Public Health Action最新文献

Impact of Truenat on TB diagnosis in Nigeria. Truenat 对尼日利亚结核病诊断的影响。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0021

R Eneogu, J Olabamiji, A Ihesie, N Nwokoye, K Ochei, P Nwadike, O Salau, Z Munguno, B Odume, A Agbaje, D Nongo, O Oyelaran, W van Germert, L Mupfumi, E Emeka, C Anyaike, E N Ossai

{"title":"Impact of Truenat on TB diagnosis in Nigeria.","authors":"R Eneogu, J Olabamiji, A Ihesie, N Nwokoye, K Ochei, P Nwadike, O Salau, Z Munguno, B Odume, A Agbaje, D Nongo, O Oyelaran, W van Germert, L Mupfumi, E Emeka, C Anyaike, E N Ossai","doi":"10.5588/pha.24.0021","DOIUrl":"10.5588/pha.24.0021","url":null,"abstract":"Objective: To evaluate the impact of Truenat assays on the diagnosis of TB at peripheral facilities in Nigeria.Methods: This was a retrospective cross-sectional study across 34 out of 38 Truenat-implementing facilities in Nigeria. These facilities offer DOTS services. Information on turnaround time (TAT) for TB diagnosis and time to commencement of treatment was obtained. Also, trends in TB case notifications at the facilities 9 months prior to and 9 months during Truenat implementation were compared.Results: Of 2,335 entries, 70.1% (1,636) were used to determine TAT, while 45.8% (n = 1,070) were used for time to treatment initiation. The median time to diagnosis was <24 hours (IQR 0-1 days). The majority (57.9%) were diagnosed in <24 hours. The median time to treatment initiation was 1.5 days (IQR 0-3). In 9 months before the introduction of Truenat, 8% of 20,424 presumptives evaluated were positive for TB, while during the implementation, 9% of 37,087 presumptives were positive for TB.Conclusion: Truenat deployment led to an increase in TB and DR-TB case detection in peripheral facilities in Nigeria. It also decreased TAT and time to TB treatment initiation. These have positive implications in the fight against TB, and Truenat is relevant in finding missing TB cases in Nigeria.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"124-128"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141363","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}

引用次数: 0

Reply to "Mirage de tuberculose in the 21^st century". 答复 "21 世纪结核病的幻影"。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0030

B Patterson, R Wood

引用次数: 0

Continuous quality improvement in a community-wide TB screening and prevention programme in Papua New Guinea. 巴布亚新几内亚全社区结核病筛查和预防计划的持续质量改进。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0013

N P Pank, A Aung, G Kama, A Murray, K L Huang, J Greig, M Bauri, G Chan, C Masah, K Kaison, S Umali, T Peter, C Wera, C Velaki, M Ase, I Krangaie, R Viru, T Kurumop, T Keam, S Islam, W Pomat, A Maha, M Boga, M Kal, N Wuatai, S M Graham, S S Majumdar, T Marukutira

{"title":"Continuous quality improvement in a community-wide TB screening and prevention programme in Papua New Guinea.","authors":"N P Pank, A Aung, G Kama, A Murray, K L Huang, J Greig, M Bauri, G Chan, C Masah, K Kaison, S Umali, T Peter, C Wera, C Velaki, M Ase, I Krangaie, R Viru, T Kurumop, T Keam, S Islam, W Pomat, A Maha, M Boga, M Kal, N Wuatai, S M Graham, S S Majumdar, T Marukutira","doi":"10.5588/pha.24.0013","DOIUrl":"10.5588/pha.24.0013","url":null,"abstract":"Setting: Daru Island in Papua New Guinea (PNG) has a high prevalence of TB and multidrug-resistant TB (MDR-TB).Objective: To evaluate the early implementation of a community-wide project to detect and treat TB disease and infection, outline the decision-making processes, and change the model of care.Design: A continuous quality improvement (CQI) initiative used a plan-do-study-act (PDSA) framework for prospective implementation. Care cascades were analysed for case detection, treatment, and TB preventive treatment (TPT) initiation.Results: Of 3,263 people screened for TB between June and December 2023, 13.7% (447/3,263) screened positive (CAD4TB or symptoms), 77.9% (348/447) had Xpert Ultra testing, 6.9% (24/348) were diagnosed with TB and all initiated treatment. For 5-34-year-olds without active TB (n = 1,928), 82.0% (1,581/1,928) had tuberculin skin testing (TST), 96.1% (1,519/1,581) had TST read, 23.0% (350/1,519) were TST-positive, 95.4% (334/350) were TPT eligible, and 78.7% (263/334) initiated TPT. Three PDSA review cycles informed adjustments to the model of care, including CAD4TB threshold and TPT criteria. Key challenges identified were meeting screening targets, sputum unavailability from asymptomatic individuals with high CAD4TB scores, and consumable stock-outs.Conclusion: CQI improved project implementation by increasing the detection of TB disease and infection and accelerating the pace of screening needed to achieve timely community-wide coverage.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"97-104"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141361","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}

引用次数: 0

Patient costs for drug-resistant TB diagnosis and pre-treatment evaluation in North India. 印度北部耐药性肺结核诊断和治疗前评估的患者费用。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0018

S Das, R Kumar, A Krishnan, S Kant, A Mohan

{"title":"Patient costs for drug-resistant TB diagnosis and pre-treatment evaluation in North India.","authors":"S Das, R Kumar, A Krishnan, S Kant, A Mohan","doi":"10.5588/pha.24.0018","DOIUrl":"10.5588/pha.24.0018","url":null,"abstract":"Introduction: India's National TB Elimination Programme (NTEP) aims to eliminate TB-related catastrophic expenditure by offering free diagnosis and treatment. However, 3.9% of TB patients have drug-resistant TB (DR-TB) and are facing higher costs.Objective: To assess DR-TB patients' diagnosis and pre-treatment evaluation costs, catastrophic cost incidence, and its relation to patient characteristics.Methods: The study included DR-TB patients from three District Drug-Resistant TB Centres in Delhi and Faridabad (October 2021-June 2022). Socio-economic and clinical characteristics and direct medical and non-medical costs from drug susceptibility testing eligibility to the start of DR-TB treatment were collected using patient interviews and records. Indirect costs were calculated via the human capital approach, defining catastrophic costs as expenses over 20% of household annual income. Multivariable regression was used to estimate the effects of patient characteristics on catastrophic costs.Results: Of 158 patients, 37.3% were aged 19-30 years, and 55.7% were women. Median total cost was USD326.6 (IQR 132.7-666.7), with 48.2% for diagnosis and 66.0% indirect. 32% faced catastrophic costs, with manual labourers at higher risk (adjusted OR 4.4).Conclusion: Despite free diagnosis and treatment, a significant portion of DR-TB households in India incur catastrophic costs, mainly from indirect expenses, indicating a need for targeted policy and programme interventions.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"129-134"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141365","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}

引用次数: 0

TB burden and diagnostic challenges at Sandaun Provincial Hospital in West Sepik Province of PNG, 2016-2021. 2016-2021 年巴布亚新几内亚西塞皮克省 Sandaun 省立医院的结核病负担和诊断挑战。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0016

S Bita, T Kelebi, A Holmes, S Vaccher, S S Majumdar, J Greig

{"title":"TB burden and diagnostic challenges at Sandaun Provincial Hospital in West Sepik Province of PNG, 2016-2021.","authors":"S Bita, T Kelebi, A Holmes, S Vaccher, S S Majumdar, J Greig","doi":"10.5588/pha.24.0016","DOIUrl":"10.5588/pha.24.0016","url":null,"abstract":"Setting: Bacteriological confirmation of TB diagnosis remains a key operational challenge in Papua New Guinea. Sandaun Provincial Hospital (SPH) is the main TB diagnostic and treatment centre of West Sepik Province.Objective: To evaluate TB caseload, patient characteristics, and quality of diagnosis at SPH between 2016 and 2021.Design: A retrospective descriptive study using TB treatment, laboratory, and presumptive TB registers to collect data on all TB patients. We used multivariable logistic regression to determine factors associated with bacteriological confirmation.Results: Of 1,305 TB patients registered, 25% were children (<15 years) and 30% had extrapulmonary TB. The quality of sputum was associated with a positive smear microscopy result (P = 0.002). The proportion bacteriologically confirmed was low (37.3%), being higher in young adults 15-44 years (50.6%, 377/745) than in children <15 years (6.3%, 20/319) or older adults ≥45 years (37.6%, 68/181). Bacteriological confirmation was less likely in people travelling ≥3 hours to a health facility (adjusted OR 0.58, 95% CI 0.34-0.97) and extrapulmonary TB (aOR 0.01, 95% CI 0.00-0.03) but more likely for retreatment cases (aOR 1.59, 95% CI 1.00-2.51).Conclusion: Diagnostic services in West Sepik Province need strengthening to achieve a higher proportion of bacteriological confirmation in new pulmonary and extrapulmonary TB cases of all ages and improve access for the rural population.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"91-96"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141308","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}

引用次数: 0

High rates of unfavourable TB treatment outcomes observed in Madang Province, Papua New Guinea. 在巴布亚新几内亚马当省观察到结核病治疗效果不佳的高发率。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0015

W Toua, V Lape, J W Bolnga, M Daimen, T Kelebi, S Vaccher, J Greig

{"title":"High rates of unfavourable TB treatment outcomes observed in Madang Province, Papua New Guinea.","authors":"W Toua, V Lape, J W Bolnga, M Daimen, T Kelebi, S Vaccher, J Greig","doi":"10.5588/pha.24.0015","DOIUrl":"10.5588/pha.24.0015","url":null,"abstract":"Setting: Madang Province is located on the northern coast of Papua New Guinea (PNG), a critical mixing point between the populous highlands and more remote regions. Madang Province faces challenges with limited capacity to diagnose and treat TB.Objective: To describe the TB caseload and investigate factors associated with known unfavourable treatment outcomes.Design: This is a retrospective cohort study using routinely collected TB programmatic data for treatments commenced 1 January 2019 to 31 December 2021. Using multivariable logistic regression, factors associated with known unfavourable treatment outcomes-death, failure after treatment, and loss to follow-up (LTFU)-were evaluated.Results: Of the 4,668 registered and treated, 3,755 had an evaluated outcome, and 33% had unfavourable outcomes, most commonly LTFU (23%). Unfavourable treatment outcomes were significantly associated with HIV-untested (aOR 2.82 compared to HIV-negative; 95% CI 2.39-3.33), having drug-resistant TB (aOR 3.26 compared to drug-susceptible TB, 95% CI 1.18-9.00), and travel time to the health facility 1-<3 hours by foot (aOR 3.53 compared to <1 hour by foot; 95% CI 1.04-12.06).Conclusion: High LTFU from TB treatment was associated with factors that indicate barriers to access to care and treatment completion. Decentralisation and strengthening of TB services for improved person-centred care and treatment support are urgently required in Madang Province.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"105-111"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142330","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}

引用次数: 0

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0014

M Urakawa, A Yasukawa, S Hirao, M Ota, Y Hatamoto, T Zama, Y Nagata, T Yoshiyama

{"title":"TB-related technical enquiries received at the Research Institute of Tuberculosis, Japan, during COVID-19.","authors":"M Urakawa, A Yasukawa, S Hirao, M Ota, Y Hatamoto, T Zama, Y Nagata, T Yoshiyama","doi":"10.5588/pha.24.0014","DOIUrl":"10.5588/pha.24.0014","url":null,"abstract":"Setting: Japan: a low-TB-burden country.Objective: To characterise TB-related technical enquiries received in 2020-2022, and share the lessons learnt.Design: This was a descriptive study.Results: We received 1,898 communications, of which 1,447 (40.2 per month) were classified as technical enquiries, 34% fewer than the 2,197 enquiries received in 2017-2019. The enquiry rates were highest for Shimane (4.32/100,000 population) and Yamanashi (2.59/100,000 population) prefectures, and lowest in Ehime (0.00/100,000 population) and Yamagata (0.09/100,000 population) prefectures. The main organisations the enquirers belonged to were local governments (n = 989, 68.3%) and healthcare facilities (n = 242, 16.7%). The enquirers included medical doctors (n = 236, 16.3%), nurses (n = 814, 56.3%), and the general public (n = 141, 9.7%). The most frequent enquiries were about TB diagnosis and treatment, including laboratory diagnosis (n = 442, 30.6%), followed by the regulatory framework (n = 216, 14.9%), contact investigation (n = 151, 10.8%), and TB in foreigners (n = 112, 7.9%).Conclusion: During the COVID-19 era, we received two-thirds of technical enquiries compared with 2017-2019, because local health offices were overwhelmed by the pandemic. Since the most frequent enquiries were about diagnosis and treatment of TB, the health ministry of Japan should maintain a few specialised TB institutions with TB physicians to provide technical assistance.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"119-123"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141309","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}

引用次数: 0

Operational research highlights ongoing challenges for comprehensive TB services in Papua New Guinea. 业务研究凸显了巴布亚新几内亚结核病综合服务目前面临的挑战。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0042

A Maha, T Kelebi, A Holmes, M Kal, J Greig, H Nindil, S M Graham

引用次数: 0

Loss to follow-up among adults with drug-resistant TB in Papua New Guinea. 巴布亚新几内亚成人耐药结核病患者失去随访机会。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0004

F Charles, Y D Lin, J Greig, S Gurra, R Morikawa, S M Graham, A Maha

{"title":"Loss to follow-up among adults with drug-resistant TB in Papua New Guinea.","authors":"F Charles, Y D Lin, J Greig, S Gurra, R Morikawa, S M Graham, A Maha","doi":"10.5588/pha.24.0004","DOIUrl":"10.5588/pha.24.0004","url":null,"abstract":"Setting: Multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) is now endemic in the National Capital District (NCD), Papua New Guinea. Loss to follow-up (LTFU) is a challenge.Objective: To evaluate and identify risk factors for LTFU, including pre-treatment LTFU, in adults with MDR/RR-TB at Port Moresby General Hospital (PMGH).Design: A retrospective analysis of treatment initiation in adults diagnosed with MDR/RR-TB (2018-2022) and outcomes for a cohort treated for MDR/RR-TB (2014-2019). We assessed the factors associated with LTFU using multivariate logistic regression.Results: Of 95 patients diagnosed with MDR/RR-TB at PMGH from 2018 to 2022, 21 (22%) were lost to follow-up before treatment. Of the 658 adults who initiated treatment for MDR/RR-TB at PMGH from 2014 to 2019, 161 (24%) were lost to follow-up during treatment. A higher proportion of patients on injectable-containing long regimens (110/404, 27%) were lost to follow-up than those on the all-oral regimen containing bedaquiline (13/66, 12%). Treatment loss to follow-up was associated with age (35-54 years age group: aOR 0.49, 95% CI 0.32-0.77; 55-75 years age group: aOR 0.42, 95% CI 0.19-0.90; compared to the 15-34 years age group), residence outside of NCD (aOR 1.79, 95% CI 1.04-3.06), and year of treatment initiation.Conclusion: Pre-treatment LTFU requires programmatic focus. Shorter oral regimens and decentralised services may address the reasons for higher LTFU in younger people and people living outside NCD.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"85-90"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142331","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}

引用次数: 0

Effects of extrapulmonary TB on patient quality of life and recurrence. 肺外结核病对患者生活质量和复发的影响。

IF 1.3

Public Health Action Pub Date : 2024-09-01 DOI: 10.5588/pha.24.0012

A Wali, N Safdar, A Ambreen, S Hassan, A Yaqoob, T Mustafa

{"title":"Effects of extrapulmonary TB on patient quality of life and recurrence.","authors":"A Wali, N Safdar, A Ambreen, S Hassan, A Yaqoob, T Mustafa","doi":"10.5588/pha.24.0012","DOIUrl":"10.5588/pha.24.0012","url":null,"abstract":"Background: Quantifying quality of life (QoL) in extrapulmonary TB patients is crucial yet often overlooked. This study examines the impact of tuberculous lymphadenitis and pleuritis on patients' QoL, associated factors, and recurrence.Methods: Data were collected prospectively from patients using a pre-designed questionnaire at baseline, post-treatment, and 2 years after treatment. Health domains are essential to overall health and well-being and can be assessed to understand health status. We included mobility for physical well-being, usual activities for self-care, pain/discomfort for disease manifestations, and anxiety/depression for emotional health.Results: Of the 376 patients, 53% had TB lymphadenitis, and 47% had TB pleuritis, with a mean age of 25 years (SD ±12.95). The most commonly reported issues at baseline were pain/discomfort and restricted usual activities. After treatment, over 90% experienced improvement, but 8% re-developed symptoms after 2 years, and two patients required retreatment for recurrent EPTB. Predictors negatively impacting QoL included private income sources, residence outside the city, and marriage, with the first two primarily affecting emotional health.Conclusion: Tuberculous lymphadenitis and pleuritis significantly impact patients' physical and emotional health, necessitating healthcare providers to address non-medical factors affecting QoL to reduce morbidity and mortality and improve QoL.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 3","pages":"112-118"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141362","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}

引用次数: 0