The Indian Journal of Tuberculosis - LRS Institute of Tuberculosis ...

INDIAN JOURNAL OF TUBERCULOSIS 63
dose of INH incorporated in a biodegradable
polymer, the levels of the free durg and its major
metabolites, 6 weeks after a single implant, were
similar to those obtained with daily oral administration
of the same dose. Homogenates of liver
and lungs from animals killed after 6 weeks
showed high antimycobacterial activity against M.
Tuberculosis. There were no significant differences
in renal, hepatic and haematological parameters
when sera were tested. Implants did not
cause any local or systemic toxicity.
ASSOCIATION OF PULMONARY TUBERCU-
LOSIS AND HLA IN SOUTH INDIA
V. BRAHMAJOTHI ET AL; TUBERCLE;
1991, 72,123.
Since many of us are exposed to mycobacterial
infection which does not result into disease, it is
suggested that hereditary predisposition may be
responsible for the oncet of disease. To find out
the relationship between disease and genetic factors,
204 patients with smear positive pulmonary
tuberculosis and 404 healthy controls were studied.
It was found that HLA-A10, B8 and DR2
were more frequent among patients than in 404
control subject (p = 0.01). A primary association
of HLA-DR2 in radiologically for advanced,
smear-positive patients has also been identified
(p = 0.001). Thus, HLA-DR2 not only predisposed
for smear-positive disease but also for far
advanced lung lesions. In 152 patients with
smear-negative pulmonary tuberculosis, the frequencies
of HLA-A10 and B8, but not of DR2,
were greater in the control subjects. The study
further revealed other HLA associations (A3,
B12 and DR4) in genetically disparate populations
(caste) unique to them suggesting that genes
linked with the HLA complex might also be significant
in the pathogenesis of tuberculosis. This
study, along with others which have revealed a
HLA-DR2 association in tuberculosis and leprosy,
suggests that the mechanism of immunogenetic
predisposition to these mycobacterial diseases
may be the same.
SUPERVISED OUT-PATIENT TERATMENT
OF TUBERCULOSIS: EVALUATION OF A
SOUTH AFRICAN RURAL PROGRAMME
M.S. WESTAWAY ET AL; TUBERCLE; 1991.
72140.
The paper reports on a supervised out-patient
treatment programme in a predominantly rural
area of South Africa for black TB patients. A 3-
year study covering 454 patients showed treatment
completion rates improving from 88% in
the first year to 94% in the third year. The rate of
default was reduced from 8.5% to 3% over the
same period. The remaining 3% to 4% of the patients
died during the course of treatment. Treatment
supervision, after an initial period of hospitalisation
was for the vast majority of patients,
entrusted to voluntary health workers. The rindings
suggest that supervised out-patient treatment
with community involvement and responsible
participation was successful in achieving the aim
viz. holding and curing TB patients.
DIFFERENTIATION OF MYCOBACTERIUM
TUBERCULOSIS STRAINS BY USE A NON-
RADIO ACTIVE SOUTHERN BLOT HYBRIDI-
ZATION METHOD
BRUCE C. ROSS ET AL; JOURNAL OF IN-
FECTIOUS DISEASES; 1991,163, 904.
Currently, the only means of distinguishing M.
tuberculosis isolates is by phage typing, which is
impractical for most laboratories. Attempts to
develop an alternative approach based on defining
differences in DNA by detecting restriction
fragment length polymorphisms (RFLP) have not
yielded satisfactory results. Moreover, the earlier
attempts used a costly and health hazard radiosotope.
The authors have developed a. non-radioactive
RFLP technique which also differs by using
enzymes that have four base recognition sites
rather than six. Various restriction enzymes such
as Alul, Ddel, Himl, Ndell, Rsal and TaqI were
used to digest genomic DNA. The high molecular
weight fragments were visualized after Southern
blotting with digoxigenin-labelled M. tuberculosis
DNA. Among all the enzymes used, AluI showed
the greatest potential by distinguishing all eight
M. tuberculosis isolates and three type strains
from tuberculosis complex, while enzyme Ndell
distinguished all but two strains. The other enzymes
used in this study were of little help. Thus,
this method is particularly useful where there is a
small amount of species diversity and where the
identity or location of variable regions within the
genome are not known.