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Article: Pathways to end TB- challenges.

Arora, V K / Chopra, Kamal Kishore

2024 Volume 71, Issue 1, Page(s) 1–2

MeSH term(s)	Humans ; Tuberculosis/prevention & control ; World Health Organization
Language	English
Publishing date	2024-01-10
Publishing country	India
Document type	Editorial
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2024.01.008
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Article: Pediatric tuberculosis - A diagnostic Dilemma.

Arora, V K / Kishore Chopra, Kamal

The Indian journal of tuberculosis

2023 Volume 70 Suppl 1, Page(s) S6–S7

MeSH term(s)	Humans ; Child ; Tuberculosis/diagnosis
Language	English
Publishing date	2023-11-14
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2023.11.003
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Article: Genital footprints of extragenital tuberculosis in infertile women: Comparison of various diagnostic modalities.

Yadav, Swati / Puri, Manju / Agrawal, Swati / Chopra, Kamal

The Indian journal of tuberculosis

2021 Volume 69, Issue 2, Page(s) 151–156

Abstract: Background: Genital tuberculosis (TB) continues to remain an important cause of infertility in women, especially in developing countries. It is mostly consequent to a primary infection elsewhere in the body. The diagnosis is challenging, considering its ...

Abstract	Background: Genital tuberculosis (TB) continues to remain an important cause of infertility in women, especially in developing countries. It is mostly consequent to a primary infection elsewhere in the body. The diagnosis is challenging, considering its paucibacillary nature. Although there are many studies on association of genital tuberculosis with infertility, there is paucity of literature on impact of extragenital tuberculosis on fertility of women through involvement of female reproductive organs. The various diagnostic modalities available have limitations and quest is ongoing for the best diagnostic test. Method: This was a prospective observational study conducted at the infertility clinic of a tertiary care health facility where 60 infertile women with either tubal factor or unexplained infertility with or without past history of extragenital tuberculosis were enrolled as study subjects or controls respectively. Mantoux test was performed in all women and diagnostic laparo-hysteroscopy was performed in all women to look for any evidence of uterine and/or tubal damage. The peritoneal fluid was sent for GeneXpert and Liquid culture for mycobacterium tuberculosis. Results of Mantoux test, GeneXpert and liquid culture were compared with the laparohysteroscopic findings. Result: Of the thirty infertile women in the study group, 27/30 (90%) had a history of pulmonary tuberculosis and 3/30 (10%) had history of tubercular cervical lymphadenopathy. It was observed that Mantoux test was positive (induration >10 mm) in 27/30 (90%) of women in the study group as compared to only 4/30 (13.3%) controls. Abnormal hysteroscopic findings were documented in 26.6% (8/30) study group women as compared to 6.6% (2/30) women in the control group. Similarly, 60% (18/30) of women in the study group had abnormal laparoscopic findings compared to 33% (10/30) in the control group. Seven out of thirty (23.3%) women were positive for GeneXpert in the study group compared to only 1/30 (3.3%) in the control group. Similarly, liquid culture was positive in 6/30 (20%) of women in the study group as compared to 1/30 (3.3%) in the control group. All the above differences were statistically significant. We observed that the sensitivity of Mantoux test (75.8%) stand alone was higher than the other tests combined (50%). However, specificity and positive predictive value (PPV) increases markedly (up to 100%) to when all the three tests are combined. Conclusion: The authors conclude that all women presenting with infertility should be screened for a past history of tuberculosis and actively worked up for genital tuberculosis in case the history is positive. The various available tests (Mantoux test, GeneXpert and liquid culture) have their limitations for the diagnosis of genital tuberculosis. Thus an approach of early resort to laparohysteroscopy in suspected patients is desirable so that definitive management may be instituted timely and promptly.
MeSH term(s)	Female ; Genitalia ; Humans ; Hysteroscopy/adverse effects ; Hysteroscopy/methods ; Infertility, Female/diagnosis ; Infertility, Female/etiology ; Mycobacterium tuberculosis ; Pregnancy ; Tuberculosis, Female Genital/complications ; Tuberculosis, Female Genital/diagnosis ; Tuberculosis, Female Genital/microbiology
Language	English
Publishing date	2021-04-16
Publishing country	India
Document type	Journal Article ; Observational Study
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2021.04.007
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Article: Correlating clinical breakpoint concentration of moxifloxacin with gyrA mutations using the GenoType MTBDRsl assay Version 2.0.

Sidiq, Zeeshan / Hanif, M / Dwivedi, Kaushal Kumar / Chopra, Kamal Kishore / Khanna, Ashwani / Vashishat, B K

The Indian journal of tuberculosis

2022 Volume 70, Issue 3, Page(s) 361–365

Abstract: Introduction: Widespread use of Fluoroquinolones (FQs) has led to the development of its resistance in clinical isolates of Mycobacterium tuberculosis. However, in Mycobacterium tuberculosis, phenotypic resistance to FQs has been shown to be ... ...

Abstract	Introduction: Widespread use of Fluoroquinolones (FQs) has led to the development of its resistance in clinical isolates of Mycobacterium tuberculosis. However, in Mycobacterium tuberculosis, phenotypic resistance to FQs has been shown to be heterogeneous, ranging from low-level resistance to high-level resistance. This stratification in resistance has important implications for the inclusion of moxifloxacin (Mfx) in the treatment regimen. The World Health Organization recommends the use of GenoType MTBDRsl assay as the initial test for detecting resistance conferring mutations (both high and low) to FQs in patients with confirmed MDR-RR TB. The present study was conducted to explore the relationship of MTBDRsl Version 2.0 detected mutations in gyrA gene and genotypic DST of Mfx at WHO defined Clinical Breakpoint (CB). Materials and methods: A total of 200 sputum samples from Confirmed MDR/RR TB patients were included in this study. All of these samples had mutations conferring resistance to FQ confirmed by GenoType MTBDRsl assay. These samples were further subjected to Phenotypic DST against moxifloxacin using the Bactec MGIT-960 system. Results: All of the 200 representative FQ resistant isolates had mutations in gyrA gene only with no detectable mutation in gyrB gene. 109 (54.5%) of the isolates had mutations associated with high-level increase in MIC while 91 (45.5%) isolates had mutations associated with low-level increase in MIC. Phenotypic DST of these 200 isolates against Mfx at CB (1.0μg/ml) revealed that of the 109 isolates with mutations associated with high-level increase in MIC and expected to be resistant at CB, only 34 (31.2%) were resistant and the remaining 75 (68.8%) were sensitive. Conclusion: Moxifloxacin is an important drug in the regimen for treating Drug-resistant TB and the decision to exclude this drug from the regimen should not be taken merely on the basis of mutational patterns. It should rather be taken after considering the combined results of mutational analysis and phenotypic DST.
MeSH term(s)	Humans ; Moxifloxacin/therapeutic use ; Antitubercular Agents/pharmacology ; Antitubercular Agents/therapeutic use ; Tuberculosis/drug therapy ; Mycobacterium tuberculosis ; Fluoroquinolones/pharmacology ; Fluoroquinolones/therapeutic use ; Mutation ; Genotype ; Microbial Sensitivity Tests ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/microbiology ; Drug Resistance, Multiple, Bacterial/genetics
Chemical Substances	Moxifloxacin (U188XYD42P) ; Antitubercular Agents ; Fluoroquinolones
Language	English
Publishing date	2022-12-01
Publishing country	India
Document type	Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2022.11.004
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Article: To study the occurrence of risk factors for pulmonary tuberculosis in the homeless population in areas of Delhi, India.

Chopra, Kamal K / Malik, Alveena / Abha Indora / Pandey, Praveen / Pandey, Surabhi

The Indian journal of tuberculosis

2022 Volume 70, Issue 3, Page(s) 356–360

Abstract: Background: In India, there are only a few studies done in the area of assessing the risk factors of Tuberculosis (TB) among the homeless population. The homeless population has quite a higher chance of developing Pulmonary Tuberculosis (PTB) as ... ...

Abstract	Background: In India, there are only a few studies done in the area of assessing the risk factors of Tuberculosis (TB) among the homeless population. The homeless population has quite a higher chance of developing Pulmonary Tuberculosis (PTB) as compared with the general population due to the presence of an inappropriate environment and high prevalence of risk factors. Methods: This study was done among the homeless population in both males and females aged 18 years and above in areas of Delhi (Yamuna Pusta and Mansarovar Park). The participants were screened for TB symptoms and risk factors to diagnose active PTB in them. Results: Out of 200 participants, 17 were diagnosed with active PTB. The overall occurrence of Tuberculosis among the studied homeless population was found to be 85 cases per 1000 population. The occurrence of behavioral habits such as smoking was found to be 41.2% (7/17), tobacco chewing at 47.1% (8/17), and alcohol at 47.1% (8/17) among the cases. The occurrence of HIV coinfection was 5.9% (1/17) and diabetes was 5.9% (1/17). The prevalence of TB among homeless females was 1.5 times higher than homeless males but out of 17 diagnosed patients, males had a higher prevalence of TB as compared to females. Conclusion: The occurrence of PTB in the homeless population is quite high as it is also reported in a study in the United States that the national incidence of tuberculosis in the homeless population was 36 cases/100,000 and it needs to be addressed to eliminate tuberculosis.
MeSH term(s)	Male ; Female ; Humans ; Risk Factors ; Tuberculosis, Pulmonary/epidemiology ; Tuberculosis, Pulmonary/diagnosis ; Tuberculosis/epidemiology ; HIV Infections/epidemiology ; India/epidemiology ; Prevalence
Language	English
Publishing date	2022-11-26
Publishing country	India
Document type	Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2022.11.001
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Article: Infection control and preventing the transmission of tuberculosis in high-risk centres - recovery shelter for homeless people.

Chopra, Kamal K / Pandey, Praveen / Malik, Alveena / Indora, Abha / Pandey, Surabhi

The Indian journal of tuberculosis

2022 Volume 70, Issue 2, Page(s) 158–161

Abstract: The term "infection control" refers to the policies and practices used in hospitals and other healthcare facilities to limit the spread of illnesses with the primary goal of lowering infection rates. The objective is to reduce the chance of infection in ... ...

Abstract	The term "infection control" refers to the policies and practices used in hospitals and other healthcare facilities to limit the spread of illnesses with the primary goal of lowering infection rates. The objective is to reduce the chance of infection in patients and Healthcare workers (HCWs). This may be achieved by making all the HCWs to follow and practice the infection prevention and control (IPC) guidelines and by providing safe and quality healthcare. Because of more exposure to TB patients and insufficient TB infection prevention and control (TBIPC) procedures in a healthcare facility, healthcare workers (HCWs) working in TB centers are at an elevated risk of contracting TB. Although there are a number of TBIPC guidelines, there is limited knowledge of their contents, if they are applicable in the given situation, and whether they are being properly applied in TB centers. The purpose of this study was to observe the TBIPC guidelines' implementation in CES (Centre of equity studies) recovery shelters well as the elements that affect it. The percentage of public health care personnel who used proper TBIPC practices was low. The execution of TBIPC guidelines in tuberculosis (TB) centers was poor. It was impacted because TB treatment institutions and centers have unique health systems and TB disease burdens.
MeSH term(s)	Humans ; Tuberculosis/prevention & control ; Infection Control ; Health Personnel ; Health Facilities ; Hospitals
Language	English
Publishing date	2022-11-26
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2022.11.002
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Article: Radiology quiz- dancing ball.

Chawla, Aditya K / Madan, Arun / Chopra, Kamal / Chawla, Rakesh K

The Indian journal of tuberculosis

2020 Volume 68, Issue 1, Page(s) 157–159

Abstract: We are presenting an interesting case of Pneumonia, who after good initial response deteriorated with recurrent hemoptysis. On culture of bronchial aspirate, patient had coexisting fungal infection and on repeat bronchoscopy showed a unique and rare ... ...

Abstract	We are presenting an interesting case of Pneumonia, who after good initial response deteriorated with recurrent hemoptysis. On culture of bronchial aspirate, patient had coexisting fungal infection and on repeat bronchoscopy showed a unique and rare picture. There was a dancing ball in RUL which was moving. Patient was initially managed conservatively but finally had to undergo lobectomy to achieve permanent cure.
MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/therapeutic use ; Antifungal Agents/administration & dosage ; Antifungal Agents/therapeutic use ; Diagnosis, Differential ; Drug Therapy, Combination ; Hemoptysis/etiology ; Humans ; Klebsiella Infections/complications ; Klebsiella Infections/diagnosis ; Klebsiella Infections/diagnostic imaging ; Klebsiella Infections/drug therapy ; Klebsiella pneumoniae/isolation & purification ; Lung Diseases, Fungal/complications ; Lung Diseases, Fungal/diagnosis ; Lung Diseases, Fungal/diagnostic imaging ; Lung Diseases, Fungal/drug therapy ; Male ; Middle Aged ; Pneumonia, Bacterial/complications ; Pneumonia, Bacterial/diagnosis ; Pneumonia, Bacterial/diagnostic imaging ; Pneumonia, Bacterial/drug therapy ; Radiography, Thoracic ; Triazoles/administration & dosage ; Triazoles/therapeutic use
Chemical Substances	Anti-Bacterial Agents ; Antifungal Agents ; Triazoles ; posaconazole (6TK1G07BHZ)
Language	English
Publishing date	2020-09-17
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2020.09.011
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Article: Adherence to Isoniazid Preventive Therapy among children living with tuberculosis patients in Delhi, India: An exploratory prospective study.

Sharma, Nandini / Basu, Saurav / Khanna, Ashwani / Sharma, Pragya / Chopra, Kamal K / Chandra, Shivani

The Indian journal of tuberculosis

2021 Volume 69, Issue 1, Page(s) 100–103

Abstract: INH Preventive Therapy (IPT) substantially reduces the risk of incidence of TB disease in pediatric household contacts of TB patients. The National TB Elimination Program (NTEP) of India prescribes a daily regimen of Isoniazid to all under-6 pediatric ... ...

Abstract	INH Preventive Therapy (IPT) substantially reduces the risk of incidence of TB disease in pediatric household contacts of TB patients. The National TB Elimination Program (NTEP) of India prescribes a daily regimen of Isoniazid to all under-6 pediatric contacts for 6 months duration. We conducted, this exploratory prospective study (June to Nov' 2020) to assess adherence to IPT and reasons for nonadherence among child contacts of microbiologically confirmed, drug sensitive, non-PLHIV Tuberculosis patients in Delhi, India. The study outcomes included the initiation, adherence and completion of IPT. The caregivers of the child TB contacts were interviewed face to face by the field investigator. The data were entered on EpiData 3.1 and analysed with IBM SPSS 25. The INH adherence was assessed in a total of 86 household child TB contacts. IPT had been initiated in 62 (72.1%) child TB contacts of which 61 (98.4%) received INH within 1 month of starting of ATT-DOTS therapy in the index TB patient of the household. Furthermore, the failure to initiate IPT was reported by 24 (27.9%) child TB contacts. Within the cohort of child TB contacts who were not initiated with IPT, the ATT-DOTS duration in the index-TB patient was ≥5 months in 18 (75%) cases, 1-2 months in 3 (12.5%) cases, and <1 month in also 3 (12.5%) cases. Reasons for non-initiation (n = 24) were reported as refusal by the family in 12 (50%) cases mostly due to concern over side-effects of the drug, while non-provision of the drug by the DOTS provider was also observed in 12 (50%) cases. The mean (SD) INH adherence in the INH initiated cohort was 5.6 (2.0) (n = 62). Reasons for INH non-adherence were attributed to forgetfulness (n = 23, 37.1%), carelessness (n = 24, 38.7%), and intermittent stopping of the medication (n = 17, 27.4%) on the child falling sick, perceived drug side effects, and running out of drug stocks. INH non-adherence defined as at-least two missed INH doses in the previous 7 days was observed in 47 (54.7%) participants (n = 86). On bivariate analysis, none of the household sociodemographic characteristics showed any statistically significant association with the rate of INH non-adherence in the child TB contacts. The findings of the present study indicate the need to periodically assess adherence and persistence to IPT in the child TB contacts as high intermittent missed dosing rates can undermine the effectiveness of IPT in preventing incident disease.
MeSH term(s)	Antitubercular Agents/therapeutic use ; Child ; HIV Infections/drug therapy ; Humans ; India ; Isoniazid/therapeutic use ; Prospective Studies ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control
Chemical Substances	Antitubercular Agents ; Isoniazid (V83O1VOZ8L)
Language	English
Publishing date	2021-03-11
Publishing country	India
Document type	Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2021.03.005
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Article: From stress to stigma - Mental health considerations of health care workers involved in COVID19 management.

Sachdeva, Ankur / Nandini, Harsh / Kumar, Vipin / Chawla, Rakesh K / Chopra, Kamal

The Indian journal of tuberculosis

2021 Volume 69, Issue 4, Page(s) 590–595

Abstract: Background: Healthcare workers (HCWs) involved in administration and patient management during COVID-19 pandemic are at high risk of developing psychological problems related to fear and stress of contacting COVID infection. This is augmented by the ... ...

Abstract	Background: Healthcare workers (HCWs) involved in administration and patient management during COVID-19 pandemic are at high risk of developing psychological problems related to fear and stress of contacting COVID infection. This is augmented by the stigma faced at home and society, owing to the nature of their job. Aim: To assess the mental health issues and stigma amongst health care workers involved in COVID care. Methodology: We conducted a hospital based cross sectional study where 150 health care workers involved in the care of COVID-19 patients, directly and indirectly, were selected using systematic random sampling. They were assessed using Depression, Anxiety and Stress Scale (DASS-21) Hindi Version, The Impact of Event Scale - Revised scale and a Modified Stigma scale. Results: Significant psychological stress, anxiety, depression and high risk for developing post-traumatic stress disorder was found in more than half of the healthcare workers, albeit more in those having direct contact with COVID patients (p < 0.05). Stigma was significantly reported in most HCWs, especially with concerns regarding public attitude and disclosure of their work profile. Conclusion: Healthcare Workers are at a higher risk for developing psychological disorders and post-traumatic stress disorder because of the immensely stressful work-related conditions and stigma related to working with COVID patients. This may lead to long lasting psychosocial consequences which may affect more severely than the infection itself. Early identification of psychological issues of HCWs and timely intervention is the key.
MeSH term(s)	Humans ; Mental Health ; COVID-19/epidemiology ; Cross-Sectional Studies ; Pandemics ; Health Personnel
Language	English
Publishing date	2021-09-27
Publishing country	India
Document type	Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2021.09.007
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Article: Mycobacterium W. - An unusual side effect.

Chawla, Rakesh K / Chawla, Aditya K / Chaudhary, Gaurav / Chopra, Kamal / Chawla, Madhav K

The Indian journal of tuberculosis

2021 Volume 69, Issue 2, Page(s) 250–252

Abstract: Objective: To present an interesting case of unusual side effect of Mycobacterium W. in an adult COVID 19 positive male and discuss its assessment and management.: Methods: - DESIGN: Case Report.: Setting: Tertiary care hospital.: Patient: One.! ...

Abstract	Objective: To present an interesting case of unusual side effect of Mycobacterium W. in an adult COVID 19 positive male and discuss its assessment and management. Methods: - DESIGN: Case Report. Setting: Tertiary care hospital. Patient: One. Results: 70 years male was admitted with complaints of fever, persistent dry cough since 10-12 days and progressive breathlessness since 3-4 days. Patient was found COVID-19 RTPCR positive and is known case of Type-II Diabetes with CAD (Post PTCA). Patient was managed conservatively with Oxygen support, I/V antibiotics, I/V Steroids, oral Favipiravir and other supportive treatment. Patient was also given injection Mycobacterium W. in dose of 0.3 ml per day intradermally at 3 different sites (both deltoids) consecutively for three days. 7-8 days after administration, patient developed bright red pustules which later got converted into small punched out ulcerations on all nine local sites of administration, which were managed conservatively with oral analgesics and local steroids for 8-10 days which healed without any scar formation. Conclusion: Injection Mycobacterium W. is used in COVID 19 patients as an immunomodulator agent and has been proved to be safe in most of the cases but we encountered this unusual side effect of bright red pustules formation at all nine local sites of injection in our case most likely because of being administered subcutaneously instead of intradermally, making this an interesting case which is being reported to scientific fraternity.
MeSH term(s)	Adjuvants, Immunologic ; Adult ; Anti-Bacterial Agents ; COVID-19 ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Male ; Mycobacterium
Chemical Substances	Adjuvants, Immunologic ; Anti-Bacterial Agents
Language	English
Publishing date	2021-03-02
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	603129-8
ISSN	0019-5707 ; 0019-5705
ISSN	0019-5707 ; 0019-5705
DOI	10.1016/j.ijtb.2021.02.013
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