Science topic

# TB-HIV - Science topic

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Questions related to TB-HIV
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Especially in a country like India. Tests which are available are time consuming leading to delay in TB/HIV infected patients?
Thanks for all the tips! This was extremely helpful
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I have a total numbers of Clients 265
183 males
82 females
21 persons less than 15 years
= > 15 were 244
244 Pulmonary TB
21 Extra pulmonary cases
33 Category 11 treatment and
231 category 1 treatment
Total TB death 33
total TB/HIV+ 61
TB/hiv+ Alive 45
TB/HIV- Alive 152
TB/HIV+ died 16
HIV/TB+ Septrin Prophylaxis 45
HIV/TB+ ON anti-rectroviral drugs 61
Hypothesis for testing.
What is the odd ratio for survival with HIV/TB co infection compared to TB only cases.?
What is the percentage increase in death rate when HIV is added to TB compared to TB alone(TB/HIV-)?
How do you statistically analysis the survival improvement when Anti-rectroviral drugs is added to co-infected cases management and also when septrin prophylaxis is added to treatment management?.
Please i need the odd ration,confidence interval including upper and Lower Limit and P-value
Please send me the copy of the software page used for analysis .
Thank you so much.
If you've already downloaded SPSS package, i think you can either use a simple chi-square test (2 by 2 table) to calculate the odds for any of the outcome (death due to the HIV infection or TB). You can as well use a binary logistic regression model to check the associations between the outcomes and the variables considered as risk factors. The odds and confidence intervals will be generated in the model. Kindly take few minutes to check logistic regression model on youtube. Best regards.
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died alive
TB/HIV+ 16 45
TB/HIV- 17 152
Odds ratio 0.3146
95 % CI: 0.1472 to 0.6722
z statistic 2.985
Significance level P = 0.0028
I totally agree with Amornrat's comments. I think the problem George had with interpreting his result was how he constructed his table. Based on the data he presented, bivariate analysis with chi-squared will give the same result as what Amornrat gave. What George did was to place HIV -ve TB patients on top on the row[left side] to get his result. However, the interpretation will be just the reverse to what Amornrat said: That HIV -ve TB patients are x3 LESS likely to die than HIV +ve TB patients.
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Can panel data be applied to biostatisics? If yes then
How do i apply panel data to the management of TB and TB with HIV co-infection?
Thanks
Dear Dr Balogun,
It's clear now. If you take n number of patients with HIV and TB and give them ATT with ART and follow them over time, you can do 2 types of measurements . some of these can be measured every month , like weight gain, change in Hb, change in CD4 counts , change in plasma viral load etc. For these you can come to multiple points of data and possibly use one,of the tests for repeated measures.
However, the primary end points llik cure rate, relapse rate, failure to respond, IRIS rate etc have,to be measured after a predefined time interval. For them you will have to use normal ratios and maybe chi square tests.
Panel data would not directly be useful here. Yes, you can look at the trends of some of the,earlier parameters that you are measuring andtry to see if they can predict any of the key end points.
Hope it helps.
Regards
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Dear valuable Colleagues,
One colleague of mine is doing an experiment on a new diagnostic test of pulmonary TB. First, MTB DNA is extracted from sputum samples, then PCR is performed.
Concerning sputum sample liquefaction procedures,I recognize from literature that NALC may cause loss of some bacilli while repeated discarding of  supernatant throughout the procedure, another point is that most of other chemical liquefaction procedures may induce PCR inhibition, I got an impression that using a physical method (heating or centrifuging) might work better.
He tried heating protocol (at 80*C for 60 mins), however, most of samples remain thick and viscid.
I would be so grateful if you kindly reply me if you have some recommendations concerning sputum liquefaction and MTB concentration procedures. Does centrifuging of the whole sample prior of getting 1 ml to be heated will help? if so what's the recommended speed & time to precipitate TB bacili? Does heating to higher temperature (95'C) or for longer period (90 mins) may facilitate mucus digestion?
Thank you!
NaOH is the best mucolytic agent you can use before DNA extraction.
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implementation experience
Hi, am looking of experiences if TB/HIV surveillance implementation (articles, reports, etc..) in developing countries ?
thank you all for your information
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As we know that the cause of death in HIV positive cases is not HIV infection itself but other infections like TB, so if we can inject the CD4 (total WBC pellet can be used) treated with agents that can eliminate the CCR5 and CXCR4 receptors (which are proteins) from the CD (by using specific enzymes) or can bind with them so making them unavailable for HIV, so that we can reduce the chances of secondary bacterial infections, improving the immunity and health status and in terms prolonging the life of Patient. Also we can use this type of specifically treated cells in various diseases (specifically immune deficiency diseases and diseases in animals) to improve the condition of patient. Can we do that?
Thats right sir, this is very primitive idea and have to go a long way  so as to get its applicability. but that doesn't its of no use. everybody is going to say many things are not possible for current time but that would may come true in near future. and i think the reasoning given for the thought already describes its validity and usefulness not only in Tb associated with HIV but also in many other diseases.
and yeah the CD4+ cells will remain useful even after their treatment (reports are there that CD4+ lacking HIV receptors have been seen in some individuals with mutation-naturally)
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Considering the increasing epidemiological burden of TB, especially drug resistant TB, should the old TB sanatoria/TB hospitals (many of which are defunct) be upgraded?
Dear Gyanshankar,
The question and answer are probably different in countries with high or low prevalence and incidence of TB. There is no doubt that the rehabilitated structures could host, isolate, eat, cure and care many patients and together form health actors.
I remember, I was a young pulmonologist thirty years ago in a Sanatorium.
Best Regards.
Jean.
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