Background. Emergence of multidrug-resistant tuberculosis (MDR-TB) poses a major challenge to prevailing disease management. MDR-TB arises from mutations in several genes comprising the resistance determining regions, including rpoB, katG and gyrA. Objective. To detect and characterize mutations in rpoB, katG and gyrA. Methods. Thirty selected Mycobacterium tuberculosis isolates from the IDS-PGH were subjected to PCR amplification and sequencing. Sequences were compared to the wild type strain H37Rv. Results. Mutations were detected in codons 512, 513, 516, 522, 526, 531 and 533 of rpoB, codons 280, 281, 315 and 333 of katG, and codons 90 and 94 of gyrA sequences. The most frequently mutating codons for rpoB, katG and gyrA were 531, 315 and 94, respectively. A clustering analysis of the sequences showed occurrence of seven, four and three clusters for the genes rpoB, katG and gyrA, respectively. The eight clusters obtained from the concatenated sequences of the three genes represent the eight potential genotypes of local strains. One cluster represents the wild type strain genotype, another cluster represents the XDR strain genotype, and six clusters represent the MDR strain genotypes. Conclusion. These findings indicate the utility of multiple RDR sequence analysis in both identifying specific drug resistance mutation and genotyping of various M. tuberculosis isolates.
TUBERCULOSIS ; THERAPEUTICS ; THERAPY

Study on the security of the anti-tuberculosis, 40 TB patients had been treated by the short course therapy (2SRHZ/ 4RH) according to DOTS (Directly Observed Therapy Short- course) during 1998 in the hospital 74. All (100%) are cured as result, only 2 of them had been prolonged 1 months in the first phase. The value of SGOT, SGPT changed but no chronic significant. In 5 patients with liver diseases (viral hepatitis, cirrhosis), the value of these enzymes increased at the second month and decreased step-by- step to the normal. The author concluded that this is a safe short-course therapy, even in the patients with liver disease if to abide by DOTS and to combine with the liver protective drugs
Tuberculosis ; drug therapy ; therapeutics ; Pharmaceutical Preparations ; Safety

BACKGROUND: Although there are many studies on the effects of TB DOTS on the treatment outcomes of adults, there are limited studies in the pediatric population.

OBJECTIVE: To compare the treatment outcomes of pediatric PTB patients who were treated in the outpatient department (OPD) and the TB DOTS Center from January 2007 - December 2011.

METHODOLOGY: A retrospective cohort study was conducted at the De La Salle University Hospital in Dasmarinas, Cavite. Charts of pediatric pulmonary tuberculosis (PTB) patients at the OPD and TB DOTS Center from January 2007 - December 2011 were reviewed. Demographic data as well as outcomes were compared.

RESULTS: There were more patients treated for PTB at the OPD than in the DOTS, with age range between 1 -3 years old. Sixty-three percent of patients at the DOTS were initially seen by private practitioners. After two months of treatment, 98.2% of patients in DOTS and 84.1% in the OPD were still compliant. The difference in percentage of patients with weight gain, relief of fever, and improved general well-being after two months between DOTS and OPD were statistically insignificant. However, the percentage of patients with relief from cough after two months of treatment was significantly higher in DOTS versus the OPD. The treatment success at the DOTS is significantly higher than in the OPD (95.4% versus 54.2%), with an approximately 1.8x times likelihood of successful treatment.

CONCLUSION: Patients at the DOTS who had cough were more likely to improve than in the OPD. The percentage of patients who defaulted after two months of treatment increased in the OPD. At the end of six months, the TB DOTS had better percentage of successful treatment.

Human ; Male ; Female ; Child Preschool ; Infant ; Tuberculosis-diagnosis, therapy, therapeutics ; Tuberculosis, Pulmonary

INTRODUCTION: Tuberculosis has been a major problem in the Philippines for the past several decades ranking as the 6th (previously 5th) leading cause of mortality and morbidity based on the recent local data. For successful implementation of the Revised National Tuberculosis Control Program, treatment outcomes and factors which influence them need to be assessed on a regular basis. This study was done to find out the sputum conversion failure rate, socio-demographic factors and clinical profiles and comorbidities of new smear positive cases and retreatment cases of pulmonary tuberculosis seen and admitted at the Tuberculosis Center (TBC) of San Lazaro Hospital from January to June 2011.

METHODOLOGY: This is a records-based prospective analytical study design. Information pertaining to new smear-positive cases (or category I) and retreatment cases (or category II) were recorded using case report form.

RESULTS: Of the 131 TB patients, 63.3% were new smear-positive cases or on category I treatment. The sputum conversion failure rates among new case and retreatment PTB patients were 2.41% and 14.58%, respectively. Using chi-square test for independence to determine the association, the sputum conversion failure rates are dependent with the type of TB patient (i.e., new smear-positive case or retreatment case) (X²= 7.004, df= 1, P= 0.008). All clinical and socio-demographic factors were entered in the model for binary logistic regression analysis. Only hemoptysis (P= 0.024) and type of TB patient (P= 0.033) are statistically significantly associated with sputum conversion failure. The odds of having a sputum conversion failure after intensive phase of treatment are 9.8 times (95% Cl: 10349-71.779) among TB patients with hemoptysis upon admission as compared to those TB patients without hemoptysis, and 8.1 times (95%Cl: 1.179-55.423) among TB patients who were admitted for retreatment (due to relapse, return after default, or treatment failure) as compared to those TB patients who were admitted as new smear-positive cases.

CONCLUSION: Sputum conversion rates were generally satisfactory in this study. However, the sputum conversion failure rates among new smear-positive cases and retreatment PTB patients were 2.41% and 14.58%, respectively. Among the rid factors, hemoptysis (OR= 9.8, 95%CL: 1.349-71.779, P= 0.024) and retreatment PTB patients (OR= 8.1, 95%Cl: 1.179-55.423, P=0.033) are statistically significantly associated with sputum conversion failure.

Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; Tuberculosis, Pulmonary-Therapeutics, therapy ; Sputum

OBJECTIVE: Tuberculosis of the upper extremity, while rare, is still a problem in the Philippines. Included in the primary aim of TB treatment is cure of the patient and restoration of quality of life and productivity. The purpose of this paper is to describe a series of patients treated for Tuberculosis of the upper extremity in the context of level of function and possible factors contributing to disability.
METHOD: Records of the University of the Philippines-Philippine General Hospital Department of Orthopaedics were reviewed to recruit adult patients treated for Tuberculosis of the upper extremity from 2009-2013. Patients who consented were asked to answer a Disability of Arm, Shoulder and Hand questionnaire (DASH) validated for Filipinos.
RESULTS: Fifteen (15) patients presenting with conditions ranging from synovitis to arthritis, treated medically and surgically, were evaluated for function at least 6 months after treatment. The average disability for strenuous activities. Patients reported minimal limitations in doing activities of daily living.
CONCLUSION: Patients treated for Tuberculosis of the upper extremity still present with relatively low levels of disability. Activities of daily living were generally performed without problems but activities requiring exertion were consistently reported as a difficult task for most participants.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Tuberculosis-therapy,therapeutics ; Upper Extremity ; Orthopedic Procedures ; Synovitis ; Arthritis ; Tuberculosis