scholarly journals Pulmonary tuberculosis incidence, trends and predictions in Monastir, Tunisia (2000-2030)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Ben Nasrallah ◽  
I Zemni ◽  
M Kacem ◽  
W Dhouib ◽  
R Bannour ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Incidence Rate ◽  
Program Effectiveness ◽  
Control Strategies ◽  
Control Program ◽  
Crude Incidence ◽  
Age Cohorts ◽  
Tb Control ◽  
Incidence Trends ◽  
The Impact

Abstract Background Tuberculosis (TB) continues to be one of the infectious diseases with the highest morbidity worldwide. The lung is the most commonly involved organ, but lesions can occur in other body systems. This study aimed to describe incidence and trends of pulmonary tuberculosis (PTB) over a period of 18 years in Monastir and to estimate predictions for 2030. Methods We carried out an observational study from 2000 to 2017. Data were collected by the regional direction of primary health care. Incidence was estimated by the crude incidence rate (CIR) and the age standardized rate (ASR). Poisson regression model was used to calculate the slope 'b' in order to describe trends and was performed to estimate incidence projection for 2030. Data were verified and analyzed using IBM SPSS Statistics version 22.0 software. Results A total of 997 patients were recorded with 486 cases of PTB (48.95%). Sex ratio was 2.85. The median age was 40.5 [IQR 28-56] years old. PTB ASR was 5.71/100,000 inhabitants (inh). CIR was the highest among the eldest cohort aged more than 60 years (12.65/100,000 inh) and the lowest among youth aged less than 19 years (1.01/100,000 inh). We established a negative trend of PTB over 18 years (b= -0.032; p < 10-4) in all age cohorts. PTB would be decreasing by 2030 with an estimate incidence rate of 1.83/100,000 inh. Conclusions The decline of PTB may be a sign of TB control program effectiveness in Monastir. Thus, the challenges for the future are to maintain PTB towards decreasing. Key messages Our study highlighted the impact of TB control strategies in Tunisia. Our findings play a key role in estimating whether the WHO’s End TB strategy targets can be achieved by 2030.

scholarly journals Factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in Cali, Colombia

2019 ◽  
Vol 43 ◽  
pp. 1
Author(s):  
Cindy Córdoba ◽  
Lucy Luna ◽  
Diana M. Triana ◽  
Freddy Perez ◽  
Lucelly López
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Initiation ◽  
Control Program ◽  
Diagnosis And Treatment ◽  
Individual Treatment ◽  
Tb Control ◽  
Factors Associated ◽  
Tb Treatment ◽  
Tuberculosis Diagnosis ◽  
Tb Control Program

Objective.To determine factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in the city of Cali, Colombia.Methods.This was a retrospective cohort study of cases of tuberculosis (TB) reported in the TB control program of Cali between January and December 2016. The information was collected from the databases of the TB control program, individual treatment cards, and clinical histories. The variables considered were sociodemographic factors, clinical factors, substance use, and performance of the health service.Results.A total of 623 cases were identified, of which 57.0% were male. The median age was 42 years (interquartile range (IQR): 27–60). The median time from onset of symptoms to TB diagnosis was 57 days (IQR: 21–117), and from onset of symptoms to TB treatment initiation was 72 days (IQR: 35–145). A factor associated with longer time from the onset of symptoms to TB treatment was being a previously treated TB patient (coefficient: 123.8 days, 95% confidence interval (CI): 48.3 to 199.3). In contrast, being incarcerated was a protective factor for earlier TB treatment initiation (coefficient: -57.3 days; 95% CI: -92.4 to -22.3).Conclusions.Our results provide important information concerning risk factors that are associated with delays in the diagnosis and treatment of tuberculosis, and that are subject to future interventions. Health insurance program managers must work together with health care providers on issues that include patient care, health promotion, and updating TB protocols and standards.

scholarly journals Impact of the herpes zoster vaccination programme on hospitalised and general practice consulted herpes zoster in the 5 years after its introduction in England: a population-based study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e037458
Author(s):  
Nick Andrews ◽  
Julia Stowe ◽  
Galena Kuyumdzhieva ◽  
Bersabeh Sile ◽  
Ivelina Yonova ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Incidence Rate ◽  
Vaccination Programme ◽  
Vaccine Coverage ◽  
Ecological Impact ◽  
Population Based ◽  
Age Cohorts ◽  
Catch Up ◽  
Rate Ratios ◽  
The Impact

ObjectivesTo assess the impact of herpes zoster vaccination in the 5 years after introduction for 70- to 79-year-olds in England in September 2013.DesignPopulation based ecological impact assessment.SettingHospitals covering the whole English population for the period 2008 to 2018 and 293 general practices (GP) for the period 2005 to 2018, in England.ParticipantsOver the period the population contributed 117·5 million person-years for hospitalisation events and 6.96 million person-years for GP events in individuals aged 60 to 89.InterventionsLive attenuated herpes zoster vaccination (Zostavax), first used on 1st September 2013, in 70- and 79-year-olds with continued use in new 70 year-olds and with a staged catch-up of those aged 71 to 78 years in 2013.Outcome measuresHerpes zoster and postherpetic neuralgia (PHN) consultation and hospitalisation rates in age-cohorts according to vaccine eligibility. Incidence rate ratios in age-cohorts eligible for vaccination compared with those non-eligible were calculated by Poisson regression. This was used to estimate prevented cases and, along with vaccine coverage, to estimate vaccine effectiveness.ResultsLarge and prolonged reductions in herpes zoster and PHN consultations and hospitalisations were observed in the 5 years post-implementation. For example, in 79 year-olds first eligible in 2013, the incidence rate ratio for consultations 5 years later was 0·65 (95% CI: 0·52 to 0·81). Over the whole period an estimated 40 500 fewer zoster consultations and 1840 fewer zoster hospitalisations occurred because of the vaccination programme. These reductions were consistent with effectiveness in the routine cohorts (vaccinated aged 70) of between 37% (for hospitalised zoster) and 75% (for PHN consultations) and, in catch up cohorts (vaccinated aged 78 to 79) of between 49% (for hospitalised PHN) and 66% (for PHN consultations).ConclusionGiven the clear and sustained impact of herpes zoster vaccination over the 5-year period since introduction, optimising vaccination coverage is important to attain maximum benefit.

scholarly journals Exogenous re-infection and the dynamics of tuberculosis epidemics: local effects in a network model of transmission

2006 ◽  
Vol 4 (14) ◽  
pp. 523-531 ◽  
Author(s):  
Ted Cohen ◽  
Caroline Colijn ◽  
Bryson Finklea ◽  
Megan Murray
Keyword(s):  
Network Model ◽  
Disease Transmission ◽  
Control Strategies ◽  
Disease Incidence ◽  
Infected Individual ◽  
Population Level ◽  
Recent Infection ◽  
Tb Control ◽  
Relative Contribution ◽  
The Impact

Infection with Mycobacterium tuberculosis leads to tuberculosis (TB) disease by one of the three possible routes: primary progression after a recent infection; re-activation of a latent infection; or exogenous re-infection of a previously infected individual. Recent studies show that optimal TB control strategies may vary depending on the predominant route to disease in a specific population. It is therefore important for public health policy makers to understand the relative frequency of each type of TB within specific epidemiological scenarios. Although molecular epidemiologic tools have been used to estimate the relative contribution of recent transmission and re-activation to the burden of TB disease, it is not possible to use these techniques to distinguish between primary disease and re-infection on a population level. Current estimates of the contribution of re-infection therefore rely on mathematical models which identify the parameters most consistent with epidemiological data; these studies find that exogenous re-infection is important only when TB incidence is high. A basic assumption of these models is that people in a population are all equally likely to come into contact with an infectious case. However, theoretical studies demonstrate that the social and spatial structure can strongly influence the dynamics of infectious disease transmission. Here, we use a network model of TB transmission to evaluate the impact of non-homogeneous mixing on the relative contribution of re-infection over realistic epidemic trajectories. In contrast to the findings of previous models, our results suggest that re-infection may be important in communities where the average disease incidence is moderate or low as the force of infection can be unevenly distributed in the population. These results have important implications for the development of TB control strategies.

Impact of a Protocol for Prevention of Ventilator-Associated Pneumonia

2007 ◽  
Vol 41 (9) ◽  
pp. 1390-1396 ◽  
Author(s):  
Rajae Omrane ◽  
Jihane Eid ◽  
Marc M Perreault ◽  
Hala Yazbeck ◽  
Djamal Berbiche ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Early Onset ◽  
Late Onset ◽  
Evidence Based ◽  
Ventilator Associated Pneumonia ◽  
Crude Incidence Rate ◽  
Crude Incidence ◽  
Mechanically Ventilated ◽  
Prevention Protocol ◽  
The Impact

Background: Several interventions have been shown to be effective in reducing the incidence of ventilator-associated pneumonia (VAP), but their implementation in clinical practice has not gained widespread acceptance. Objective: To determine the impact of a protocol that incorporates evidence-based interventions shown to reduce the frequency of VAP on the overall rate of VAP, early-onset VAP, and late-onset VAP in the intensive care unit (ICU) of a tertiary care adult teaching hospital. Methods: This pre- and postintervention observational study included mechanically ventilated patients admitted to the Montreal General Hospital ICU between November 2003 and May 2004 (preintervention) and between November 2004 and May 2005 (postintervention). A multidisciplinary prevention protocol was developed, implemented, and reinforced. Rates of VAP per 1000 ventilator-days were calculated pre- and postprotocol implementation for all patients, for patients with early-onset VAP, and for those with late-onset VAP. Results: In the pre- and postintervention groups, 349 and 360 patients, respectively, were mechanically ventilated. Twenty-three VAP episodes occurred in 925 ventilator-days (crude incidence rate 25 per 1000) in the preintervention period. Following implementation, the VAP rate decreased to 22 episodes in 988 ventilatordays (crude incidence rate 22.3 per 1000), corresponding to a relative reduction in rate of 10.8% (p < 0.001). The incidence of early-onset VAP decreased from 31.0 to 18.5 VAP per 1000 ventilator-days (p < 0.001), while the incidence of late-onset VAP increased from 21.9 to 24.1 VAP per 1000 ventilator-days (p < 0.001). However, when all covariates were adjusted, the impact of the prevention protocol was not statistically significant. Conclusions: Implementation of a VAP prevention protocol incorporating evidence-based interventions reduced the crude incidence of VAP, early-onset VAP, and late-onset VAP. However, when covariates were adjusted, the beneficial effect was no longer observed. Further research is needed to assess the impact of such measures on VAP, early-onset VAP, and late-onset VAP.

scholarly journals PENGARUH CAKUPAN IMUNISASI CAMPAK TERHADAP INCIDENCE RATE PENYAKIT CAMPAK DI INDONESIA TAHUN 2016

2018 ◽  
Vol 11 (2) ◽  
pp. 159-166
Author(s):  
Satriya Wijaya
Keyword(s):  
Public Health ◽  
Linear Regression ◽  
Incidence Rate ◽  
Child Mortality ◽  
Immunization Coverage ◽  
Control Program ◽  
Health Profile ◽  
Simple Linear Regression ◽  
Cross Sectional ◽  
The Impact

Immunization has proven to be one of the most important public health efforts. The immunization program has shown remarkable success and is a very cost-effective effort in preventing infectious diseases (MOH, 2003). Immunization has also saved so many lives compared to other public health efforts. Very important role of measles immunization in reducing child mortality, so measles immunization become one of indicator in achieving fourth goal of MDGs that is decrease child mortality rate. In this case, what is seen is the proportion of one-year-old children who get measles immunization (WHO, 2014 in the Ministry of Health RI, 2014). The design of this study was cross-sectional with a retrospective approach. The target of this research is all people in Indonesia who are positive for measles. The data used are secondary data derived from the Health Profile of Indonesia Year 2015, to describe the implementation of measles control program in Indonesia in 2016. The variables measured in this study include the success rate of measles immunization coverage in Indonesia in 2016 and the extent of the decrease in measles incidence rate as the impact of measles immunization coverage program in Indonesia in 2016. The overall data used in this study is obtained from data health that is reported on the Health Profile of Indonesia Year 2015. Statistical method used is parametric statistics with the test used is Simple Linear Regression with the help of computer software that is SPSS to help analyze the regression results between the dependent variable and independent variables. The results showed that all infants in Jambi, West Nusa Tenggara, South Sumatera, Central Java and Lampung provinces had measles immunization. Meanwhile, the lowest coverage is Papua with 62.40%, followed by Aceh with 69.60% and West Papua with 73.69%. Then the result of analysis by using simple linear regression statistic test showed that the measles immunization coverage program has an effect on the incidence rate of measles disease with significance value equal to 0,035. In addition, from the research results obtained information that an effective way to prevent measles is the immunization of children under the age of 9 months (<1 year). During the period 2000-2013, measles immunization succeeded in reducing 15.6 million (75%) deaths from measles in Indonesia.

scholarly journals Paediatric tuberculosis during universal and selective Bacillus Calmette–Guérin vaccination policy: a nationwide population-based retrospective study, Finland, 1995–2015

2021 ◽  
Vol 26 (11) ◽  
Author(s):  
Antti Kontturi ◽  
Satu Kekomäki ◽  
Hanna Soini ◽  
Jukka Ollgren ◽  
Eeva Salo
Keyword(s):  
Incidence Rate ◽  
Rate Ratio ◽  
Second Generation ◽  
Incidence Rate Ratio ◽  
Population Based ◽  
Vaccination Policy ◽  
Bcg Vaccination ◽  
Incidence Trends ◽  
The Impact ◽  
Second Generation Migrants

Introduction In 2006, the Bacillus Calmette–Guérin (BCG) vaccination policy in Finland changed from universal to selective. Aim We assessed the impact of the policy change on tuberculosis (TB) morbidity in children under 5 years and epidemiological trends of paediatric TB in Finland. Methods We conducted a nationwide, population-based, retrospective registry study of all newly diagnosed active TB cases younger than 15 years in Finland from 1995 to 2015 by linking data from the National Infectious Diseases Register, Finnish Care Register for Health Care, medical patient records and Finnish Population Information System. We compared the TB incidence rate ratio of under 5 year-olds with universal and selective BCG vaccinations with a Poisson log-linear model and analysed incidence trends among those younger than 15 years with a negative binomial model. Results We identified 139 paediatric TB cases: 50 native (including 24 second-generation migrants) and 89 foreign-born children. The TB rate of under 5 year-olds remained stable after changing to selective BCG vaccination (incidence rate ratio (IRR): 1.3; 95% confidence interval (CI): 0.7–2.3). TB rate in the native population under 15 years increased slightly (IRR = 1.06; 95% CI: 1.01–1.11). Discussion Paediatric TB cases in Finland were concentrated in families with migrant background from high-TB incidence countries. The native TB morbidity in under 5-year-olds did not increase after the BCG policy revision, suggesting that selective vaccinations can prevent TB in the most vulnerable age group in low-incidence settings. Second-generation migrants under 15 years in Finland with high TB risk are probably increasing.

47. Evaluation of new implementation strategies, program effectiveness and dissemination of new pedagogical knowledge: Centre for faculty development's stepping stones teaching certificate program

2007 ◽  
Vol 30 (4) ◽  
pp. 53
Author(s):  
D. Richardson ◽  
I. Silver ◽  
A. Dionne
Keyword(s):  
Program Evaluation ◽  
Faculty Development ◽  
Program Effectiveness ◽  
Teaching Practice ◽  
Journal Club ◽  
Development Program ◽  
Faculty Development Program ◽  
Stepping Stones ◽  
Certificate Program ◽  
The Impact

This evaluation of the integrated Stepping Stones (SS) Teaching Certificate program, including its instructional development (workshops) and theory review (journal club) components, will inform further program development. Results of this project will also add to the limited amount of scholarly work in the area of faculty development program evaluation. Faculty development literature in the area of organized program assessment reveals use of either quantitative OR qualitative methods. In this project, a novel method combining both techniques was used to explore program impact. Participants completed 2 questionnaires to identify skill-set knowledge gaps in teaching effectiveness. Pre- and post-program quantitative gaps were generated. Focus groups were used for qualitative exploration. Areas explored pre-program included: a) motives for enrollment, b) program expectations and c) prior teaching preparation. Post-program discussion explored: the impact of the program on a) participant’s perceived gaps, b) teaching behaviour change, and c) its influence on their career in education. We believed the program’s interprofessional environment would foster development of a learning community having impact on faculty knowledge, skills and attitudes related to teaching, and potentially elicit behavioural change in teaching practices. Results from a 2004-2005 cohort of participants have identified a variety of benefits for faculty and their teaching practice. Results from a second separate cohort, 2005-2006 participants, validated the initial findings. Remarkable harmonization in the results of the qualitative analysis between the two cohort samples was evident. Statistically significant differences (p < 0.05) were found in each of the domains examined qualitatively. Both qualitative and quantitatively, program effectiveness was demonstrated immediately following completion of the program. Follow up to assess the sustainability of the effects is ongoing. The analysis of the quantitative discrepancy (gaps) data has lead to a possible technique to assist in identifying unperceived educational needs. McLeod PJ, Steinert Y, Nasmith L, Conochie L. Faculty Development in Canadian medical schools: a 10-year update. CMAJ 1997; 156(10):1419-23. Hewson MG, Copeland HL, Fishleder AJ. What’s the use of faculty development? Program evaluation using retrospective self-assessments and independent performance ratings. Teach Learn Med 2001; 13(3):153-60. Moore EM. A Framework for Outcomes Evaluation in the Continuing Development of Physicians, in: The Continuing Professional Development of Physicians. Eds. Davis D, Barnes BE, Fox R. AMA Press, 2003.

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