Showing papers by "Soumya Swaminathan published in 2003"

Seroprevalence of human immunodeficiency virus (HIV) infection among tuberculosis patients in Tamil Nadu.

Abstract: Background & objectives: The dual epidemic of HIV and tuberculosis is a cause for concern in those countries where these two infections are prevalent in epidemic proportions. We undertook a survey at two sites in North Arcot district of Tamil Nadu in 1992-1993, to know the seroprevalence of HIV infection among tuberculosis patients. The objective of this study was to re-examine the prevalence of HIV infection among tuberculosis patients in a repeat survey. Methods: The study was undertaken in four centres: District Tuberculosis Centre (DTC), Vellore, Tuberculosis Sanatorium, Pennathur (Vellore), District TB Centre (DTC), Kancheepuram and the Government Thiruvotteswarar Tuberculosis Hospital (GTTH), Chennai in the northern part of Tamil Nadu during 1997-1998. A total of 2361 newly diagnosed TB patients were registered in this study. HIV serology after pre-test counseling was done along with sputum examination for acid-fast bacillus by smear and culture for mycobacteria for all patients. Results: The overall HIV seroprevalence among TB patients was 4.7 per cent. The highest HIV seropositivity rate was found among patients aged 30-39 yr (10.6%). HIV seroprevalence showed a wide variation among the different centres ranging from 0.6. per cent in DTC, Kancheepuram to 9.4 per cent in Pennathur Sanatorium, Vellore. Sputum smear positivity was 88 per cent among the HIV-negative and 83 per cent among HIV-positive tuberculosis patients. Interpretation & conclusion: HIV infection is on the rise among TB patients in Tamil Nadu. Acid-fast smear microscopy is adequate for the diagnosis of pulmonary tuberculosis, and drug resistance among HIV positive patients is not a major problem at this point of time; hence antituberculosis regimens recommended by the Revised National Tuberculosis Control Program (RNTCP) can be used to treat HIV positive patients with tuberculosis.

Reduced exercise capacity in non-cystic fibrosis bronchiectasis

Abstract: Objective : Bronchiectasis not due to cystic fibrosis is usually a consequence of severe bacterial or tuberculous infection of the lungs, which is commonly seen in children in developing countries. Our aim was to study its functional sequelae and affect on work capacity in children.Methods : Seventeen children (7-17 years of age) with clinical and radiological evidence of bronchiectasis of one or both lungs were studied at the Cardiopulmonary Unit of the Tuberculosis Research Centre. Pulmonary function tests including spirometry and lung volume measurements were performed. Incremental exercise stress test was done on a treadmill, and ventilatory and cardiac parameters were monitored. Control values were taken from a previous study.Results : Children with bronchiectasis had lower forced vital capacity (FVC) (1.1 + 0.4 L versus 1.5 + 0.4 L, p=0.003) and FEV, (0.95 ±0.2 L versus 1.4 ±0.3 L, p<0.002) compared to age- and sex-matched healthy controls. The patient group had significantly higher residual lung volumes (0.7 ±0.3 L versus 0.4 + 0.1 L, p<0.02). At maximal exercise, they had lower aerobic capacity (28 +- 6 ml/min/kg versus 38 ±5 ml/min/kg, p<0.0001) and maximal ventilation (24 ±8 L/min versus 39 ±10 L/min, p<0.001). At maximal exercise, while none of the controls desaturated, oxygen saturation fell below 88% in eight of 17 patients.Conclusion : The findings show that children and adolescents with non-cystic fibrosis bronchiectasis have abnormal pulmonary function and reduced exercise capacity. This is likely to interfere with their life as well as future work capacity. Efforts should be made to minimize lung damage in childhood by ensuring early diagnosis and instituting appropriate treatment of respiratory infections.

Age-related changes in blood lymphocyte subsets of south Indian children.

Abstract: Background. Enumeration of lymphocyte subsets has been widely used for the diagnosis and monitoring of several haematological and immunological disorders. Various studies have demonstrated age, sex and racial differences in lymphocyte subset expression. Reference values are not available for Indian children and there is a need for this information to replace commonly used, but inappropriate, adult lymphocyte subset ranges. Methods. One hundred thirty-eight healthy children be tween 3 and 15 years of age, attending a local government school in Chennai, South India were included in the study. Haemoglobin levels, and total and differential cell counts were determined using an automated counter and lymphocyte subsets were analysed by flowcytornetry. Results. The mean (SD) absolute lymphocyte count declined with age from 4338 (1031) at 3 years to reach a plateau of 3096 (914) at 11-13 years (p < 0.05). A significant decline was also observed in the absolute numbers of CD3+, CD4+, CD8+ and CD19 + cells. However, the percentage values of CD3+, CD4+, CD8+, CD16/56+ cells and the CD4/CD8 ratio remained fairly stable across the age range. Conclusion. Our data would prove useful in interpreting disease-related changes in lymphocyte subsets in Indian children of different age groups. Age-related decrease in the absolute lymphocyte count as well as numbers of CD4 and CD8 cells was found to occur between the ages of 3 and 11 years. A normogram relating age to CD4 count has been developed.