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Rachow A, Ivanova O, Bakuli A, Khosa C, Nhassengo P, Owolabi O, Jayasooriya S, Ntinginya NE, Sabi I, Rassool M, Bennet J, Niemann S, Mekota AM, Allwood BW, Wallis RS, Charalambous S, Hoelscher M, Churchyard G. Performance of spirometry assessment at TB diagnosis. Int J Tuberc Lung Dis 2023; 27:850-857. [PMID: 37880896 PMCID: PMC10599411 DOI: 10.5588/ijtld.23.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/08/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND: Spirometry is considered relevant for the diagnosis and monitoring of post-TB lung disease. However, spirometry is rarely done in newly diagnosed TB patients.METHODS: Newly diagnosed, microbiologically confirmed TB patients were recruited for the study. Spirometry was performed within 21 days of TB treatment initiation according to American Thoracic Society/European Respiratory Society guidelines. Spirometry analysis was done using Global Lung Initiative equations for standardisation.RESULTS: Of 1,430 eligible study participants, 24.7% (353/1,430) had no spirometry performed mainly due to contraindications and 23.0% (329/1,430) had invalid results; 52.3% (748/1,430) of participants had a valid result, 82.8% (619/748) of whom had abnormal spirometry. Of participants with abnormal spirometry, 70% (436/619) had low forced vital capacity (FVC), 6.1% (38/619) had a low ratio of forced expiratory volume in 1 sec (FEV1) to FVC, and 19.1% (118/619) had low FVC, as well as low FEV1/FVC ratio. Among those with abnormal spirometry, 26.3% (163/619) had severe lung impairment.CONCLUSIONS: In this population, a high proportion of not performed and invalid spirometry assessments was observed; this was addressed by removing tachycardia as a (relative) contraindication from the study guidance and retraining. The high proportion of patients with severe pulmonary impairment at the time of TB diagnosis suggests a huge morbidity burden and calls for further longitudinal studies on the relevance of spirometry in predicting chronic lung impairment after TB.
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Affiliation(s)
- A Rachow
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - O Ivanova
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich
| | - A Bakuli
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich
| | - C Khosa
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - P Nhassengo
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - O Owolabi
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - S Jayasooriya
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - N E Ntinginya
- Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania
| | - I Sabi
- Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania
| | - M Rassool
- Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - J Bennet
- Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - S Niemann
- Leibniz Lung Center, Research Center Borstel, Borstel, Germany
| | - A-M Mekota
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich
| | - B W Allwood
- Division of Pulmonology, Department of Medicine Stellenbosch University and Tygerberg Hospital, Cape Town
| | | | - S Charalambous
- The Aurum Institute, Johannesburg, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - M Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - G Churchyard
- The Aurum Institute, Johannesburg, Department of Medicine, Vanderbilt University, Nashville, TN, USA
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Schlinkmann KM, Bakuli A, Karch A, Meyer F, Dreesman J, Monazahian M, Mikolajczyk R. Transmission of respiratory and gastrointestinal infections in German households with children attending child care. Epidemiol Infect 2018; 146:627-632. [PMID: 29478420 PMCID: PMC9134537 DOI: 10.1017/s0950268818000316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/25/2017] [Accepted: 01/30/2018] [Indexed: 11/06/2022] Open
Abstract
Transmission of acute respiratory infections (ARI) and acute gastroenteritis (AGE) often occurs in households. The aim of this study was to assess which proportion of ARI and AGE is introduced and transmitted by children in German households with children attending child care. We recruited families with children aged 0-6 years in Braunschweig (Germany), for a 4 months prospective cohort study in the winter period 2014/2015. Every household member was included in a health diary and used nasal swabs for pathogen identification in case of ARI. We defined a transmission if two persons had overlapping periods with symptoms and used additional definitions for sensitivity analyses. In total, 77 households participated with 282 persons. We observed 277 transmission events for ARI and 23 for AGE. In most cases, the first infected person in a household was a child (ARI: 63%, AGE: 53%), and the risk of within-household transmission was two times higher when the index case was a child. In 26 ARI-transmission events, pathogens were detected for both cases; hereof in 35% (95% confidence interval (17-56%)) the pathogens were different. Thus, symptomatic infections in household members, apparently linked in time, were in 2/3 associated with the same pathogens.
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Affiliation(s)
- K. M. Schlinkmann
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- PhD Programme Epidemiology, Hannover Medical School, Braunschweig-Hannover, Germany
| | - A. Bakuli
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- PhD Programme Epidemiology, Hannover Medical School, Braunschweig-Hannover, Germany
| | - A. Karch
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - F. Meyer
- Helmholtz Centre for Infection Research, KOM – Microbial Communication, Braunschweig, Germany
| | - J. Dreesman
- Governmental Institute of Public Health of Lower Saxony, Hannover, Germany
| | - M. Monazahian
- Governmental Institute of Public Health of Lower Saxony, Hannover, Germany
| | - R. Mikolajczyk
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Braunschweig-Hannover, Germany
- Medical Faculty of the Martin Luther University Halle-Wittenberg, Institute for Medical Epidemiology, Biometry, and Informatics (IMEBI), Halle (Saale), Germany
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Gupta S, Bhattacharyya S, Sonathi V, Bakuli A, Mathur AK, Leteneux C. Transition Probability Estimation Using Repeated Sampling from a Fitted Mixed Model. Value Health 2014; 17:A326. [PMID: 27200545 DOI: 10.1016/j.jval.2014.08.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Gupta
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | | | - V Sonathi
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - A Bakuli
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - A K Mathur
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
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Jain M, Sonathi V, Rathi H, Bakuli A, Thomas SK, Mollon P. A DE-NOVO Model to Predict Outcomes of a New Hypothetical Intervention to Reduce CV Risk in Post Mi Patients. Value Health 2014; 17:A558. [PMID: 27201839 DOI: 10.1016/j.jval.2014.08.1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Jain
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - V Sonathi
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - H Rathi
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - A Bakuli
- Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - S K Thomas
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - P Mollon
- Novaris Pharma AG, Basel, Switzerland
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