Sains Malaysia, Penang, Penang, Malaysia International Islamic University Malaysia, Kuantan, Pahang DM, Malaysia 3 National Institute of Health, Ministry of Health, Kuala Lumpur, Kuala Lumpur, Malaysia 4 Penang Hospital, Penang, Penang, Malaysia 5 Institut Perubatan Respiratori, Wilayah Persekutuan Kuala Lumpur, Kuala Lumpur, Malaysia 6 Universiti Putra Malaysia, Serdang, Selangor DE, Malaysia 7 Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia 2 Background: Suf鍖cient evidence concludes that tobacco smoking is strongly linked to tuberculosis (TB). It was suggested that a considerable proportion of the global burden of TB may be attributable to smoking. This study aimed to document the prevalence of smoking among newly diagnosed TB patients and to learn about their tobacco use knowledge and attitudes. Methods: Data on smoking prevalence were obtained based on reviews of routinely collated data from January through December 2008 in the state of Penang. The study setting comprised of 鍖ve chest clinics located within Penang and Wilayah Persakutuan Kuala Lumpur health districts, Malaysia. A validated 58-item questionnaire was used to assess the tobacco use knowledge and attitudes of those TB patients who were smokers. Results: Smoking status was determinant in 817 of 943 new cases of TB during study period. Of this, it was estimated that the prevalence rates of current and exsmoking among TB patients was 40.27% (329/817) and 13.95% (114/817), respectively. Of 86 cigarette smokers who were eligible for a larger project, 93% responded to the survey. The mean (賊SD) total score of tobacco use knowledge items was 4.23 賊 2.66 (maximum possible score = 11). More than half of the participants (51.3%) were moderately dependent on nicotine and less than half (47.5%) had knowledge about the body system on which cigarette smoking has the greatest negative effect. The majority wrongly believed that smokeless tobacco can increase athletic performance (60%) and that it is a safe and harmless product (46.2%). However, an overwhelming proportion (>80%) of the patients believed that: tobacco use is dangerous to health and that smokers are more likely to die from heart disease when compared with nonsmokers. The use of smokeless tobacco was moderately prevalent among the participants with 28.8% reporting ever snuffed, but the use of cigar and pipe was uncommon. Conclusion: Smoking prevalence rate was high among patients with TB in Malaysia. These patients generally had de鍖ciencies in knowledge of tobacco use and its health dangers, but had positive attitudes against it. Efforts should be