Browsing by Author "Bam, DS"
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Publication Gene Xpert based detection of drug resistant tuberculosis among retreatment patients visiting National Tuberculosis Centre, Nepal(Institute of Medicine, 2017) Khadka, DK; Bam, DS; Ghimire, P; Singh, AAbstract Introduction: Tuberculosis is still one of the major public health problems in Nepal and multi drug resistant and extensively drug resistant tuberculosis (MDR /XDRTB) additionally has become serious issue. Prompt diagnosis and effective treatment of MDR/XDRTB is urgently needed. The main objective of this study was to detect MDR TB using novel molecular techniques (rpob gene mutations) in reference with drug susceptibility test (DST). Methods: A cross sectional study was carried out identifying MDRTB among retreatment patients using Gene Xpert, culture and DST on first line drugs (FLD-DST). A total of 159 sputum samples were collected from retreatment TB patients (Female 40.3%, Male 59.7%) with median age of 30 years visiting to the DR TB treatment centres of eastern and central Nepal (via private courier and directly to National TB Reference Laboratory (NRL) at NTC from April 2013 to August 2017. Results:M. tuberculosis and rifampicin resistance were detected on all 159 (100%) samples by Gene Xpert of which, 73.3%, 21.4% and 6.3% were positive, negative and contaminated respectively by culture. FLD-DST was performed on 115 cultures positives of which, 94.78% showed MDRTB, 1.74% showed mono resistance to isoniazid or rifampicin, 0.87% to streptomycin and isoniazid and 3.47% were pan susceptible. Conclusion: One hundred fifteen of 159 cases detected rifampicin resistances (RR) by Gene Xpert were culture positive and almost 95% strains were MDRTB by FLD-DST, which was found to be higher in 15-60 years group. Sputa from retreatment TB patients required to be tested by rapid diagnostics with reference to culture and DST. Key words:Gene Xpert, Culture, Drug Susceptibility Test, Multi Drug Resistant Tuberculosis, SputaPublication Human Immuno-Deficiency Virus co-infection in suspected TB patients(Institute of Medicine, 2008) Sherchand, JB; Maharajan, S; Bam, DS; Singh, A; Cuevas, LEAbstract Introduction: Tuberculosis is one of the major public health problems in Nepal and HIV has become the most potent risk factor for the progression of TB infection as HIV-positive people are more likely to develop TB when newly infected or reinfected with Mycobecterium tuberculosis. Our main aim was to determine TB/HIV co-infection cases visiting DOTS center and Research center. Materials and Methods: The study was conducted in DOTS center of TUTH, Maharajgunj and Infectious and Tropical Disease Research and Prevention Center, Tripureshwor. We included a total of 300 patients with the respiratory tract symptoms and cough more than 3 weeks suggesting the symptom of pulmonary tuberculosis and having risk behaviour towards HIV infection. They were interviewed with a structured questionnaire during October 2006 to July 2007. All of them were screened for tuberculosis by sputum microscopy, AFB culture, radiology and HIV infection by standard ELISA method. Results: Among 300 suspected TB patients, 79 were diagnosed as pulmonary TB positive patients and 34 as HIV seropositive. The coprevalence of TB/HIV was 4.33 percent (13/300) among total patients among which 12 males and 1 female were found to be coinfected with TB/HIV. Conclusion: HIV co-infection in pulmonary TB positive cases was 16.46 percent (13/79), which revealed it as an alarming situation in developing countries, like Nepal. More cases were found in young adults aged range from 21-40. Males were found to be more infected than female. Keywords: TB, HIV, Co-infection, DOTS, ELISAPublication The pattern of anti-tuberculosis drug resistance in pulmonary tuberculosis patients(Institute of Medicine, 2005) Rijal, KR; Ghimire, P; Bam, DSAbstract Background: Tuberculosis is one of the major public health problems in Nepal.. , Drug resistant tuberculosis has posed a serious challenge in TB control program. Drug resistance tuberculosis is the most difficult for the treatment and cure of the patient. Objective: To find out the current situation of drug resistant pattern at national tuberculosis center, Nepal. Design: Central Department of Microbiology, Tribhuvan University in collaboration with NTC, STC, conducted a prospective study. Methods: One hundred ninety-nine Mycobacterium tuberculosisisolated from the sputum in national tuberculosis center (NTC) were studied to find out the drug resistant pattern by utilizing absolute concentration method. Results: Of the 199 culture positive strains were tested, 161from previously treated cases and 38 from new cases. Overall primary and acquired resistance were 36.82%and 75.05%respectively. The study showed that the Primary drug resistance (PDR) to one drug was found to be 23.67%, to two drugs was 10.52%, to three drugs was 0%, and four drugs was 2.63%where as acquired drug resistance (ADR) to one drug was 32.38%, to two drug was 19.19%, to three drugs was 11.78%, to four drugs was 11.80%. Primary and acquired multi-drug resistance (MDR)) was in 2.63% and 19.25% of the isolates respectively. Conclusion: Overall, drug resistance of M.tuberculosisis high. It is concluded that regular monitoring of MDR–TB and making policy according to research finding is necessary as it is changing every year, which helps to control MDR-TB.