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Chanda E. The clinical profile and outcomes of drug resistant tuberculosis in Central Province of Zambia. BMC Infect Dis 2024; 24:364. [PMID: 38556907 PMCID: PMC10983631 DOI: 10.1186/s12879-024-09238-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The emergence of Drug Resistant Tuberculosis (DR-TB) is one of the main public health and economic problems facing the world today. DR-TB affects mostly those in economically productive years and prevents them from being part of the workforce needed for economic growth. The aim of this study was to determine the Clinical Profile and Outcomes of DR-TB in Central Province of Zambia. METHODS This was a retrospective cross sectional study that involved a review of records of patients with confirmed DR-TB who were managed at Kabwe Central Hospital's Multi-Drug Resistant TB (MDR-TB) Ward from the year 2017 to 2021. 183 patients were managed during this period and all were recruited in the study. Data was collected from DR-TB registers and patient files and then entered in SPSS version 22 where all statistical analyses were performed. RESULTS The study revealed that the prevalence of DR-TB among registered TB patients in Central Province was 1.4%. Majority of those affected were adults between the ages of 26 and 45 years (63.9%). The study also found that more than half of the patients were from Kabwe District (60.7%). Other districts with significant number of cases included Kapiri Mposhi 19 (10.4%), Chibombo 12 (6.6%), Chisamba 10 (5.5%), Mumbwa 7 (3.8%) and Mkushi 7 (3.8%). Furthermore, the analysis established that most of the patients had RR-TB (89.6%). 9.3% had MDR-TB, 0.5% had IR-TB and 0.5% had XDR-TB. RR-TB was present in 93.8% of new cases and 88.9% of relapse cases. MDR-TB was present in 6.2% of new cases and 10% of relapse cases. With regard to outcomes of DR-TB, the investigation revealed that 16.9% of the patients had been declared cured, 45.9% had completed treatment, 6% were lost to follow up and 21.3% had died. Risk factors for mortality on multivariate analysis included age 36-45 years (adjusted odds ratio [aOR] 0.253, 95% CI [0.70-0.908] p = 0.035) and male gender (aOR 0.261, 95% CI [0.107-0.638] p = 0.003). CONCLUSION The research has shown beyond doubt that the burden of DR-TB in Central Province is high. The study recommends putting measures in place that will help improve surveillance, early detection, early initiation of treatment and proper follow up of patients.
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Affiliation(s)
- Evaristo Chanda
- Department of Public Health, Texila American University, Lusaka, Zambia.
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Saikia M, George LS, Unnikrishnan B, Nayak BS, Ravishankar N. Thirty years of emotional intelligence: A scoping review of emotional intelligence training programme among nurses. Int J Ment Health Nurs 2024; 33:37-51. [PMID: 37772479 DOI: 10.1111/inm.13235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
The stressful environment of any healthcare setting can be detrimental to nurses' mental and emotional health. In recent years, emotional intelligence (EI) has emerged as a vital psychological resource that positively impacts mental and emotional health and improves organizational functioning and success. This scoping review aimed to collate, synthesize and outline the research conducted on EI training programmes among nurses to assess their effectiveness in improving staff nurses' EI. Electronic databases of MEDLINE via PubMed, CINAHL, Scopus, Cochrane, ProQuest, Embase and Web of Science were comprehensively searched for related studies published between 1990 and 2021 (updated in May 2022). Two investigators independently screened the abstracts of the retrieved studies against the inclusion and exclusion criteria. Out of 728 initially retrieved studies, only 7 were included in the final synthesis. The PRISMA-ScR (2018) checklist was used to report the study findings. All the studies included in the review reported a significant improvement in nurses' EI after a training programme. The results also indicate that EI interventions are an effective way to improve nurses' psychological resources (improve resilience and coping skills; reduce anxiety and stress), leadership qualities, job performance and patient experience of nursing care. As nurses are exposed to a wide range of emotions, human pain and suffering, the results of this review suggest that improving the EI skills of nurses through short training programmes is an effective way to maintain their emotional and mental well-being. This scoping review is preregistered in Prospero (CRD42020161084).
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Affiliation(s)
- Monalisa Saikia
- Department of Fundamentals of Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Linu Sara George
- Department of Fundamentals of Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | | | - Baby S Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - N Ravishankar
- Department of Statistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
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Rosu L, Madan J, Bronson G, Nidoi J, Tefera MG, Malaisamy M, Squire BS, Worrall E. Cost of digital technologies and family-observed DOT for a shorter MDR-TB regimen: a modelling study in Ethiopia, India and Uganda. BMC Health Serv Res 2023; 23:1275. [PMID: 37980524 PMCID: PMC10657602 DOI: 10.1186/s12913-023-10295-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND In 2017, the WHO recommended the use of digital technologies, such as medication monitors and video observed treatment (VOT), for directly observed treatment (DOT) of drug-susceptible TB. The WHO's 2020 guidelines extended these recommendations to multidrug-resistant tuberculosis (MDR-TB), based on low evidence. The impact of COVID on health systems and patients underscored the need to use digital technologies in the management of MDR-TB. METHODS A decision-tree model was developed to explore the costs of several potential DOT alternatives: VOT, 99DOTS (Directly-observed Treatment, Short-course) and family-observed DOT. Assuming a 9-month, all-oral regimen (as evaluated within the STREAM trial), we constructed base-case cost models for the standard-of-care DOTs in Ethiopia, India, and Uganda, as well as for the three alternative DOT approaches. The models were populated with STREAM Stage 2 clinical trial outcome and cost data, supplemented with market prices data for the digital DOT strategies. Sensitivity analyses were conducted on key parameters. RESULTS Modelling suggested that the standard-of-care DOT approach is the most expensive DOT strategy from a societal perspective in all three countries evaluated (Ethiopia, India, Uganda), with considerable direct- and indirect-costs incurred by patients. The second most expensive DOT approach is VOT, with high health-system costs, largely caused by up-front technology expenditure. Each of VOT, 99DOTS and family-observed DOT would reduce by more than 90% patients' direct and indirect costs compared to standard of care DOT. Results were robust to the sensitivity analyses. CONCLUSIONS While data on the costs and efficacy of alternative DOT approaches in the context of shorter MDR-TB treatment is limited, our modelling suggests alternative DOT approaches can significantly reduce patient costs in all three countries. Health system costs are higher for VOT and lower for 99DOTS and family-observed therapy when compared to standard of care DOT, as low smartphone penetration and internet availability requires the VOT health system to fund the cost of making them available to patients.
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Affiliation(s)
- Laura Rosu
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Jason Madan
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Jasper Nidoi
- Makerere University Lung Institute, Kampala, Uganda
| | - Mamo G Tefera
- Addis Ababa Science and Technology University, Addis Ababa, Ethiopia
| | | | - Bertel S Squire
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Eve Worrall
- Liverpool School of Tropical Medicine, Vector Biology Department, Liverpool, UK
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Iruedo JO, Pather MK. Time-to-Treatment Initiation in a Decentralised Community-Care Model of Drug-Resistant Tuberculosis Management in the OR Tambo District Municipality of South Africa. Int J Environ Res Public Health 2023; 20:6423. [PMID: 37510655 PMCID: PMC10379855 DOI: 10.3390/ijerph20146423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Drug-resistant tuberculosis (DR-TB) continues to challenge global efforts toward eradicating and having a tuberculosis-free world. Considering the high early mortality, especially among HIV-infected individuals, early diagnosis and prompt initiation of effective treatment are needed to significantly reduce mortality and halt transmission of DR-TB in the community. AIM This study aims to assess the effectiveness of a community DR-TB care model with the specific objective of determining the Time-to-treatment initiation of DR-TB among patients in the OR Tambo district municipality. METHODS A prospective cohort study of patients with DR-TB was conducted in the OR Tambo district municipality of Eastern Cape Province, South Africa. Patients were enrolled as they presented for treatment initiation at the decentralised facilities following a diagnosis of DR-TB and compared with a centralised site. RESULTS A total of 454 DR-TB patients from six facilities between 2018 and 2020 were included in the analysis. The mean age was 37.54 (SD = 14.94) years. There were slightly more males (56.2%) than females (43.8%). Most of the patients were aged 18-44 years (67.5%), without income (82.3%). Results showed that slightly over thirteen percent (13.4%) of patients initiated treatment the same day they were diagnosed with DR-TB, while 36.3% were on the time-to-treatment target of being initiated within 5 days. However, about a quarter (25.8%) of patients failed to initiate treatment two weeks after diagnosis. Time-to-treatment initiation (TTTI) varied according to the decentralised sites, with progressive improvement with each successive year between 2018 and 2021. No demographic factor was significantly associated with TTTI. CONCLUSION Despite rapid diagnosis, only 36% of patients were initiated on treatment promptly. Operational challenges remained, and services needed to be reorganised to maximise the exceptional potentials that a decentralised community DR-TB care model brings.
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Affiliation(s)
- Joshua Oise Iruedo
- Division Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Michael K Pather
- Division Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7602, South Africa
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Choi H, Mok J, Ae Kang Y, Jeong D, Kang HY, Kim HJ, Kim HS, Jeon D. Retreatment after loss to follow-up reduces mortality in patients with multidrug/rifampicin-resistant tuberculosis. ERJ Open Res 2023; 9:00135-2023. [PMID: 37583964 PMCID: PMC10423986 DOI: 10.1183/23120541.00135-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/22/2023] [Indexed: 08/17/2023] Open
Abstract
Background This study evaluated the risk factors of long-term mortality in patients with multidrug/rifampicin-resistant tuberculosis (MDR/RR-TB) in South Korea who were lost to follow-up (LTFU). Methods This was a retrospective longitudinal follow-up study using an integrated database constructed by data linkage of the three national databases, which included 7226 cases of MDR/RR-TB notified between 2011 and 2017 in South Korea. Post-treatment outcomes of patients who were LTFU were compared with those of patients who achieved treatment success. Results Of the 7226 MDR/RR-TB cases, 730 (10.1%) were LTFU. During a median follow-up period of 4.2 years, 101 (13.8%) of the LTFU patients died: 25 deaths (3.4%) were TB related and 76 (10.4%) were non-TB related. In the LTFU group, the adjusted hazard ratio (aHR) of all-cause mortality (aHR 2.50, 95% CI 1.99-3.15, p<0.001), TB-related mortality (aHR 5.38, 95% CI 3.19-9.09, p<0.001) and non-TB-related mortality (HR 2.21, 95% CI 1.70-2.87, p<0.001) was significantly higher than that in the treatment success group. Independent risk factors for all-cause mortality in the LTFU group were age >55 years, fluoroquinolone resistance, cancer and no retreatment. In the LTFU patients who did not receive retreatment, the risk of non-TB-related mortality (aHR 5.00, 95% CI 1.53-16.37, p=0.008) and consequent all-cause mortality (aHR 2.18, 95% CI 1.08-4.40, p=0.030) was significantly higher than that of patients who received retreatment. Conclusion Non-TB-related mortality was the main cause of death and might be reduced by retreatment in LTFU patients with MDR/RR-TB.
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Affiliation(s)
- Hongjo Choi
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Young Ae Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Dawoon Jeong
- Department of Preventive Medicine, Seoul National University, College of Medicine, Seoul, South Korea
| | - Hee-Yeon Kang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, South Korea
| | - Hee Jin Kim
- Central Training Institute, Korean National Tuberculosis Association, Seoul, South Korea
| | - Hee-Sun Kim
- Department of Health Policy Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea
| | - Doosoo Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea
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Manyazewal T, Woldeamanuel Y, Getinet T, Hoover A, Bobosha K, Fuad O, Getahun B, Fekadu A, Holland DP, Marconi VC. Patient-reported usability and satisfaction with electronic medication event reminder and monitor device for tuberculosis: a multicentre, randomised controlled trial. EClinicalMedicine 2023; 56:101820. [PMID: 36684395 PMCID: PMC9853306 DOI: 10.1016/j.eclinm.2022.101820] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 01/18/2023] Open
Abstract
Background The success of a tuberculosis digital adherence technology relies on patients' satisfaction with and the usability of the technology. This study aimed to evaluate treatment satisfaction and usability of a digital medication event reminder and monitor (MERM) device for patients with tuberculosis to address the prespecified secondary endpoint of the SELFTB trial. Methods In this multicenter, randomised controlled trial, adults (≥18 years) with new or previously treated, bacteriologically-confirmed, drug-sensitive pulmonary tuberculosis who were eligible to start anti-tuberculosis therapy were recruited from 10 healthcare facilities in Ethiopia. With a computer-generated random number sequence, participants were randomly assigned 1:1 to receive a 15-day tuberculosis medication supply dispensed with an evriMED500® MERM device to self-administer and return every 15 days or the standard in-person DOT. Both arms were followed throughout the standard two-month intensive treatment phase. Treatment was based on the WHO-recommended two-month fixed-dose-combination of first-line anti-tuberculosis drug delivered as a single daily dose (2RHZE). Treatment Satisfaction Questionnaire for Medication version 4 (TSQM 1.4©) was used to measure and compare treatment satisfaction between arms. Adapted System Usability Scale (SUS) was used to assess the usability of the device, with emphasis on ease of use, challenges, benefits, motivation, popularity, and recommendation. The findings were correlated with adherence and clinical endpoints including sputum smear conversion and IsoScreen urine isoniazid test results. This trial is registered with ClinicalTrials.gov, NCT04216420. Findings Between June 2, 2020, and June 15, 2021, 337 patients were screened for eligibility, of whom 109 participants enrolled and completed the satisfaction [control (n = 57) and intervention (n = 52) arms] and usability [intervention arm (n = 52)] questionnaires. TSQM 1.4© geometric mean scores were: Effectiveness 73.25 [geometric standard deviation (GSD) 1.28], Side Effects 100, Convenience 63.31 (GSD 1.45), and Global Satisfaction 77.29 (GSD 1.25). TSQM score was significantly higher in the intervention vs the control: Effectiveness [85.78 vs 63.43, 95% CI 1.35 (1.26-1.45), p < 0.001], Convenience [85.41 vs 48.18, 95% CI 1.77 (1.63-1.93), p < 0.001], and Global Satisfaction [90.19 vs 67.11, 95% CI 1.34 (1.26-1.43), p < 0.001]. There were significant associations between Global Satisfaction and medication adherence (p = 0.017). Average SUS score was 97.45%, which was close to the best imaginable SUS value of 100%. Likelihood to Recommend (LTR) value was ≥9, on a scale of 0-10, for 90.4% of MERM users, yielding higher net promoters. There was no significant association between usability and medication adherence (p = 0.691). Interpretation Our findings suggested that treatment satisfaction scores were superior in the intervention vs control arms and across the domains of Effectiveness, Convenience, and Global Satisfaction. There was excellent usability of the MERM device and a significantly higher number of users likely to promote the device. High tuberculosis burden countries may transform patient-centered care through ongoing evaluation and scale-up of digital health innovations. Funding U.S. National Institute of Health (NIH) Fogarty International Center and National Institute of Allergy and Infectious Diseases (D43 TW009127) and the Emory Center for AIDS Research (P30 AI050409).
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Affiliation(s)
- Tsegahun Manyazewal
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | - Tewodros Getinet
- St. Paul's Hospital Millennium Medical College, School of Public Health, Addis Ababa, Ethiopia
| | - Alison Hoover
- Emory University School of Medicine, Division of Infectious Diseases, Global Health Programs, Atlanta, 30322, Georgia, USA
| | - Kidist Bobosha
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Oumer Fuad
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | | | - Abebaw Fekadu
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | - David P. Holland
- Emory University School of Medicine and Rollins School of Public Health, Atlanta, 30322, Georgia, USA
| | - Vincent C. Marconi
- Emory University School of Medicine and Rollins School of Public Health, Atlanta, 30322, Georgia, USA
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Rahayu SR, Susilastuti MS, Saefurrohim MZ, Azam M, Indrawati F, Supriyono M, Miarso D, Safitri BD, Daniswara S, Merzistya AN, Amilia R, Affandi MD, Wahidah N, Isbandi, Wandastuti AD, Laila AK, Muflikhah Z. Lost to Follow-Up among Tuberculosis Patients during the Public-Private Mix Era in Rural Area of Indonesia. Ethiop J Health Sci 2023; 33:115-122. [PMID: 36890941 PMCID: PMC9987293 DOI: 10.4314/ejhs.v33i1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Indexed: 03/10/2023] Open
Abstract
Background Indonesia's national Tuberculosis (TB) strategy is public-private mix (PPM). The PPM aims to treat patients who have lost sight during TB treatment as these patients are TB carriers and at risk of transmitting TB. The purpose of this study was to identify predictive factors for loss to follow-up (LFTU) among TB patients receiving treatment when the PPM was at place in Indonesia. Methods The design of this study was a retrospective cohort study. The data used in this study was sourced from the Tuberculosis Information System (SITB) of Semarang which was recorded routinely during 2020-2021. Univariate analysis, crosstabulation, and logistic regression were performed on 3434 TB patients meeting the minimum variables. Results The participation of health facilities in reporting TB during the PPM era in Semarang reached 97.6% consisting of 37 primary healthcare center (100%), 8 public hospitals (100%), 19 private hospitals (90.5%), and a community-based pulmonary health center (100%). The regression analysis reveal that the predictive factors of LTFU-TB during the PPM are the year of diagnosis (AOR=1.541; p-value=<0.001; 95% CI=1.228-1.934), referral status (AOR=1.562, p-value=0.007; 95% CI=1.130-2160), healthcare and social security insurance ownership (AOR=1.638; p-value=<0.001; 95% CI=1.263-2.124), drugs source (AOR=4.667; p-value=0.035; 95% CI=1.117-19.489). Conclusions The PPM strategy in dealing with LTFU patients should focus on TB patients without Healthcare and Social Security Insurance and who receive TB treatment rather than program drugs.
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Affiliation(s)
- Sri R Rahayu
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
| | | | - Muhamad Z Saefurrohim
- Semarang City Health Office, Semarang, Indonesia.,Master of Public Health, Postgraduate, Universitas Negeri Semarang, Indonesia
| | - Mahalul Azam
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
| | - Fitri Indrawati
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
| | | | - Dani Miarso
- Semarang City Health Office, Semarang, Indonesia
| | | | | | - Aufiena Na Merzistya
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
| | - Rizqi Amilia
- Gadjah Mada University Academic Hospital, Yogyakarta
| | - Mustafa D Affandi
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
| | - Nur Wahidah
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
| | - Isbandi
- Master of Public Health, Postgraduate, Universitas Negeri Semarang, Indonesia
| | - Anggun D Wandastuti
- Master of Public Health, Postgraduate, Universitas Negeri Semarang, Indonesia
| | - Annisa K Laila
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
| | - Zuyyinatun Muflikhah
- Public Health Department, Sport Science Faculty, Universitas Negeri Semarang, Indonesia
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Memani B, Beko B, Dumile N, Mohr-Holland E, Daniels J, Sibanda B, Damse Z, Scott V, von der Heyden E, Pfaff C, Reuter A, Furin J. Causes of loss to follow-up from drug-resistant TB treatment in Khayelitsha, South Africa. Public Health Action 2022; 12:55-57. [PMID: 35734003 PMCID: PMC9176197 DOI: 10.5588/pha.21.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/22/2022] [Indexed: 01/24/2023] Open
Abstract
Patients initiated on drug-resistant TB(DR-TB) treatment in 2019 in Khayelitsha, South Africa, with a loss to follow-up outcome were evaluated to better understand reasons for loss to follow-up and to determine if any had returned to care. Of a total of 187 patients, 28 (15%) were lost to follow-up (LTFU), 24 (86%) of whom were traced: 20/24 (83%) were found when they re-presented to facilities and 8/28 (29%) were linked back to DR-TB care. People with DR-TB continue to seek care even after being LTFU; thus better coordination between different components of the healthcare system are required to re-engage with these patients. Interventions to mitigate the socio-economic challenges of people on DR-TB treatment are needed. Many people who were LTFU and symptomatic were willing to re-engage with DR-TB care, which highlights the importance of for compassionate interventions to welcome them back.
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Affiliation(s)
- B. Memani
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - B. Beko
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - N. Dumile
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - E. Mohr-Holland
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
, MSF Southern Africa Medical Unit, Cape Town, South Africa
| | - J. Daniels
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - B. Sibanda
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - Z. Damse
- City of Cape Town Department of Health, Eastern Area, Cape Town, South Africa
| | - V. Scott
- City of Cape Town Department of Health, Eastern Area, Cape Town, South Africa
| | | | - C. Pfaff
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - A. Reuter
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - J. Furin
- Harvard Medical School, Boston, MA, USA
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Ghia CJ, Rambhad GS. Systematic review and meta-analysis of comorbidities and associated risk factors in Indian patients of community-acquired pneumonia. SAGE Open Med 2022; 10:20503121221095485. [PMID: 35509959 PMCID: PMC9058354 DOI: 10.1177/20503121221095485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 03/31/2022] [Indexed: 11/23/2022] Open
Abstract
Objective: Comorbidities and risk factors have a major implication on incidence, complications, mortality, and management of community-acquired pneumonia complications and treatment outcomes. This study attempts to identify the same in the Indian population through a systematic review and meta-analysis. Methods: We screened observational studies (between January 1990 and February 2021) that reported potential comorbidities and other factors associated with increased risk of community-acquired pneumonia in the Indian population (⩾12 years) using PubMed, Google Scholar, and manual search. The risk of bias was identified using the Joanna Briggs Institute checklist for prevalence studies. Meta-analysis was conducted by using the random intercept logistic regression model. Results: Twenty-three studies were included in this analysis. The most prevalent comorbidities were chronic obstructive pulmonary disease (24.2%; 95% confidence interval: 16.4%–34.2%), hypertension (23.7%; 95% confidence interval: 13.6%–38.1%), and diabetes mellitus (16%; 95% confidence interval: 9.9%–24.7%). The prevalence of community-acquired pneumonia was high in patients with a current or previous history of smoking (51.4%; 95% confidence interval: 42.3%–61%) and advanced age ⩾50 years: (55.8%; 95% confidence interval: 48.4%–62%). Conclusions: Comorbid conditions like chronic obstructive pulmonary disease, hypertension, and diabetes mellitus and factors like advanced age and smoking history were common risk factors for community-acquired pneumonia in the Indian population.
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