scholarly journals Estimating TB diagnostic costs incurred under the National Tuberculosis Elimination Programme: a costing study from Tamil Nadu, South India

2021 ◽  
Author(s):  
Malaisamy Muniyandi ◽  
Jayabal Lavanya ◽  
Nagarajan Karikalan ◽  
Balakrishnan Saravanan ◽  
Sellappan Senthil ◽  
...  
Keyword(s):  
Tamil Nadu ◽  
South India ◽  
Diagnostic Tools ◽  
Smear Microscopy ◽  
Drug Resistant ◽  
X Ray ◽  
Unit Costs ◽  
National Tuberculosis ◽  
Costing Study ◽  
Elimination Programme

Abstract Background The National Tuberculosis Elimination Programme (NTEP) of India is aiming to eliminate TB by 2025. The programme has increased its services and resources to strengthen the accurate and early detection of TB. It is important to estimate the cost of TB diagnosis in India considering the advancement and implementation of new diagnostic tools under the NTEP. The objective of this study was to estimate the unit costs of providing TB diagnostic services at different levels of public health facilities with different algorithms implemented under the NTEP in Chennai, Tamil Nadu, South India. Methods This costing study was conducted from the perspective of the health system. This study used only secondary data and information that were available in the public domain. Data were collected with the approval of health authorities. The patient's diagnostic path from the point of registration until the final diagnosis was considered in the costing exercise. The unit costs of different diagnostic tools used in the NTEP implemented by Chennai Corporation were calculated. Results We estimated the unit cost of the eight laboratory tests (Ziehl–Neelsen [ZN], fluorescence microscopy [FM], x-ray, digital x-ray, gene Xpert MTB/RIF (cartridge-based nucleic acid amplification test [NAAT] that identifies rifampicin resistant Mycobacterium Tuberculosis) Mycobacterium Tuberculosis/Rifampicin [MTB/RIF], mycobacteria growth indicator tube [MGIT], line probe assay [LPA] and Lowenstein Jensen [LJ] culture) for diagnosis of drug-sensitive and drug-resistant TB. The unit costs included fixed and variable costs for smear examination by ZN microscopy (₹ [Indian Rupee] 326 [US${\$}$4.72], FM (₹104 [US${\$}$1.5]), x-ray (₹218 [US${\$}$3.15]), digital X-ray (₹281 [US${\$}$4.07]), gene Xpert MTB/RIF (₹1137 [US${\$}$16.47]), MGIT (₹7038 [US${\$}$102]), LPA (₹6448 [US${\$}$93.44]) and LJ culture (₹4850 [US${\$}$70.28]). Out of 10 diagnostic algorithms used for TB diagnosis, algorithms using only smear microscopy had the lowest cost, followed by smear microscopy with x-ray for drug-sensitive TB (₹104 [US${\$}$1.5] to ₹544 [US${\$}$7.88]). Diagnostic algorithms for drug-resistant TB involving LPA and gene Xpert MTB/RIF were the most expensive. Conclusions Understanding the various costs contributing to TB diagnosis in India provides crucial evidence for policymakers, programme managers and researchers to optimise programme spending and efficiently use resources.

scholarly journals Costs of TB services in India (No 1)

2021 ◽  
Vol 25 (12) ◽  
pp. 1013-1018
Author(s):  
S. Chatterjee ◽  
M. N. Toshniwal ◽  
P. Bhide ◽  
K. S. Sachdeva ◽  
R. Rao ◽  
...  
Keyword(s):  
Unit Cost ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Systems Perspective ◽  
Unit Costs ◽  
Multi Stage ◽  
National Tuberculosis ◽  
Elimination Programme ◽  
Line Drug ◽  
Children Under 5

BACKGROUND: There is a dearth of economic analysis required to support increased investment in TB in India. This study estimates the costs of TB services from a health systems´ perspective to facilitate the efficient allocation of resources by India´s National Tuberculosis Elimination Programme.METHODS: Data were collected from a multi-stage, stratified random sample of 20 facilities delivering TB services in two purposively selected states in India as per Global Health Cost Consortium standards and using Value TB Data Collection Tool. Unit costs were estimated using the top-down (TD) and bottom-up (BU) methodology and are reported in 2018 US dollars.RESULTS: Cost of delivering 50 types of TB services and four interventions varied according to costing method. Key services included sputum smear microscopy, Xpert® MTB/RIF and X-ray with an average BU costs of respectively US$2.45, US$17.36 and US$2.85. Average BU cost for bacille Calmette-Guérin vaccination, passive case-finding, TB prevention in children under 5 years using isoniazid and first-line drug treatment in new pulmonary and extrapulmonary TB cases was respectively US$0.76, US$1.62, US$2.41, US$103 and US$98.CONCLUSION: The unit cost of TB services and outputs are now available to support investment decisions, as diagnosis algorithms are reviewed and prevention or treatment for TB are expanded or updated in India.

scholarly journals Compliance of St Joseph’s Hospital Roma, Lesotho with the National Tuberculosis Programme of Lesotho, 2007 and 2008

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Oladoyinbo O. Samuel ◽  
Pierre J.T. De Villiers
Keyword(s):  
Treatment Failure ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sputum Smear Microscopy ◽  
X Ray ◽  
National Tuberculosis Programme ◽  
National Tuberculosis ◽  
Tuberculosis Programme ◽  
Chest X Ray ◽  
Smear Negative

Background: In 2009 Lesotho had an estimated TB prevalence of 696 cases/100 000 population − the 4th highest in the world. This epidemic was characterised by high rates of death, treatment failure and unknown treatment outcomes. These adverse outcomes were attributable to a high rate of TB and/or HIV co-infection and weaknesses in the implementation of Lesotho’s National Tuberculosis Programme (NTP). This study was conducted in St Joseph’s Hospital, Roma (SJHR) to assess the implementation of the NTP.Method: Records of 993 patients entered into the SJHR TB register between 2007 and 2008 were reviewed. Patients’ treatment details were extracted from the register, validated and analysed by STATA 10.0.Results: Of 993 patients registered: 88% were new patients, 37% were diagnosed on sputum smear microscopy alone, 35% were diagnosed on sputum smear microscopy with chest X-ray, whilst 25% were diagnosed on chest X-ray alone. In addition: 33% were sputum smear positive, 45% were sputum smear negative, and 22% had extra-pulmonary TB. As to treatment outcome: 26% were cured, 51% completed treatment, and 51% converted from sputum smear positive to sputum smear negative over six months, whilst 16% died. Regarding HIV, 77% of patients were tested for HIV and 59% had TB and/or HIV co-infection. Of ten NTP targets only the defaulter and treatment failure rate targets were met.Conclusion: Whilst only two out of ten NTP targets were met at SJHR in 2007–2008, improvements in TB case management were noted in 2008 which were probably due to the positive effects of audit on staff performance.

THE TRENDS OF TUBERCULOSIS IN CHILDREN AGED 1- 12 YEARS AND ITS MANAGEMENT FROM 2011 TO 2015 AT ARTHUR DAVISON CHILDRENS HOSPITAL IN NDOLA: Retrospective study (Preprint)

2019 ◽  
Author(s):  
Martin Greta
Keyword(s):  
The Body ◽  
Smear Microscopy ◽  
Newly Diagnosed ◽  
X Ray ◽  
Children's Hospital ◽  
Co Morbidity ◽  
Children’S Hospital ◽  
Childhood Tb ◽  
Tuberculosis In Children ◽  
Age Range

BACKGROUND Tuberculosis is a widespread and in many cases a fatal, infectious disease caused by many strains of mycobacterium complex usually mycobacterium tuberculosis. It can affect any part of the body but mainly the lungs hence called pulmonary tuberculosis. Tuberculosis in children has been less of a public health priority in the recent years despite the fact that TB has been a major cause of childhood morbidity and mortality worldwide with difficulties in diagnosis. Data on trends of childhood TB is rarely in published literature hence need for this research which will help in publishing OBJECTIVE To establish the trends in TB among children aged 1-12 years and its management over a period of five years from 2011- 2015 at Arthur Davison children’s hospital in Ndola and also to determine the proportion of TB in these children and to establish the age group most affected by TB over the period of five years and lastly to assess the proportion of TB and HIV as a co-morbidity METHODS The study reviewed all records that were registered in the MOH TB register at ADH from 2011 to 2015 coming up with a total number of 483 TB records and these records had satisfied the inclusion and exclusion criteria. The data capturing tool was used to collect the data. RESULTS : This study determined the trends of TB in children aged 1 to 12 over the five years period from a total of 483 reviewed paediatric TB cases , its proportion in these children, the age range most affected by TB and lastly assessed TB and HIV as a co-morbidity at Arthur Davison Children’s hospital. It revealed that the trends were decreasing and that out of 483 TB patient, the majority 157(32.5%) of the TB patients were seen in the year 2011, followed by 129(26.7%), 84(17.4%), 57(11.8%) and 56(11.6%) representing the year 2012, 2013, 2014 and 2015 respectively. Findings on the age range most affected are that the majority 282(58.4%) of the TB patients were aged (5-12) years old while 201(41.6%) were aged between (1-5) years old. Therefore, the age range most affected by TB was between (5-12) years. The TB proportion results showed that Out of 483, the majority 467(96.7%) of the TB patient type were newly diagnosed, followed by 13(2.7%), 2(.4%) and the rest 1(.2%) that were Relapse, Trans-in and Treatment resumed respectively. And that many 467(96.7%) of TB condition types were PTB while 16(3.3%) were EPTB. Furthermore, the majority of 463(95.9%) were diagnosed by X-ray while 20(4.1%) were diagnosed by smear microscopy. And lastly In terms of HIV as a co-morbidity, the majority 175(36.2%) of the TB patients were HIV positive, followed by 173(35.8%) that were HIV negative while the rest 135(28%) of the TB patients were not tested for HIV CONCLUSIONS This study reports that the trends of TB in children aged 1-12 years have been decreasing from 2015 to 2011 .And the age range most affected was found to have been 5-12 years and the proportion of TB cases were mostly newly diagnosed and the diagnosis was made by use x-ray and lastly the large proportion of TB patients had tested positive for HIV as a co-morbidity. Therefore efforts should be made to sustain this decreasing trend of childhood TB.

scholarly journals Lecanicillium lecanii (Zimmermann) Zare & Gams, as an efficient biocontrol agent of tea thrips, Scirtothrips bispinosus Bagnall (Thysanoptera: Thripidae)

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Mariappan Sankara Rama Subramaniam ◽  
Azariah Babu ◽  
Bhabesh Deka
Keyword(s):  
Tamil Nadu ◽  
South India ◽  
Biocontrol Agent ◽  
Uv Light ◽  
Biological Control Agents ◽  
Optimum Conditions ◽  
Lecanicillium Lecanii ◽  
Wettable Powder ◽  
Label Claim ◽  
Yeast Powder

Abstract Background Continuous and non-judicial application of synthetic insecticides to control the tea thrips, Scirtothrips bispinosus (Bagnall), one of the major tea pests in South India has led to certain undesirable issues in the ecosystem besides the presence of the pesticide residues in manufactured tea. Biological control agents are of immense importance in tea cultivation. The present study was designed to isolate Lecanicillium lecanii (Zimmermann) Zare & Gama from the field-collected cadavers of the insects/mites infected by fungi of tea growing areas of Anamallais (Tamil Nadu, South India), and to evaluate their field bio-efficacy against the tea thrips. Results Lecanicillium lecanii isolated from the tea ecosystem had been formulated into a wettable powder (WP) formulation and evaluated against tea thrips under both laboratory and field conditions. Among the several media evaluated, the PDAY (Potato Dextrose Agar + 1% Yeast powder) was found to be the best suitable medium for the growth and germination of spores. Optimum conditions for the growth of L. lecanii were found in PDAY medium at the pH 6-7, temperature 25-30°C and 90-95% RH. Exposure to UV light for more than 30 min significantly inhibited the growth of the fungus. Lecanicillium lecanii at (1 × 107 spore/ha) was found significantly effective against thrips. Fungal development index (FDI) of L. lecanii + jaggery significantly differed than other treatments. Lecanicillium lecanii at 1500g (1×107 conidia/ml) mixed in 400 l of water was effective against the tea thrips. Addition of equal amount of jaggery with L. lecanii wettable powder in the tank mixture could increase the efficacy of the mycopesticide against tea thrips. Conclusion The powder formulation of L. lecanii was found safer to natural enemies present in the tea ecosystem. After fulfilling the requirements for its registration and label claim on tea, this strain of L. lecanii could be commercialized for the benefit of the tea industry for the management of tea thrips in an eco-friendly manner.

Representing Disasters and Long-term Recovery – Insights from Tamil Nadu

2021 ◽  
Author(s):  
Chandni Singh ◽  
Mark Tebboth ◽  
Jasmitha Arvind ◽  
Yashodara Udupa
Keyword(s):  
Tamil Nadu ◽  
Shape Recovery ◽  
South India ◽  
State Policies ◽  
Indian Ocean Tsunami ◽  
Recovery Processes ◽  
Disaster Impacts ◽  
Chennai City ◽  
Post Disaster

This study focuses on disaster impacts and recovery in Tamil Nadu, drawing on insights from Chennai city and Nagapattinam district. The research is part of a larger three-year project called “Recovery with Dignity”, which examines the experiences of recovery in post-disaster situations across three states in India – Odisha, Tamil Nadu, and Kerala – and explores how recovery processes represent vulnerable populations. In this report, we focus on three key disasters in Tamil Nadu: the 2004 Indian Ocean Tsunami, the 2015 South India flood, and the 2018 Cyclone Gaja. Through these events, we examine how the ways disasters and their losses are represented shape recovery outcomes. The study uses a range of data, from a review of state policies in Tamil Nadu (2005-2019), an analysis of media articles published in English and Tamil (2004-2019), to interviews with disaster-affected people and secondary stakeholders. The findings indicate that disaster responses and outcomes are highly differentiated based on how disaster-affected people and their needs and losses are represented. To enable inclusive recovery, it is necessary to recognising the heterogenous nature of disaster impacts and acknowledge different ideas of what recovery means.

scholarly journals The mineralogical and fabric analysis of ancient pottery artifacts

Cerâmica ◽  
2011 ◽  
Vol 57 (341) ◽  
pp. 56-62 ◽  
Author(s):  
R. Palanivel ◽  
U. Rajesh Kumar
Keyword(s):  
Firing Temperature ◽  
Tamil Nadu ◽  
Thermal Characteristic ◽  
Inert Atmosphere ◽  
X Ray ◽  
Ancient Pottery ◽  
Mineral Phases ◽  
Fabric Analysis ◽  
Physical Attributes ◽  
Xrd Studies

The present investigation is carried out to estimate the firing temperature and conditions of firing of ancient pottery shreds excavated recently from Sembiankandiyur, Tamil Nadu, India. FTIR and XRD studies have been attempted on these shreds to characterize the mineral composition of the pottery artifacts in respect of their different physical attributes. The firing temperature and conditions were inferred from the mineral phases of the samples exhibited by the infrared spectra and X-ray diffractograms recorded in as received state. TG-DTA is the complementary technique to elucidate the firing temperature from the thermal characteristic reactions such as dehydration, decomposition and transformations of minerals under the controlled firing of the samples in inert atmosphere.

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