Tuberculosis Research and Treatment最新文献

{"title":"Determinants of Weight Gain among Adult Tuberculosis Patients during Intensive Phase in Debre Markos Town Public Health Facilities, Northwest Ethiopia, 2020: Unmatched Case-Control Study","authors":"B. Meselu, Birhanu Barud Demelie, Tigist Adeb Shedie","doi":"10.1155/2022/6325633","DOIUrl":"https://doi.org/10.1155/2022/6325633","url":null,"abstract":"Background Ethiopia is one of the highest tuberculosis burden countries globally, and tuberculosis is one of the most pressing health problems nationally. Weight gain during treatment is the main indicator of good treatment outcome, but there is no adequate information regarding the factors that affect weight gain in Ethiopia. Objective The objective of this study was to identify determinants of weight gain among adult tuberculosis patients during the intensive phase, in Debre Markos town public health institutions Northwest Ethiopia, 2020. Methods Unmatched case-control study was conducted in Debre Markos town public health facilities with a total sample size of 236. Cases (clients who got weight) and controls (clients who did not get weight) were enrolled in the study consecutively, and data were collected using standardized questionnaires. Data were entered through Epi-Data version 4.2 and exported to SPSS version 25 for analysis. Bivariable analysis was done, and all independent variables that had p < 0.25 were entered into multivariable binary logistic regression analysis. Finally, independent variables which were significantly associated with weight gain at p < 0.05 were considered determinant factors of weight gain. Result Pulmonary tuberculosis (AOR: 5 (95% CI: 2.3, 11.2)), monitoring by health professionals (AOR: 3.7 (1.6, 8.4)), ≥18.5 baseline body mass index (AOR: 3.4 (95% CI: 1.6, 7.3)), parasitic disease (AOR: 3.2 (95% CI: 1.3, 7.99)), <30 days duration of illness before start of treatment (AOR: 2.8 (95% CI: 1.2, 6.1)), and human immune virus/acquired immune deficiency syndrome (AOR: 3.3 (95% CI: 1.2, 9.1)) were independently associated with weight gain compared to their counterpart. Conclusion Type of tuberculosis, monitoring by health professionals, baseline status, parasitic disease, duration of illness before start of treatment, and human immune virus/acquired immune deficiency syndrome were with the determinants of weight gain. Therefore, early detection, support and supervision, and attention for comorbidity are mandatory during antituberculosis treatment.","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2022 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48888279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Questions and Priorities for Pediatric Tuberculosis: A Survey of Published Systematic Reviews and Meta-Analyses.","authors":"Thomas Achombwom Vukugah,&nbsp;Vera Nyibi Ntoh,&nbsp;Derick Akompab Akoku,&nbsp;Simo Leonie,&nbsp;Amed Jacob","doi":"10.1155/2022/1686047","DOIUrl":"https://doi.org/10.1155/2022/1686047","url":null,"abstract":"<p><strong>Background: </strong>Advancing a research agenda designed to meet the specific needs of children is critical to ending pediatric TB epidemic. Systematic reviews are increasingly informing policies in pediatric tuberculosis (TB) care and control. However, there is a paucity of information on pediatric TB research priorities. <i>Methodology</i>. We searched MEDLINE, EMBASE, Web of Science, and the Cochrane Library for systematic reviews and meta-analyses on any aspect related to pediatric TB published between 2015 and 2021. We used the UK Health Research Classification System (HRCS) to help us classify the research questions and priorities. <i>Findings</i>. In total, 29 systematic reviews, with 84 research questions, were included in this review. The four most common research topics in the area of detection were 43.33% screening and diagnosis of TB, 23.33% evaluation of treatments and therapeutic interventions, 13.34% TB etiology and risk factors, and 13.34% prevention of disease and conditions and promotion of well-being. The research priorities focused mainly on evaluating TB diagnosis by improving yield through enhanced in specimen collection or preparation and evaluating of bacteriological TB diagnostic tests. Other topics of future research were developing a treatment for TB in children, assessing the use of IPT in reducing TB-associated morbidity, evaluating the prioritization of an IPT-friendly healthcare environment, and providing additional guidance for the use of isoniazid in the prevention of TB in HIV-infected children.</p><p><strong>Conclusion: </strong>There is a need for more systematic reviews on pediatric TB. The review identified several key priorities for future pediatric TB research mainly in the domain of (1) \"Detection, screening and diagnosis,\" \"Development of Treatments and Therapeutic Interventions,\" and \"Prevention of Disease and Conditions, and Promotion of Well-Being.\" These domains are very relevant in the research component of the roadmap towards ending TB in children. It also will serve as an additional action in the WHO End TB strategy.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":" ","pages":"1686047"},"PeriodicalIF":0.0,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39809852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of <i>Mycobacterium tuberculosis</i> and Rifampicin Resistance Using GeneXpert MTB/RIF Assay at Enat Hospital, Central Ethiopia.","authors":"Sebsib Selfegna,&nbsp;Amir Alelign","doi":"10.1155/2022/1250404","DOIUrl":"https://doi.org/10.1155/2022/1250404","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis remains to be a public health threat in Ethiopia. However, the use of ill diagnostic methods and the lack of enough epidemiological information in the country contributed to the diagnostic delay and development of anti-TB drug resistance. Therefore, the present study is aimed at assessing the prevalence of pulmonary TB (PTB) and the development of drug resistance using GeneXpert MTB/RIF assay in Merhabete district, Central Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional, health facility-based study was conducted from December 2019 to June 2020. Bacteriological examination and GeneXpert molecular diagnostic methods were used for the detection of <i>M</i>. <i>tuberculosis</i> and rifampicin resistance (RR). Descriptive statistics and logistic regression analysis were used to determine the possible association of risk factors with the occurrence of PTB and RR. <i>P</i> values of <0.05 were considered statistically significant.</p><p><strong>Results: </strong>The overall prevalence rates of PTB and RR <i>M</i>. <i>tuberculosis</i> were 11.2% and 15.8%, respectively. The logistic regression analysis revealed that being in the age group of 49-64 years was significantly associated with the occurrence of TB (<i>P</i> = 0.01). The odds of HIV-positive and retreatment study participants to be infected by <i>M</i>. <i>tuberculosis</i> were much more than those of HIV-negative and newly treated cases, respectively (<i>P</i> < 0.05). However, none of the sociodemographic and clinical patient characteristics was significantly associated with the development of RR-TB (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>In the present study, high prevalence rates of PTB and RR <i>M</i>. <i>tuberculosis</i> were observed. The findings, which were attributed to different risk factors, suggested an urgent need for appropriate intervention measures to reduce the transmission of PTB and the development of anti-TB drug resistance in the study area.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":" ","pages":"1250404"},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8789425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39865597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Develop and Predictors for Incidence of Tuberculosis among Children Receiving Antiretroviral Therapy.","authors":"Fassikaw Kebede,&nbsp;Tsehay Kebede,&nbsp;Birhanu Kebede,&nbsp;Abebe Abate,&nbsp;Dube Jara,&nbsp;Belete Negese,&nbsp;Tamrat Shaweno","doi":"10.1155/2021/6686019","DOIUrl":"https://doi.org/10.1155/2021/6686019","url":null,"abstract":"<p><p>Infection by the human immune deficiency virus (HIV) is the strongest risk factor for latent or new infection of tuberculosis (TB) through reduction of CD4 T-lymphocytes and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence of tuberculosis for children living with HIV. Thus, this study assessed time to develop and predictors for incidence of tuberculosis in children attending HIV/AIDS care in public hospitals: North West Ethiopia 2021. <i>Methods</i>. A facility-based retrospective cohort study was conducted among 421 seropositive children on antiretroviral therapy in two hospitals between January 1, 2011 and December 31, 2020. EPI-DATA version 3.2 and STATA/14 software were used for data entry and analysis, respectively. Tuberculosis-free survival time was estimated using the Kaplan-Meier survival curve. Bivariate and multivariable Cox regression model was fitted to identify predictors at a <i>P</i> value <0.05 within 95% CI. <i>Results</i>. In the final analysis, a total of 421 seropositive children were included, of whom, 64 (15.2%) developed tuberculosis at the time of follow-up. The mean (±SD) age of the children was 10.62 ± 3.32 years, with a median (IQR) time to develop TB that was 23.5 (IQR = ±19) months. This study found that the incidence of tuberculosis was 5.9 (95% CI: 4.7; 7.6) per 100 person-years (PY) risk of observation. Cases at baseline not taking cotrimoxazol preventive therapy (CPT) (AHR = 2.5; 95% CI, 1.4-4.7, <i>P</i> < 0.021), being severely stunted (AHR = 2.9: 95% CI, 1.2-7.8, <i>P</i> < 0.03), and having low hemoglobin level (AHR = 4.0; 95% CI, 2.1-8.1, <i>P</i> < 0.001) were found to be predictors of tuberculosis. <i>Conclusion</i>. A higher rate of tuberculosis incidence was reported in our study as compared with previous studies in Ethiopia. Cases at baseline not taking cotrimoxazol preventive therapy (CPT), being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk to developed TB incidence.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2021 ","pages":"6686019"},"PeriodicalIF":0.0,"publicationDate":"2021-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8605917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39761884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycobacterial Lineages Associated with Drug Resistance in Patients with Extrapulmonary Tuberculosis in Addis Ababa, Ethiopia.","authors":"Getu Diriba, Abebaw Kebede, Habteyes Hailu Tola, Ayinalem Alemu, Bazezew Yenew, Shewki Moga, Desalegn Addise, Zemedu Mohammed, Muluwork Getahun, Mengistu Fantahun, Mengistu Tadesse, Biniyam Dagne, Misikir Amare, Gebeyehu Assefa, Dessie Abera, Kassu Desta","doi":"10.1155/2021/5239529","DOIUrl":"10.1155/2021/5239529","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopia, tuberculosis (TB) is one of the most common causes of illness and death. However, there is limited information available on lineages associated with drug resistance among extrapulmonary tuberculosis patients in Ethiopia. In this study, researchers looked into <i>Mycobacterium tuberculosis</i> lineages linked to drug resistance in patients with extrapulmonary tuberculosis in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>On 151 <i>Mycobacterium tuberculosis</i> isolates, a cross-sectional analysis was performed. Spoligotyping was used to characterize mycobacterial lineages, while a phenotypic drug susceptibility test was performed to determine the drug resistance pattern. Data were analyzed using SPSS version 23.</p><p><strong>Results: </strong>Among 151 <i>Mycobacterium tuberculosis</i> complex (MTBC) genotyped isolates, four lineages (L1-L4), and <i>Mycobacterium bovis</i> were identified. The predominantly identified lineage was Euro-American (73.5%) followed by East-African-Indian (19.2%). Any drug resistance (RR) and multidrug-resistant (MDR) tuberculosis was identified among 16.2% and 7.2% of the Euro-American lineage, respectively, while it was 30.8% and 15.4% among the East-African-Indian lineages. Among all three preextensively drug-resistance (pre-XDR) cases identified, two isolates belong to T3-ETH, and the other one strain was not defined by the database. There was no statistically significant association between any type of drug resistance and either lineage or sublineages of <i>Mycobacterium tuberculosis</i>.</p><p><strong>Conclusion: </strong>A higher proportion of any type of drug resistance and MDR was detected among the East-African-Indian lineage compared to others. However, there was no statistically significant association between any type of drug resistance and either lineages or sublineages. Thus, the authors recommend a large-scale study.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2021 ","pages":"5239529"},"PeriodicalIF":0.0,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39470482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes and Associated Factors in Tuberculosis Patients at Atwima Nwabiagya District, Ashanti Region, Ghana: A Ten-Year Retrospective Study.","authors":"Sadick Ahmed Agyare,&nbsp;Francis Adjei Osei,&nbsp;Samuel Frimpong Odoom,&nbsp;Nicholas Karikari Mensah,&nbsp;Ernest Amanor,&nbsp;Charles Martyn-Dickens,&nbsp;Michael Owusu-Ansah,&nbsp;Aliyu Mohammed,&nbsp;Eugene Osei Yeboah","doi":"10.1155/2021/9952806","DOIUrl":"10.1155/2021/9952806","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis poses a great threat to public health around the globe and affects persons mostly in their productive age, notwithstanding; everyone is susceptible to tuberculosis (TB) infection. To assess the effectiveness and performance of the tuberculosis control program activities, the percentage of cases with treatment success outcome is key. To control tuberculosis, interrupting transmission through effective treatment cannot be overemphasized. The study was conducted to determine factors associated with TB treatment outcome, in the Atwima Nwabiagya District from 2007-2017.</p><p><strong>Method: </strong>A Retrospective review of routine/standard TB registers was carried out in five directly observed therapy short-course (DOTS) centres at the Atwima Nwabiagya District from January 2007 to December 2017. Demographic characteristics, clinical characteristics, and treatment outcomes were assessed. Bivariate and multivariate logistic regression was conducted to determine the predictors of successful treatment outcome.</p><p><strong>Results: </strong>Of the 891 TB client's data that was assessed in the district, the treatment success rate was 68.46%. Patients, aged ≤ 20 years (adjusted odds ratio (aOR) = 4.74, 95%CI = 1.75 - 12.83) and 51-60 years (aOR = 1.94, 95%CI = 1.12 - 3.39), having a pretreatment weight of 35-45 kg (aOR = 2.54, 95%CI = 1.32 - 4.87), 46-55 kg (aOR = 2.75, 95%CI = 1.44 - 5.27) and 56-65 kg (aOR = 3.04, 95%CI = 1.50 - 6.14) were associated with treatment success. However, retreatment patients (aOR = 0.31, 95%CI = 0.11 - 0.84) resulted in unsuccessful treatment outcome.</p><p><strong>Conclusion: </strong>Successful treatment outcome among TB patients was about 20.00% and 30.00% lower compared to the national average treatment success rate and WHO target, respectively. Active monitoring, motivation, and counselling of retreatment patients and patients with advanced age are key to treatment success.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2021 ","pages":"9952806"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39265606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity of <i>Mycobacterium tuberculosis</i> Complex Lineages Associated with Pulmonary Tuberculosis in Southwestern, Uganda.","authors":"Lisa Nkatha Micheni,&nbsp;Kennedy Kassaza,&nbsp;Hellen Kinyi,&nbsp;Ibrahim Ntulume,&nbsp;Joel Bazira","doi":"10.1155/2021/5588339","DOIUrl":"https://doi.org/10.1155/2021/5588339","url":null,"abstract":"<p><p>Uganda is among the 22 countries in the world with a high burden of tuberculosis. The southwestern region of the country has consistently registered a high TB/HIV incidence rate. This study is aimed at characterizing the <i>Mycobacterium tuberculosis</i> complex (MTBC) genotypic diversity in southwestern Uganda. A total of 283 sputum samples from patients with pulmonary tuberculosis were genotyped using specific single nucleotide polymorphism markers for lineages 3 and 4. Most of the patients were males with a mean age of 34. The lineage 4 Ugandan family was found to be the most dominant strains accounting for 59.7% of all cases followed by lineage 3 at 15.2%. The lineage 4 non-Ugandan family accounted for 14.5% of all cases while 4.2% showed amplification for both lineage 4 and lineage 3. Eighteen samples (6.4%) of the strains remained unclassified since they could not be matched to any lineage based on the genotyping technique used. This study demonstrates that a wide diversity of strains is causing pulmonary tuberculosis in this region with those belonging to the lineage 4 Ugandan family being more predominant. However, to confirm this, further studies using more discriminative genotyping methods are necessary.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2021 ","pages":"5588339"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39224486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging Informal Private Health Care Providers for TB Case Detection: Experiences from RIPEND Project in India.","authors":"Santosha Kelamane,&nbsp;Srinath Satyanarayana,&nbsp;Sharath Burugina Nagaraja,&nbsp;Vikas Panibatla,&nbsp;Ramesh Dasari,&nbsp;Rajeesham,&nbsp;Amera Khan,&nbsp;Vishnuvardhan Kamineni","doi":"10.1155/2021/9579167","DOIUrl":"https://doi.org/10.1155/2021/9579167","url":null,"abstract":"<p><strong>Background: </strong>Informal (unqualified) health care providers are an important source of medical care for persons with presumptive TB (PPTB) in India. A project (titled RIPEND) was implemented to engage informal providers for the identification of PPTBs and TB patients in 4 districts of Telangana State, India, during October 2018-December 2019 project period. Engagement involved sensitizing the informal providers about TB, providing them financial incentives to identify PPTBs, and linking these PPTBs to diagnostic and treatment services provided by the Government of India's National TB Elimination Programme.</p><p><strong>Objectives: </strong>To describe (a) the characteristics of the informal providers, along with their self-reported practices on TB diagnosis, treatment, and challenges encountered by the RIPEND project staff in engaging them in the project and (b) the outputs and outcomes of this engagement.</p><p><strong>Methods: </strong>We used a combination of one-on-one interviews with informal providers, group interviews with RIPEND project staff, and secondary analysis of data available within the project's recording and reporting systems.</p><p><strong>Results: </strong>A total of 555 informal providers were actively engaged under the project. The majority (87%) had a nonmedicine-related graduate degree and had been providing medical care for more than 10 years. Most (95%) were aware that a cough for 2 weeks or more is a symptom of pulmonary TB and that such patients should be referred for sputum-smear microscopy at a government health facility. Challenges in engaging the informal providers included motivating them to participate in the study, suboptimal mobile usage for referral services, and delays in providing financial incentives to them for referring PPTBs. During the project period (October 2018-December 2019), 8342 PPTBs were identified of which 1003 TB patients were detected and linked to TB treatment services.</p><p><strong>Conclusion: </strong>This project showed that engaging informal providers is feasible and that a large number of PPTB and TB patients can be identified through this effort. The Government of India should consider engaging informal providers for the early diagnosis of TB to reduce the missing TB cases in the country.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2021 ","pages":"9579167"},"PeriodicalIF":0.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8241510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39166362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis Drug Susceptibility, Treatment, and Outcomes for Belarusian HIV-Positive Patients with Tuberculosis: Results from a National and International Laboratory.","authors":"Daria N Podlekareva, Dorte Bek Folkvardsen, Alena Skrahina, Anna Vassilenko, Aliaksandr Skrahin, Henadz Hurevich, Dzmitry Klimuk, Igor Karpov, Jens D Lundgren, Ole Kirk, Troels Lillebaek","doi":"10.1155/2021/6646239","DOIUrl":"10.1155/2021/6646239","url":null,"abstract":"<p><strong>Background: </strong>To cure drug-resistant (DR) tuberculosis (TB), the antituberculous treatment should be guided by <i>Mycobacterium tuberculosis</i> drug-susceptibility testing (DST). In this study, we compared conventional DST performed in Minsk, Belarus, a TB DR high-burden country, with extensive geno- and phenotypic analyses performed at the WHO TB Supranational Reference Laboratory in Copenhagen, Denmark, for TB/HIV coinfected patients. Subsequently, DST results were related to treatment regimen and outcome.</p><p><strong>Methods: </strong>Thirty TB/HIV coinfected patients from Minsk were included and descriptive statistics applied.</p><p><strong>Results: </strong>Based on results from Minsk, 10 (33%) TB/HIV patients had drug-sensitive TB. Two (7%) had isoniazid monoresistant TB, 8 (27%) had multidrug-resistant (MDR) TB, 5 (17%) preextensive drug-resistant (preXDR) TB, and 5 (17%) had extensive drug-resistant (XDR) TB. For the first-line drugs rifampicin and isoniazid, there was DST agreement between Minsk and Copenhagen for 90% patients. For the second-line anti-TB drugs, discrepancies were more pronounced. For 14 (47%) patients, there were disagreements for at least one drug, and 4 (13%) patients were classified as having MDR-TB in Minsk but were classified as having preXDR-TB based on DST results in Copenhagen. Initially, all patients received standard anti-TB treatment with rifampicin, isoniazid, pyrazinamide, and ethambutol. However, this was only suitable for 40% of the patients based on DST. On average, DR-TB patients were changed to 4 (IQR 3-5) active drugs after 1.5 months (IQR 1-2). After treatment adjustment, the treatment duration was 8 months (IQR 2-11). Four (22%) patients with DR-TB received treatment for >18 months. In total, sixteen (53%) patients died during 24 months of follow-up.</p><p><strong>Conclusions: </strong>We found high concordance for rifampicin and isoniazid DST between the Minsk and Copenhagen laboratories, whereas discrepancies for second-line drugs were more pronounced. For patients with DR-TB, treatment was often insufficient and relevant adjustments delayed. This example from Minsk, Belarus, underlines two crucial points in the management of DR-TB: the urgent need for implementation of rapid molecular DSTs and availability of second-line drugs in all DR-TB high-burden settings. Carefully designed individualized treatment regimens in accordance with DST patterns will likely improve patients' outcome and reduce transmission with drug-resistant <i>Mycobacterium tuberculosis</i> strains.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2021 ","pages":"6646239"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38885029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Adherence to Tuberculosis Treatment in the Ketu North District of the Volta Region, Ghana.","authors":"Eyram Dogah,&nbsp;Mark Aviisah,&nbsp;Da-Ama Mawulom Kuatewo,&nbsp;Godsway Edem Kpene,&nbsp;Sylvester Yao Lokpo,&nbsp;Florence Shine Edziah","doi":"10.1155/2021/6685039","DOIUrl":"https://doi.org/10.1155/2021/6685039","url":null,"abstract":"<p><p>Annually, ten million cases of tuberculosis (TB) and about 1.8 million mortalities are recorded. Adherence to TB treatment not only reduces death outcomes but prevents prolonged sickness, transmission to others, and the development of multidrug-resistant TB. This study is aimed at determining the rate of treatment adherence, knowledge of TB infection, and the possible factors influencing adherence to TB treatment in the Ketu North District in the Volta Region of Ghana. A cross-sectional study design was employed. A semistructured questionnaire was used to obtain data from respondents. Adherence to TB treatment and knowledge level about TB infection were assessed. A Chi-square test analysis was used to determine the variables that were associated with treatment adherence. Logistic regression analysis was used to determine potential factors that contribute to treatment adherence. A total of 125 TB registrants were enrolled in the study. The majority (102 (81.6%)) adhered to the TB treatment regimen. However, the level of knowledge about night sweat being a symptom of TB infection was relatively low (78 (62.4%)). Logistic regression analysis revealed that the male gender was about three times more likely (OR = 2.978, 95%CI = 1.173-7.561; <i>p</i> = 0.022) to be associated with adherence to TB treatment. However, food availability (OR = 2.208, 95% CI (0.848-5.753); <i>p</i> = 0.10) and household size (OR = 0.538, 95% CI (0.195-1.483); <i>p</i> = 0.23) were not significantly associated with treatment adherence. In this study, adherence to TB treatment and the knowledge level of TB infection were high. However, the knowledge level of night sweat being a symptom of TB infection was relatively low. Being a male was significantly associated with treatment adherence. An intensified health education on the symptoms of TB infection is therefore recommended.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2021 ","pages":"6685039"},"PeriodicalIF":0.0,"publicationDate":"2021-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38877798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}