Tuberculosis Research and Treatment最新文献

{"title":"The Presence of Cough and Tuberculosis: Active Case Finding Outcomes in the Philippines","authors":"SiWon Lee, L. Lau, K. Lim, Jansel Ferma, Warren Dodd, D. Cole","doi":"10.1155/2019/4578329","DOIUrl":"https://doi.org/10.1155/2019/4578329","url":null,"abstract":"The results of a tuberculosis (TB) active case finding (ACF) program, implemented by International Care Ministries (ICM) in the Philippines, were examined to understand how the presence of physical symptoms might influence ACF outcomes among extreme low-income Filipinos. ICM health staff implemented symptom screening in villages and suspected cases were referred to the closest rural health unit (RHU) for TB testing. ACF was carried out in Mindanao and the Visayas, across 16 different provinces. All participants were interviewed pre/postprogram, and screening outcomes were collected. A multilevel regression model was constructed to explore the effect of factors on the likelihood of getting tested. A total of 4635 individuals were screened; 1290 (27.8%) were symptom positive and referred. From those referred, 336 (7.2%) were tested for TB and 53 (1.1%) were TB positive. “Cough for more than two weeks” was associated with a 1.09 (95% CI 1.01, 1.15) times increase in likelihood of getting tested. The finding that the presence of cough is associated with higher rate of testing suggests that individuals in these settings might not know or believe that the lack of cough does not equate to lack of TB infection. While technologies and screening algorithms give us the ability to refine the ‘supply' side of the TB screening, addressing the knowledge gap should improve ‘demand'.","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/4578329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446774","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":"Community Contribution to Tuberculosis Care in the Krachi West District of Ghana: A Qualitative Study.","authors":"Samuel Agbenyegah Addy,&nbsp;Eric Osei,&nbsp;Joyce Komesuor,&nbsp;Evelyn Acquah,&nbsp;Prince Justin Anku,&nbsp;Elvis Enowbeyang Tarkang,&nbsp;Farrukh Ishaque Saah,&nbsp;Hubert Amu","doi":"10.1155/2019/5039197","DOIUrl":"https://doi.org/10.1155/2019/5039197","url":null,"abstract":"<p><strong>Background: </strong>Eradicating tuberculosis (TB) is one of the targets of the recently constituted Sustainable Development Goal (SDG) Three. In the light of limitations inherent in prevailing tuberculosis care and the global urgency to improve TB care, decentralising TB care beyond health facilities by harnessing the contribution of communities is essential in ensuring effective tuberculosis care. In this paper, we explored community contribution to TB care in the Krachi West District of Ghana.</p><p><strong>Methods: </strong>In this qualitative study, 24 TB stakeholders made up of 7 health workers, 9 tuberculosis patients, 4 community health volunteers, 2 treatment supporters, and 2 opinion leaders were interviewed. Data collected were analysed manually, but thematically. Statements of the participants were presented as quotes to substantiate issues discussed.</p><p><strong>Results: </strong>Community contribution to TB care was low. Most of the community members were not aware of any community level activity towards tuberculosis care. Though patients were mainly the ones responsible for the selection of their treatment supporters, there were instances where health workers selected supporters for them without their consent. Some treatment supporters were also not given any education concerning their roles in supporting their patients, resulting in some patients defaulting treatment and others taking their medications wrongfully.</p><p><strong>Conclusion: </strong>Our study revealed low community involvement in tuberculosis care in the Krachi West District of Ghana. Community sensitisation on the World Health Organisation's Directly Observed Treatment Strategy (which Ghana adopted in 1994) to increase community involvement in tuberculosis activities is, therefore, recommended.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2019 ","pages":"5039197"},"PeriodicalIF":0.0,"publicationDate":"2019-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5039197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41214676","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":"Characteristics and Treatment Outcomes of “Transfer Out” TB Patients after Crosschecking Registers at Four Hospitals of Tigray Regional State, Ethiopia: 2011-2015","authors":"Haftamu Hailekiros, M. A. Mahmud, Alemayehu Bayray Kahsay","doi":"10.1155/2019/1761694","DOIUrl":"https://doi.org/10.1155/2019/1761694","url":null,"abstract":"Globally, transferring TB patients to another health unit for treatment continuation is common trend while posing challenges for proper treatment outcomes monitoring. National guidelines indicated the importance of incorporating the treatment outcomes of those cases by the transferring unit when performing annual cohort analysis. However, in most instances, this is not taken into account. This study was conducted to determine the characteristics and treatment outcomes of ‘transfer out' TB cases during the time period between 2011 and 2015 at four Hospitals of Tigray: Ethiopia. Initial data was extracted from TB treatment logbooks of transferring units using standardize checklist that were followed by a visit to each of the receiving units. The generated data were entered and analyzed using SPSS v. 22.0. Descriptive statistics were computed. P-value less than 0.05 were considered statistically significant. A total of 143 TB patients were transferred out during the specified time period whereas 73.4% (105/143) patients were traced and classified as “arrivals”. From these, more than three-quarters, 87.6% (92/105), of patients had a successful treatment outcome (5.7% cured and 81.9% completed treatment) while 13/105 (12.3%) had an unsuccessful outcome (2.8% defaulted, 5.7% died, 1.9% failed, and 1.9% transferred out). However, none of the transferring unit received and traced status of the cases. Therefore, regular monitoring is needed to improve the existing communication gap.","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1761694","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43737771","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":"Risk Factors of Gout in MDR-TB Patients in Eritrea: A Case-Control Study.","authors":"Mulugeta Russom,&nbsp;Hager Tesfaselassie,&nbsp;Rozina Goitom,&nbsp;Tadese Ghirmai,&nbsp;Freweini Weldedhawariat,&nbsp;Abiel Berhe,&nbsp;Dawit Tesfai,&nbsp;Merhawi Debesai,&nbsp;Tesfit Berhane,&nbsp;Henok G Woldu","doi":"10.1155/2019/9429213","DOIUrl":"https://doi.org/10.1155/2019/9429213","url":null,"abstract":"<p><p>Though the incidence of gout in general population is less than 5% (globally), a study conducted in Eritrea among patients with multidrug resistant tuberculosis (MDR-TB) revealed a higher incidence (25%). Other similar studies conducted elsewhere, however, did not report gout as an adverse effect. It is unknown why a higher incidence of gout is being reported in Eritrea compared to similar studies from other countries. The objective of this study is therefore to explore risk factors for the increased risk of incident gout among MDR-TB patients in Eritrea. A case-control study was conducted in Merhano MDR-TB National Referral Hospital in Eritrea. All MDR-TB patients diagnosed with gout between June 2011 and June 2018 were considered as cases. Controls matched by age, sex, and cumulative drug exposure time were selected from the same study population (1:1 ratio). A total of 84 MDR-TB patients, 42 cases and 42 controls, were included in this study. No patient from the control group has comorbidities, while six patients from the case group have diabetes (<i>χ</i>2 = 6.46, df=1, p=0.026). Patients having tachycardia (OR=3.26, 95% CI=1.28, 8.27), alopecia (OR=3.11, 95% CI=1.00, 9.67), and gastrointestinal upset (OR=3.17, 95% CI=1.26, 7.96) as adverse effects and being on prolonged use of propranolol (OR=3.26, 95% CI=1.28, 8.27) were found to be more likely to develop incident gout compared to their controls. In conclusion, MDR-TB patients with diabetes mellitus, tachycardia, alopecia, and gastrointestinal upset and on prolonged use of propranolol tablet had increased risk of incident gout.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2019 ","pages":"9429213"},"PeriodicalIF":0.0,"publicationDate":"2019-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9429213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37103003","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":"Perceived Stigma and Associated Factors among Patient with Tuberculosis, Wolaita Sodo, Ethiopia: Cross-Sectional Study.","authors":"Bereket Duko,&nbsp;Asres Bedaso,&nbsp;Getinet Ayano,&nbsp;Zegeye Yohannis","doi":"10.1155/2019/5917537","DOIUrl":"https://doi.org/10.1155/2019/5917537","url":null,"abstract":"Background Tuberculosis is a historically stigmatized disease and the stigma associated with it affects the institution, community, and interpersonal factors. Therefore, understanding tuberculosis-related perceived stigma has importance in improving quality of the patients. Objective The aim of this study was to assess prevalence and factors associated with perceived stigma among patients with tuberculosis attending Wolaita Sodo University Referral Hospital, Ethiopia. Methods Institution based cross-sectional study was conducted among a total of 417 tuberculosis patients who had treatment follow-up at TB clinics and were recruited for the study. Systematic random sampling technique was used to recruit study participants. A 12-item perceived TB stigma scale was used to assess tuberculosis-related perceived stigma. In addition, Oslo social support scale was used to assess social support related factors. Results Prevalence of tuberculosis-related perceived stigma by using perceived tuberculosis stigma scale was 42.4%. Patients who had pulmonary TB [AOR=2.49, (95% CI: 1.24, 4.87)], being intensive phase category [AOR=1.42, (95% CI: 1.19, 2.58)], TB/HIV coinfection [AOR= 3.54, (95% CI: 1.37, 9.12)], poor social support [AOR=2.45, (95% CI: 1.18, 5.09)], and using substance (alcohol, khat and cigarette) [AOR=1.78, (95% CI: 1.28, 3.17)] were more likely to have perceived TB stigma when compared to their counter parts. Conclusion Health education programs should be conducted to reduce TB stigma and improve patients' compliance.","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2019 ","pages":"5917537"},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5917537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37318665","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 at Farmer-Cattle Interface in the Rural Villages of South Gondar Zone of Northwest Ethiopia","authors":"Amir Alelign, A. Zewude, B. Petros, G. Ameni","doi":"10.1101/605154","DOIUrl":"https://doi.org/10.1101/605154","url":null,"abstract":"Background Tuberculosis (TB) has been an important public health concern in Ethiopia, particularly at areas of human-animal intersection. However, limited epidemiological information is available in this respect in the country. Therefore, the present study was conducted to investigate the transmission of TB at human-cattle interface, associated risk factors and public awareness about the disease at South Gondar Zone, northwest Ethiopia. Methods A cross sectional study was conducted between March 2015 and April 2018 on 186 farmers and 476 cattle in South Gondar Zone, northwest Ethiopia. Bacteriological examination, region of difference (RD) 9 based polymerase chain reaction (PCR), single intradermal comparative tuberculin test (SIDCTT) and questionnaire were used for undertaking this study. Results Culture positivity in farmers was 59.7% (111/186) and all the culture positive isolates were M. tuberculosis. About 68% (74/111) of culture positive respondents did not know about the transmission of TB from cattle to human or vice versa. The animal and herd prevalence of bovine TB were 1.5% (7/476) and 7.4% (7/95) respectively. The odd of bovine TB in cattle owned by TB positive households was slightly higher than those owned by TB free households (adjusted odds ratio, AOR=1.39; 95% CI: 0.31-7.10; p = 0.76). Conclusion Although SIDCTT reactivity was slightly higher in cattle owned by TB positive households, all the human isolates were M. tuberculosis and no M. bovis was isolated from farmers, which could be due to the low prevalence of bovine TB in the area.","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43933881","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":"Diagnostic Yield of Fluorescence and Ziehl-Neelsen Staining Techniques in the Diagnosis of Pulmonary Tuberculosis: A Comparative Study in a District Health Facility.","authors":"Eben Godsway Dzodanu,&nbsp;Justice Afrifa,&nbsp;Desmond Omane Acheampong,&nbsp;Isaac Dadzie","doi":"10.1155/2019/4091937","DOIUrl":"https://doi.org/10.1155/2019/4091937","url":null,"abstract":"<p><strong>Background: </strong>Despite the recent advancement in diagnostic methods, the smear microscopy remains the gold standard for the diagnosis of pulmonary tuberculosis in high burden countries like Ghana. Notwithstanding, fluorescence staining technique provides a more efficient option for the detection of <i>Mycobacterium tuberculosis</i> positive smears. This study therefore aimed at assessing the diagnostic performance of fluorescence microscopy (FM) and Ziehl-Neelsen (ZN) staining techniques in the diagnosis of pulmonary tuberculosis.</p><p><strong>Methods: </strong>A comparative study was carried out on 100 patients who reported at the Out Patients Department (OPD) or the Directly Observed Therapy (DOT) center of the Kade Government Hospital and were suspected of having pulmonary tuberculosis. Two (2) sputum samples each were collected. This included one spot and one morning sample. The smears were prepared and stained with FM and ZN staining techniques. Xpert MTB/RIF assay was also performed.</p><p><strong>Results: </strong>Of the 200 samples analyzed, 71 (35.5%), 46 (23.0%), and 84 (42.0%) were positive for pulmonary tuberculosis when FM, ZN, and XPERT MTB/RIF assays were used, respectively. The mean reading time of FM was three times faster than the ZN technique with very good acceptance (1.5min: 4.6min). The sensitivity and specificity of fluorescent staining to that of XPERT MTB/RIF assay were 84.5% and 100%, respectively, while those of ZN staining were 54.8% and 100%, respectively.</p><p><strong>Conclusion: </strong>For a routine laboratory test in a resource-limited setting, our study has demonstrated that fluorescence staining technique is a more sensitive test for the diagnosis of pulmonary tuberculosis as compared to the conventional ZN technique.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2019 ","pages":"4091937"},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/4091937","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37407543","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 Treatment Outcomes and Associated Factors among TB Patients Attending Public Hospitals in Harar Town, Eastern Ethiopia: A Five-Year Retrospective Study.","authors":"Assefa Tola,&nbsp;Kirubel Minsamo Minshore,&nbsp;Yohanes Ayele,&nbsp;Abraham Nigussie Mekuria","doi":"10.1155/2019/1503219","DOIUrl":"https://doi.org/10.1155/2019/1503219","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis remains a major public health threat throughout the world particularly in developing countries. Evaluating the treatment outcome of tuberculosis and identifying the associated factors should be an integral part of tuberculosis treatment.</p><p><strong>Objectives: </strong>The aim of this study was to assess the treatment outcome of tuberculosis and its associated factors among TB patients in the TB clinics of Harar public hospitals, Eastern Ethiopia, 2017.</p><p><strong>Methods: </strong>A retrospective document review was conducted in two public hospitals of Harar town, located 516 km east of Addis Ababa. A systematic random sampling technique was used to select the document of TB patients who were registered in the hospitals from 1st of January, 2011, to 30th of December, 2015. The data were collected using a pretested structured data extraction format. SPSS Version 21 for window was used for data processing. Bivariate and multivariate analysis with 95% confidence interval was employed in order to infer the associations between TB treatment outcome and potential predictor variables.</p><p><strong>Results: </strong>One thousand two hundred thirty-six registered TB patients' documents were reviewed. Of these, 59.8% were male, 94.2% were urban dwellers, 97% were new cases, 61.2% were presented with pulmonary TB, and 22.8% were HIV positive. Regarding the treatment outcome, 30.4% were cured, 62.1% completed their treatment, 3.9% died, 2.4% were defaulted, and the remaining 1.2% had failed treatment. The overall rate of the treatment success among the patients was 92.5%. In the present study, being female (AOR = 1.89, 95% CI: 1.14 - 3.14), having pretreatment weight of 20 - 29 kg (AOR = 11.03, 95% CI: 1.66 - 73.35), being HIV negative (AOR = 6.50, 95% CI: 3.95 - 10.71), and being new TB patient (AOR = 3.22 95% CI: 1.10 - 9.47) were factors independently associated with successful treatment outcome. On the other hand, being in the age group 54 - 64 years (AOR =10.41, 95% CI: 1.86 - 58.30) and age greater than 65 years (AOR =24.41, 95% CI: 4.19 - 142.33) was associated with unsuccessful TB treatment outcome.</p><p><strong>Conclusion: </strong>In the current study, the rate of successful TB treatment outcome was acceptable. This rate should be maintained and further improved by designing appropriate monitoring strategies.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2019 ","pages":"1503219"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1503219","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37216474","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":"The Proportion of Student Tuberculosis Cases and Treatment Outcome at Jimma University Medical Center: 5-Year Retrospective Study (11 Sep. 2010-10 Sep. 2015).","authors":"Hiwot Tibebu,&nbsp;Habtemu J Hebo","doi":"10.1155/2019/4597154","DOIUrl":"https://doi.org/10.1155/2019/4597154","url":null,"abstract":"<p><strong>Background: </strong>University students are highly congregated at classroom and residence (dormitory) which offer a special risk to exposure and transmission of tuberculosis. In Ethiopia, the number of students joining universities is increasing from time to time though infrastructure of the universities has not kept pace with this increment. However, compiled reports on the magnitude and trend of tuberculosis in the higher education institutions of Ethiopia are limited.</p><p><strong>Objective: </strong>This study was designed to determine the five years (Sep. 2010 to Sep. 2015) trend of the proportion of student tuberculosis cases and treatment outcome at Jimma University Medical Center.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Jimma University Medical Center. A total of 347 students from Jimma University who were registered and treated at Tuberculosis Clinic of Jimma University Medical Center were included in this study. Data were collected by record review using checklist prepared in English. Data were entered into EpiData and cleaned and analyzed by SPSS 20.</p><p><strong>Results: </strong>The mean proportion of student tuberculosis cases among total adult tuberculosis cases was 29.71% (347/1168). The mean proportion of student tuberculosis cases among the total students enrolled was nearly 0.38% (347/92,004). More than three-fourths (76.37% (265/347)) were male. Pulmonary tuberculosis accounted for 72.62% (252/347) and 54.40% (137/252) of these were smear-positive. Eight cases were positive for Human Immunodeficiency Virus. More than four-fifths (281/347) were new cases. The highest proportion (37.62%) was observed in 2010/11 while the lowest (12.03%) was observed in 2012/13. The proportion of tuberculosis dramatically decreased in the third year and significantly increased again in the last two years. Regarding treatment outcome, 98.75% (316/347) had successful treatment outcome (61.71% treatment completed; 38.29% cured). Four cases were defaults and there was not any death.</p><p><strong>Conclusion: </strong>The five years' mean proportion of student tuberculosis cases among the total students enrolled was high in this study. However, the treatment success rate was better than the report of previous studies. Therefore, governmental and nongovernmental organizations concerned with tuberculosis must consider universities as focal points for the prevention and control of tuberculosis in Ethiopia.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2019 ","pages":"4597154"},"PeriodicalIF":0.0,"publicationDate":"2019-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/4597154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37277601","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":"Predictors of Treatment Outcomes among Multidrug Resistant Tuberculosis Patients in Tanzania.","authors":"Tamary Henry Leveri,&nbsp;Isack Lekule,&nbsp;Edson Mollel,&nbsp;Furaha Lyamuya,&nbsp;Kajiru Kilonzo","doi":"10.1155/2019/3569018","DOIUrl":"https://doi.org/10.1155/2019/3569018","url":null,"abstract":"<p><strong>Background: </strong>According to World Health Organization (WHO) the final multidrug resistant tuberculosis (MDRTB) treatment outcome is the most important direct measurement of the effectiveness of the MDRTB control program. Literature review has shown marked diversity in predictors of treatment outcomes worldwide even among the same continents. Therefore, findings could also be different in Tanzanian context, where the success rate is still lower than the WHO recommendation. This study sought to determine the predictors of treatment outcomes among MDRTB patients in Tanzania in order to improve the success rate.</p><p><strong>Methodology: </strong>This was a retrospective cohort study, which was conducted at Kibong'oto Infectious Diseases Hospital (KIDH) in Tanzania. Patients' demographic and clinical parameters were collected from the MDRTB registry and clinical files. Then, a detailed analysis was done to determine the predictors of successful and unsuccessful MDRTB treatment outcomes.</p><p><strong>Results: </strong>Three hundred and thirty-two patients were diagnosed and put on MDRTB treatment during the year 2009 to 2014. Among them, males were 221 (67%), and 317 (95.48%) were above 18 years of age, mean age being 36.9 years. One hundred and sixty-one patients (48.5%) were living in Dar es Salaam. The number of MDRTB patients has increased from 16 in 2009 to 132 in 2014. Majority of patients (75.7%) had successful treatment outcomes. The following predictors were significantly associated with MDRTB cure: presence of cavities in chest X-rays (aOR 1.89, p value 0.002), low BMI (aOR 0.59, p value 0.044), and resistance to streptomycin (aOR 4.67, p value 0.007) and ethambutol (aOR 0.34, p value 0.041). Smoking and presence of cavities in chest X-rays were associated with MDRTB mortality, aOR 2.31, p value 0.043 and aOR 0.55, p value 0.019, respectively.</p><p><strong>Conclusion: </strong>The study indicated that overall number of MDRTB patients and the proportion of successful treatment outcomes have been increasing over the years. The study recommends improving nutritional status of MDRTB patients, widespread antismoking campaign, and close follow-up of patients with ethambutol resistance.</p>","PeriodicalId":30261,"journal":{"name":"Tuberculosis Research and Treatment","volume":"2019 ","pages":"3569018"},"PeriodicalIF":0.0,"publicationDate":"2019-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3569018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37072696","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}