Public Health Action最新文献_第10页

Participation of private providers in the National TB Programme in South India 私营医疗机构参与印度南部的国家结核病防治计划

IF 1.4

Public Health Action Pub Date : 2023-12-01 DOI: 10.5588/pha.23.0032

Anand D Meundi, J. Richardus

{"title":"Participation of private providers in the National TB Programme in South India","authors":"Anand D Meundi, J. Richardus","doi":"10.5588/pha.23.0032","DOIUrl":"https://doi.org/10.5588/pha.23.0032","url":null,"abstract":"SETTING: India has the highest number of new TB cases worldwide. The participation of private providers (PPs) in the National TB Elimination Programme (NTEP) has remained suboptimal. OBJECTIVE: To explore the experiences, barriers and facilitators about their participation in the NTEP as perceived by PPs working in varied settings. DESIGN: Focus group discussions and in-depth interviews were used to engage PPs to obtain their views on participation in the NTEP. Framework and thematic content analysis was used to analyse qualitative data. RESULTS: Non-availability of a comprehensive range of diagnostics and lack of flexibility in the NTEP were barriers to participation in NTEP. PPs were predisposed to think that NTEP was for those who could not afford to purchase medications. Attitudes and previous experiences with NTEP made them sceptical about the NTEP regimen. Although more frequent interactions were sought with NTEP, some bitterness about previous interactions was perceived. CONCLUSION: Challenges identified by PPs for the NTEP include improvement of the quality of TB care, especially at the lower levels of care, availability of a comprehensive range of diagnostics, being friendly to PPs and patients, more frequent interactions with PPs, and more caring conversations with patients at NTEP centres.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":" 22","pages":"142 - 147"},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138612933","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}

引用次数: 0

A single synthetic lipid antigen for improved serological diagnosis of Buruli ulcer 改进布路里溃疡血清学诊断的单一合成脂质抗原

IF 1.4

Public Health Action Pub Date : 2023-12-01 DOI: 10.5588/pha.23.0038

J. Hacking, V. V. Gwenin, R. J. Dacombe, M. S. Baird, M. Frimpong, R. O. Phillips, C. D. Gwenin

{"title":"A single synthetic lipid antigen for improved serological diagnosis of Buruli ulcer","authors":"J. Hacking, V. V. Gwenin, R. J. Dacombe, M. S. Baird, M. Frimpong, R. O. Phillips, C. D. Gwenin","doi":"10.5588/pha.23.0038","DOIUrl":"https://doi.org/10.5588/pha.23.0038","url":null,"abstract":"SETTING: The diagnosis of Buruli ulcer (BU) is frequently made by experienced health workers in rural regions. This leads to long turnaround times to confirm the diagnosis as it requires specialised laboratory infrastructure to perform confirmatory testing. BACKGROUND: Given the lack of success with protein antigens to detect BU in human sera, the aim of this study was to evaluate a range of single synthetic lipid antigens using an enzyme-linked immunosorbent assay (ELISA). The ELISA system used was initially developed to detect TB using single synthetic lipid antigens. METHODS: Thirty polymerase chain reaction (PCR) positive BU samples and 30 PCR-negative healthy contact samples collected from Asante Akim North and Ahafo Ano North Districts, Ghana, that are endemic for BU between 2013 and 2016 were used to evaluate the synthetic lipid antigen ELISA. A Quantikine ELISA was also conducted on a randomly blinded sub-set of 30 samples. RESULTS: The synthetic lipid ELISA evaluated here outperforms all other ELISA tests using protein antigens to detect BU to date and has shown potential as a fast (2 h) test for BU which may be adapted for use at the point of care. A sensitivity of 63% and specificity of 80% was observed for 30 BU-positive and 30 BU-negative samples, with significantly reduced interleukin-8 (IL-8) levels in a subset of patients with BU. CONCLUSION: A single lipid was shown for the first time to have the ability to distinguish between PCR-positive BU and negative sera using ELISA. The low lipid antibody load detected may be a result of immune suppression caused by the presence of mycolactone in patients with BU, given that levels of IL-8 were significantly reduced in patients with BU compared to the control serum samples.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":" 5","pages":"173 - 178"},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621112","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}

引用次数: 0

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0021

E C Mendoza-Hisey, A Dier, N V Marquez, L V Bumanglag, S B A Cadiao, S F Guirgis

{"title":"Gender-related factors affecting access to TB services and treatment outcomes in the Philippines.","authors":"E C Mendoza-Hisey, A Dier, N V Marquez, L V Bumanglag, S B A Cadiao, S F Guirgis","doi":"10.5588/pha.23.0021","DOIUrl":"https://doi.org/10.5588/pha.23.0021","url":null,"abstract":"Setting: The Philippines is one of the countries with the highest TB burdens. While TB affects men and women differently, studies also show that gender affects people's experience of and access to healthcare. Men and women have usually assigned roles and responsibilities that affect their decisions and health-seeking behaviour.Objective: The gender analysis aimed to examine the relationship between gender and access to TB services and treatment outcomes according to five domains: cultural norms and beliefs; patterns of power and decision-making; gender roles and responsibilities; access to resources; laws and policies.Design: The team conducted 19 in-depth interviews and five focus group discussions with project staff, TB coordinators from healthcare facilities, representatives from the private and informal business sector and representatives from the Philippine Department of Health from August to November 2019.Results: Study findings indicated that men faced greater limitations than women in terms of accessing TB resources and services, which highlight the differences between genders in relation to health-seeking behaviours and ability to access healthcare.Conclusion: This demonstrates the importance of integrating a gender lens into the service provision set up, from screening to treating and monitoring, to ensure equitable health benefits for men, women, transgender and gender-diverse persons.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"13 3","pages":"107-111"},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41133363","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

Health worker views on pre-treatment loss to follow-up in adults with pulmonary TB in Western Kenya. 卫生工作者对肯尼亚西部成人肺结核患者治疗前随访损失的看法。

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0016

M N Mulaku, O M Corrie, I Odero, T Young, K R Steingart, E Ochodo

{"title":"Health worker views on pre-treatment loss to follow-up in adults with pulmonary TB in Western Kenya.","authors":"M N Mulaku, O M Corrie, I Odero, T Young, K R Steingart, E Ochodo","doi":"10.5588/pha.23.0016","DOIUrl":"https://doi.org/10.5588/pha.23.0016","url":null,"abstract":"Setting: County referral hospital in Western Kenya.Objectives: To explore factors contributing to pre-treatment loss to follow-up (PTLFU) in adults with pulmonary TB and propose solutions to address PTLFU from healthcare worker (HCW) perspectives.Design: This was an exploratory qualitative study using thematic analysis.Results: We conducted 19 key informant interviews with HCWs representing laboratory, clinical care, management and the community. Participant age ranged from 26 to 62 years; 14 (74%) were females; and most (74%) had worked in TB care for ⩽5 years. They reported that patients experienced stigma and had misconceptions about TB that contributed to PTLFU. HCWs were hesitant to work in the TB clinic, which contributed to suboptimal patient care, leading to PTLFU. Unclear linkage between laboratory and clinician, and limited financial resources to track patients were among the healthcare system factors that led to PTLFU. HCWs suggested having proper patient preparation, assigning resources to track patients and holding regular interdisciplinary meetings as practical solutions to address PTLFU.Conclusion: HCWs reported multiple factors that may influence PTLFU and recommended various solutions to address these. Knowledge of TB management, patient preparation, resources to track patients and multidisciplinary meetings will be central to addressing PTLFU.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"13 3","pages":"77-82"},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170203","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

Geographic distribution and predictors of diagnostic delays among possible TB patients in Uganda. 乌干达可能的结核病患者诊断延误的地理分布和预测因素。

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0010

E Ochom, K O Robsky, A J Gupta, A Tamale, J Kungu, P Turimumahoro, S Nakasendwa, I B Rwego, W Muttamba, M Joloba, W Ssengooba, J L Davis, A Katamba

{"title":"Geographic distribution and predictors of diagnostic delays among possible TB patients in Uganda.","authors":"E Ochom, K O Robsky, A J Gupta, A Tamale, J Kungu, P Turimumahoro, S Nakasendwa, I B Rwego, W Muttamba, M Joloba, W Ssengooba, J L Davis, A Katamba","doi":"10.5588/pha.23.0010","DOIUrl":"10.5588/pha.23.0010","url":null,"abstract":"Background: Understanding the geographic distribution and factors associated with delayed TB diagnosis may help target interventions to reduce delays and improve patient outcomes.Methods: We conducted a secondary analysis of adults undergoing TB evaluation within a public health demonstration project in Uganda. Using Global Moran's I (GMI) and Getis-Ord GI* statistics, we evaluated for residential clustering and hotspots associated with patient-related and health system-related delays. We performed multivariate logistic regression to identify individual predictors of both types of delays.Results: Of 996 adults undergoing TB evaluation (median age: 37 years, IQR 28-49), 333 (33%) experienced patient delays, and 568 (57%) experienced health system delays. Participants were clustered (GMI 0.47-0.64, P ⩽ 0.001) at the sub-county level, but there were no statistically significant hotspots for patient or health system delays. Married individuals were less likely to experience patient delays (OR 0.6, 95% CI 0.48-0.75; P < 0.001). Those aged 38-57 years (OR 1.2, 95% CI 1.07-1.38; P = 0.002) were more likely than those aged ⩾58 years to experience patient delays. Knowledge about TB (OR 0.8, 95% CI 0.63-0.98; P = 0.03) protected against health system delays.Conclusions: We did not identify geographic hotspots for TB diagnostic delays. Instead, delays were associated with individual factors such as age, marital status and TB knowledge.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"13 3","pages":"70-76"},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41113227","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

Improving TB control: efficiencies of case-finding interventions in Nigeria. 改进结核病控制：尼日利亚病例发现干预措施的效率。

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0028

A P Babayi, B B Odume, C L Ogbudebe, O Chukwuogo, N Nwokoye, C C Dim, S Useni, D Nongo, R Eneogu, O Chijioke-Akaniro, C Anyaike

{"title":"Improving TB control: efficiencies of case-finding interventions in Nigeria.","authors":"A P Babayi, B B Odume, C L Ogbudebe, O Chukwuogo, N Nwokoye, C C Dim, S Useni, D Nongo, R Eneogu, O Chijioke-Akaniro, C Anyaike","doi":"10.5588/pha.23.0028","DOIUrl":"https://doi.org/10.5588/pha.23.0028","url":null,"abstract":"Setting: KNCV Nigeria implements seven key TB case-finding interventions. It was critical to evaluate the efficiency of these interventions in terms of TB yield to direct future prioritisation in the country.Objectives: To compare the efficiency of active case-finding (ACF) interventions for TB in Nigeria.Design: Data from the 2020-2022 implementing period were analysed retrospectively. Intervention efficiencies were analysed using the number needed to screen (NNS), the number needed to test (NNT) and the true screen-positive (TSP) rate.Results: Across the interventions, 21,704,669 persons were screened for TB, 1,834,447 (8.5%) were presumed to have TB (7.7% pre-diagnostic drop-out rate) and 122,452 were diagnosed with TB (TSP rate of 7.2%). The average TSP rate of interventions that used both the WHO four-symptom screen (W4SS) and portable digital X-ray (PDX) screening algorithm was significantly higher (22.6%) than those that employed the former alone (7.0%; OR 3.9, 95% CI 3.74-3.98; P < 0.001). The average NNT for interventions with W4SS/PDX screening was 4 (range: 4-5), while that of W4SS-only screening was 14 (range: 11-22).Conclusions: Interventions using the PDX in addition to W4SS for TB screening were more efficient in terms of TB case yield than interventions that used symptom-based TB screening only.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"13 3","pages":"90-96"},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160096","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

Tuberculin skin testing and QuantiFERON™-TB Gold Plus positivity among household contacts in Vietnam. 结核菌素皮肤测试和QuantiFERON™-越南家庭接触者中TB Gold Plus阳性。

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0020

A L Innes, S T Nguyen, V Lebrun, T T H Nguyen, T P Huynh, V L Quach, G L Hoang, T B Nguyen, T B P Nguyen, H M Pham, A Martinez, N Dinh, V L Dinh, B H Nguyen, T T H Truong, V C Nguyen, V N Nguyen, T H Mai

{"title":"Tuberculin skin testing and QuantiFERON™-TB Gold Plus positivity among household contacts in Vietnam.","authors":"A L Innes, S T Nguyen, V Lebrun, T T H Nguyen, T P Huynh, V L Quach, G L Hoang, T B Nguyen, T B P Nguyen, H M Pham, A Martinez, N Dinh, V L Dinh, B H Nguyen, T T H Truong, V C Nguyen, V N Nguyen, T H Mai","doi":"10.5588/pha.23.0020","DOIUrl":"https://doi.org/10.5588/pha.23.0020","url":null,"abstract":"Setting: TB infection (TBI) is diagnosed using the technique-dependent tuberculin skin test (TST) or costly, more accurate interferon-gamma release assays. The TST (⩾10 mm) threshold was indicated by previous research among household contacts in Vietnam, but routine implementation with a different tuberculin reagent showed unexpectedly low TST positivity.Objective: TST (⩾5 mm and ⩾10 mm) results were compared to QuantiFERON™-TB Gold Plus (QFT) results in household contacts during community campaigns in 2020 and 2021.Design: This was a cross-sectional multi-center implementation study.Results: Among 1,330 household contacts in 2020, we found a TBI prevalence of 38.6% (QFT), similar to TST ⩾5 mm (37.4%) and higher than TST ⩾10 mm (13.1%). QFT+/TST+ was higher for TST ⩾5 mm (20.7%) than TST ⩾10 mm (9.4%). QFT was not discordant with TST ⩾5 mm (McNemar's test = 0.6, P = 0.5) but was discordant with TST ⩾10 mm (McNemar's test = 263.9, P < 0.01). Older age and Southern region increased odds for positive TST ⩾5 mm and QFT with weaker associations for TST ⩾10 mm. Agreement and discordance were similar in 2021 for 1,158 household contacts.Conclusion: Tuberculin reagents affect TST positivity rates. High TB burden countries should monitor reliability of TBI diagnosis, including tuberculin potency, cold chain, and TST technique to optimize eligibility for TB preventive treatment.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"13 3","pages":"83-89"},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165425","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 programme stakeholder views on lessons from the COVID-19 response in South Africa. 结核病方案利益攸关方对南非新冠肺炎应对经验教训的看法。

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0015

H Myburgh, S-A Meehan, D T Wademan, M Osman, A C Hesseling, G Hoddinott

{"title":"TB programme stakeholder views on lessons from the COVID-19 response in South Africa.","authors":"H Myburgh, S-A Meehan, D T Wademan, M Osman, A C Hesseling, G Hoddinott","doi":"10.5588/pha.23.0015","DOIUrl":"https://doi.org/10.5588/pha.23.0015","url":null,"abstract":"Background: The global COVID-19 pandemic has reversed many of the hard-won gains made in TB programmes and the associated reduction in the number of TB deaths, case notifications and incidence over the last three decades. Modelling estimates show that the impact will be lasting. There are global calls to recover the shortfalls along the TB care cascade that have resulted from COVID-19, with the recognition that the COVID-19 response holds lessons to inform more robust and comprehensive TB programmes and services.Objective: To explore lessons from response measures to the COVID-19 pandemic in two high TB burden South African provinces.Design: This was an exploratory qualitative study. We conducted interviews with TB programme stakeholders (managers and facility-level staff: n = 35) between February and June 2022.Results: We identified eight facilitators of the COVID-19 response, including political will, rapid policy development, multi-sectoral collaboration, patient-centred models of care delivery, community engagement, mHealth and telehealth technologies, rigorous contact tracing and widespread mask wearing. Political will was singled out as a critical driver of the response.Conclusion: Leveraging COVID-19 inspired collaborations, technologies and avenues for health service delivery is an opportunity to maximise benefits for the TB programme. Reinvestment in national TB programmes and political prioritisation of TB are critical.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"13 3","pages":"97-103"},"PeriodicalIF":1.4,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10446663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41162616","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: 1

How youth engagement can break surgery out of its silo in global health. 年轻人的参与如何将外科手术从全球健康的筒仓中打破。

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0027

R Dutta, H Sana, R Sawhney, O El Omrani, A Ehsan, P Fallah, M Pigeolet, A Jayaram, R Riviello, K B Park

引用次数: 0

One size does not fit all: community views on choices for TB treatment and prevention. 一刀切并不适合所有人：社区对结核病治疗和预防选择的看法。

IF 1.4

Public Health Action Pub Date : 2023-09-21 DOI: 10.5588/pha.23.0034

A Makone, K Angami, D Bhattacharya, M Frick, J G Castillo, R Herrera, L McKenna, G K Moses, O Rucsineanu, A H Sari, J Stillo, P Agbassi

引用次数: 0