Public Health Action最新文献_第10页

Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB. 评估感染艾滋病毒并患有药物敏感结核病的孕妇的结核病治疗结果。

IF 1.6

Public Health Action Pub Date : 2025-03-01 DOI: 10.5588/pha.24.0051

N Hernandez-Morfin, S Cohn, Z Waja, R E Chaisson, N Martinson, N Salazar-Austin

{"title":"Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB.","authors":"N Hernandez-Morfin, S Cohn, Z Waja, R E Chaisson, N Martinson, N Salazar-Austin","doi":"10.5588/pha.24.0051","DOIUrl":"10.5588/pha.24.0051","url":null,"abstract":"Background: Limited data exist on TB treatment outcomes among pregnant women with TB. Physiological and immunological adaptations during pregnancy may affect the efficacy of TB treatment. We aimed to evaluate factors associated with unsuccessful TB treatment outcomes among pregnant women living with HIV (PWLHIV) and diagnosed with TB in the Tshepiso study.Methods: In this secondary analysis, we used multivariable logistic regression to evaluate factors associated with unsuccessful TB treatment outcomes among PWLHIV with drug-sensitive TB disease enrolled in the Tshepiso study in Soweto, South Africa, from 2011-2014.Results: This analysis includes 79 PWLHIV diagnosed with drug-sensitive TB during pregnancy; 18 (23%) had an unsuccessful treatment outcome. Factors associated with unsuccessful TB treatment include detectable HIV RNA viral load at enrollment to the study (aOR 5.1, 95% CI 1.1-25.3), presence of extrapulmonary TB (aOR 2.2, 95% CI 0.4-11.7), bacteriological (positive smear and/or culture) confirmation of TB (aOR 2.1, 95% CI 0.7-6.7), and anemia (Hb ≤ 10.5 g/dL) (aOR 1.0, 95% CI 0.3-3.1). The only factor with statistical significance was a detectable HIV RNA viral load.Conclusion: Detectable HIV viral load emerges as a critical factor associated with an unsuccessful TB treatment outcome in pregnant women living with HIV and diagnosed with TB.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 1","pages":"33-37"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543978","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

Information counselling during treatment with ototoxic medications for TB: a call to action. 使用耳毒性结核病药物治疗期间的信息咨询：行动呼吁。

IF 1.3

Public Health Action Pub Date : 2025-03-01 DOI: 10.5588/pha.24.0053

K Khoza-Shangase, S M Arendse

引用次数: 0

Electronic medical oxygen dashboard system for daily oxygen monitoring and stockout prevention in Lesotho. 用于莱索托每日氧气监测和缺氧预防的电子医用氧气仪表板系统。

IF 1.3

Public Health Action Pub Date : 2025-03-01 DOI: 10.5588/pha.24.0046

K S Joseph, T Ntelane, T D Lekhela, M Mungati, M Shoba, S Montsi, S F Leluma, L Oyewusi, H Schuh, B Hansoti, J Mirembe, N Shilkofski, M Strachan, N Mahachi, E D McCollum

引用次数: 0

Choice-architecture TB preventive therapy prescribing for HIV patients in Mozambique. 莫桑比克艾滋病毒患者结核病预防治疗处方的选择架构。

IF 1.6

Public Health Action Pub Date : 2025-03-01 DOI: 10.5588/pha.24.0033

I Salles, S Munguambe, R Chiau, E Valverde, J E Golub, C J Hoffmann, K Shearer

{"title":"Choice-architecture TB preventive therapy prescribing for HIV patients in Mozambique.","authors":"I Salles, S Munguambe, R Chiau, E Valverde, J E Golub, C J Hoffmann, K Shearer","doi":"10.5588/pha.24.0033","DOIUrl":"10.5588/pha.24.0033","url":null,"abstract":"Introduction: Despite the effectiveness of TB preventive treatment (TPT) in reducing TB incidence and mortality among people living with HIV (PLHIV), uptake has been low. We conducted a cluster randomised trial to evaluate a choice architecture-based intervention for prescribing TPT (the 'CAT' study) to PLHIV in Mozambique, nested within the short-course 3HP regimen roll-out, and qualitatively assessed intervention acceptability and feasibility with healthcare workers (HCWs).Methods: The CAT intervention comprised training on default TPT prescribing and prescribing stickers integrated into antiretroviral therapy (ART) stationery. We assessed intervention acceptability and feasibility to increase TPT prescribing through 25 in-depth interviews (IDIs) with HCWs from participating clinics between August and September 2022. Thematic analysis of the IDIs identified key themes.Results: Participants reported a positive impact of the intervention on patient care, though workload opinions varied. Participants reported that CAT did not significantly alter routine TPT prescribing processes but highlighted the need for reminders and decision-support tools. CAT was viewed to streamline patient management, particularly identifying eligible TPT patients and simplifying documentation.Conclusion: The CAT strategy could enhance TPT delivery to PLHIV and integrate it into preventive care for other diseases.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 1","pages":"21-25"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543980","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 outcomes in South Fly District, Papua New Guinea, were maintained through COVID-19. 巴布亚新几内亚南飞区结核病规划成果在2019冠状病毒病期间得以保持。

IF 1.3

Public Health Action Pub Date : 2024-12-01 DOI: 10.5588/pha.24.0020

M Bauri, S Vaccher, T Marukutira, K L Huang, A Murray, G Chan, L Morris, M Boga, S M Graham, N Wuatai, S S Majumdar

{"title":"TB programme outcomes in South Fly District, Papua New Guinea, were maintained through COVID-19.","authors":"M Bauri, S Vaccher, T Marukutira, K L Huang, A Murray, G Chan, L Morris, M Boga, S M Graham, N Wuatai, S S Majumdar","doi":"10.5588/pha.24.0020","DOIUrl":"https://doi.org/10.5588/pha.24.0020","url":null,"abstract":"Setting: An established response to an outbreak of drug-resistant TB (DR-TB) on Daru Island, South Fly District (SFD), Western Province, Papua New Guinea (PNG).Objective: To describe and evaluate the trends in TB case notification disaggregated by demographic and clinical characteristics, programmatic interventions for TB and COVID-19 and treatment outcomes in 2017-2022.Design: A cohort study of routinely collected programmatic data of all patients registered for TB treatment in SFD comparing pre-COVID (2017-2019) to COVID (2020-2022) periods.Results: Of the 3,751 TB cases registered, 19.6% had DR-TB, and the case notification rate was 1,792/100,000 for Daru and 623/100,000 for SFD. There was a 29.2% reduction in case notifications from 2019 to 2021, with recovery in 2022. During COVID, the healthcare workforce was adversely impacted, and active TB case-finding was stopped. During COVID, compared to pre-COVID, bacteriological confirmation increased (62.3% to 71.9%), whereas rates of child TB notifications (11.6% to 9.1%), pulmonary TB (60.8% to 57.4%) and DR-TB (20.7% to 18.6%) decreased. High rates of treatment success were maintained for both drug-susceptible (86.5%) and DR-TB (83.6%).Conclusion: Health systems strengthening and community engagement before COVID likely contributed to resilience and mitigated potential impacts on TB in this remote and resource-limited setting. Case notifications remain very high, and additional interventions are needed to interrupt transmission.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 4","pages":"139-145"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773401","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

Tolerability of linezolid in patients with drug-resistant TB in Daru, Western Province, PNG. 巴布亚新几内亚西部省达鲁耐药结核病患者对利奈唑胺的耐受性

IF 1.3

Public Health Action Pub Date : 2024-12-01 DOI: 10.5588/pha.24.0041

M Boga, T Marukutira, A Murray, G G Chan, G K Huang

{"title":"Tolerability of linezolid in patients with drug-resistant TB in Daru, Western Province, PNG.","authors":"M Boga, T Marukutira, A Murray, G G Chan, G K Huang","doi":"10.5588/pha.24.0041","DOIUrl":"https://doi.org/10.5588/pha.24.0041","url":null,"abstract":"Setting: Linezolid (LZD) has emerged as a critical agent and core component of regimens to treat drug-resistant TB (DR-TB); however, there are ongoing uncertainties regarding its safety and the optimal dosing approach. Since 2016, linezolid has been used in the treatment of patients diagnosed with DR-TB at Daru Provincial Hospital, PNG.Objective: To describe the patient characteristics, treatment outcomes, and tolerability of linezolid-containing regimens used to treat DR-TB in Daru, Western Province.Design: This was a retrospective analysis of programmatic data.Results: A total of 632 eligible patients were diagnosed with DR-TB during the study period. Of these, 580 (91.8%) were commenced on a LZD-containing regimen. Among patients with baseline haemoglobin results available (380/632, 60.1%), the median value was 10.1 g/dL, with a mean corpuscular volume of 70.7 fL, 78.1% of those with haemoglobin results were anaemic at baseline. Despite this, 242/580 (41.7%) patients were able to complete the full LZD course of treatment (typically 18 months) without dose reduction or interruption. Treatment success was observed in 87.9% of the cohort. Neurotoxicity was not commonly reported, but adverse events were likely under-reported.Conclusion: In this cohort, with high rates of baseline anaemia, prolonged therapy with LZD was relatively well tolerated.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 4","pages":"158-163"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773419","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

The integrated care costs of HIV and non-communicable diseases in South Africa. 南非艾滋病毒和非传染性疾病的综合护理费用。

IF 1.3

Public Health Action Pub Date : 2024-12-01 DOI: 10.5588/pha.24.0027

M Moyo-Chilufya, T Mgutshini, A Musekiwa, C Hongoro

{"title":"The integrated care costs of HIV and non-communicable diseases in South Africa.","authors":"M Moyo-Chilufya, T Mgutshini, A Musekiwa, C Hongoro","doi":"10.5588/pha.24.0027","DOIUrl":"https://doi.org/10.5588/pha.24.0027","url":null,"abstract":"Setting: In sub-Saharan Africa, the syndemic of HIV and non-communicable diseases (NCDs) poses a significant challenge. To address this, leading global think tanks like the WHO advocate for integrated HIV/NCD care at primary healthcare levels. However, comparative empirical data on the costs of integrated care are limited. South Africa, with the largest HIV programme globally, was purposively selected for our comparative case study.Objective: To determine the cost of integrated HIV/NCD care from the providers' perspective at two 'ideal status' public healthcare facilities in South Africa as case studies.Design: A multi-pronged methodology was used to collect provider cost data via retrospective documentary sources or records and a question-and-answer session with facility managers who provided key information on cost-related data. Data analysis utilised an activity-based costing (ABC) method.Results: Despite the difference in the size of the clinics, the cost per patient in terms of ABC is similar between the two primary healthcare facilities, USD261.60 and USD226.30, respectively.Conclusion: The ABC method can be utilised to cost integrated care, foster health economic data availability for future research, and inform health policymakers.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 4","pages":"164-168"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773485","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

Drug-resistant TB in Morobe Province, Papua New Guinea, 2012-2021. 2012-2021年巴布亚新几内亚莫罗贝省耐药结核病情况。

IF 1.3

Public Health Action Pub Date : 2024-12-01 DOI: 10.5588/pha.24.0011

L Bumbu, S Vaccher, A Holmes, K Sodeng, S M Graham, Y D Lin

{"title":"Drug-resistant TB in Morobe Province, Papua New Guinea, 2012-2021.","authors":"L Bumbu, S Vaccher, A Holmes, K Sodeng, S M Graham, Y D Lin","doi":"10.5588/pha.24.0011","DOIUrl":"https://doi.org/10.5588/pha.24.0011","url":null,"abstract":"Setting: Papua New Guinea (PNG) is a high-burden country for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB). There are limited data on MDR/RR-TB notifications and treatment from the most populous province.Objective: Describe MDR/RR-TB detection and treatment outcomes in Morobe Province, the impact of the COVID-19 pandemic and factors associated with unfavourable treatment outcomes.Design: Retrospective cohort study of MDR/RR-TB notifications between 2012 and 2021 using routine programme registration data. Favourable outcomes were compared to unfavourable outcomes using multivariable regression.Results: Between 2012 and 2021, 160 cases of MDR/RR-TB were bacteriologically confirmed. Few diagnoses were made among children (2.5%), extrapulmonary cases (0.6%) or rural residents (38%). Case notifications rose sharply from 2016 after the introduction of GeneXpert to 5.6 cases per 100,000 population in 2020 before a reduction in 2021 coinciding with COVID-19 disruptions. Loss to follow-up (27.5%) and death (8.1%) were common. Unfavourable treatment outcomes were more common among male participants (aOR 3.00, 95% CI 1.38-6.45) and those treated with longer injectable-containing regimens (aOR 3.39, 95% CI 1.30-8.80).Conclusion: MDR/RR-TB detection has increased overall, but enhanced and decentralised diagnostic capacity is needed, including in important sub-populations. Persisting low treatment success rates must be urgently addressed to minimise the further emergence of drug-resistant TB in Morobe Province.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 4","pages":"146-151"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773517","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

Sputum culture contamination and associated characteristics in a diagnostic clinical trial, Papua New Guinea. 巴布亚新几内亚一项诊断性临床试验中的痰培养物污染及其相关特征

IF 1.3

Public Health Action Pub Date : 2024-12-01 DOI: 10.5588/pha.24.0029

N D Tenakanai, J K Banamu, Y Lin, D Walsh, R Simbil, M Globan, A Penn-Nicholson, P du Cros, J Greig

{"title":"Sputum culture contamination and associated characteristics in a diagnostic clinical trial, Papua New Guinea.","authors":"N D Tenakanai, J K Banamu, Y Lin, D Walsh, R Simbil, M Globan, A Penn-Nicholson, P du Cros, J Greig","doi":"10.5588/pha.24.0029","DOIUrl":"https://doi.org/10.5588/pha.24.0029","url":null,"abstract":"Setting: Papua New Guinea is a high-burden multidrug-resistant TB (MDR/RR-TB) country that reports low rates of bacteriological confirmation. Sputum drug susceptibility testing for second-line drugs is important. Access to culture is limited.Objective: To evaluate the prevalence of mycobacterial sputum sample culture contamination and determine factors associated with contamination.Design: A retrospective analysis of data from a TB diagnostic accuracy study that used culture as the diagnostic reference standard. Data included characteristics of people with presumptive pulmonary TB who provided sputum, sputum quality and culture results.Results: Sputum (1-3 samples) was collected from 174 adults. The median age was 33 years (IQR 24-47). Of 337 samples sent for culture, 28% were contaminated. Contamination was strongly associated with samples self-collected by participants outside clinic hours (aOR 5.69; 95% CI 2.62-12.38). Contamination risk increased with delays in shipping to the reference laboratory (aOR 1.19 per day, 95% CI 1.10-1.29) beyond the minimum 3 days. Contamination was less frequent among people aged 35-44 years compared to 18-24 years (aOR 0.27, 95% CI 0.10-0.73). Sputum quality was not associated with culture contamination.Conclusion: Culture contamination could be reduced using spot sputum collection, expedited submission to laboratories and faster shipping when required.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 4","pages":"152-157"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773500","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

Adapting a mobile TB screening unit to provide integrated screening services and linkage to primary care. 调整一个流动结核病筛查单位，以提供综合筛查服务并与初级保健联系起来。

IF 1.3

Public Health Action Pub Date : 2024-12-01 DOI: 10.5588/pha.24.0025

A K Millones, S Cohen, D Acosta, H Campos, A Condeso, S Farroñay, I Torres, C Vargas, K Abanto, C Contreras, S Palomino, J Jimenez, L Lecca, C M Yuen

{"title":"Adapting a mobile TB screening unit to provide integrated screening services and linkage to primary care.","authors":"A K Millones, S Cohen, D Acosta, H Campos, A Condeso, S Farroñay, I Torres, C Vargas, K Abanto, C Contreras, S Palomino, J Jimenez, L Lecca, C M Yuen","doi":"10.5588/pha.24.0025","DOIUrl":"10.5588/pha.24.0025","url":null,"abstract":"Objective: We adapted a mobile TB screening unit to create an integrated screening program for noncommunicable diseases and TB, using community health worker (CHW) navigators to support linkage to care. We piloted the model in underserved communities of Lima, Peru, evaluating its feasibility, acceptability, and ability to continue supporting TB case detection.Design: The program provided screening for TB, hypertension, diabetes, and depression and was rebranded to avoid TB-associated stigma. CHW navigators were trained to link people to care for all four conditions. Implementation barriers and facilitators were identified from the implementation team's meeting minutes.Results: During August-December 2023, we screened 1,000 adults, of whom 254 (25%) were referred for evaluation and paired with CHW navigators. Of these, 197 (78%) underwent evaluation at a health center, and 151 (59%) initiated some form of treatment, including 4 for TB. Completion of the linkage cascade was 93% for TB, 81% for hypertension, 71% for diabetes and 69% for depression. Limitations in equipment and staff were implementation barriers, while multiple flexibility-related facilitators were identified.Conclusion: The integrated screening program was acceptable and feasible and still identified people with TB. CHW navigators were effective in supporting linkage to primary care services.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"14 4","pages":"169-174"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773511","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