scholarly journals TREATMENT SUCCESS OF DRUG RESISTANT TUBERCULOSIS IN HUMAN IMMUNODEFICIENCY VIRUS COINFECTED PATIENT AND RELATED FACTORS

Respirology ◽  
2019 ◽  
Vol 24 (S2) ◽  
pp. 29-30
2019 ◽  
Author(s):  
Yitagesu Habtu ◽  
Tesema Bereku ◽  
Girma Alemu ◽  
Ermias Abera

BACKGROUND Ethiopia is one of among thirty high burden countries of multi-drug resistant tuberculosis (MDR-TB) in the regions of world health organization. Contextual evidence on the emergence of the disease is limited at a program level. OBJECTIVE The aim of the study is to explore patient-provider factors that may facilitate the emergence of multi-drug resistant tuberculosis. METHODS We used a phenomenological study design of qualitative approach from June to July, 2015. We conducted ten in-depth interviews and 4 focus group discussions with purposely selected patients and providers. We designed and used an interview guide to collect data. Verbatim transcribes were exported to open code 3.4 for emerging thematic analysis. Domain summaries were used to support core interpretation. RESULTS The study explored patient-provider factors facilitating the emergence of multi-drug resistant tuberculosis. These factors as underlying, health system and patient-related factors. Especially, the a shows conflicting finding between having a history of discontinuing drug-susceptible tuberculosis and emergence of multi-drug resistant tuberculosis. CONCLUSIONS The patient-provider factors may result in poor early case identification, adherence to and treatment success in drug sensitive or multi-drug resistant tuberculosis. Our study implies the need for awareness creation about multi-drug resistant tuberculosis for patients and further familiarization for providers. This study also shows that patients developed multi-drug resistant tuberculosis though they had never discontinued their drug-susceptible tuberculosis treatment. Therefore, further studies may require for this discording finding.


1994 ◽  
Vol 3 (5) ◽  
pp. 389-397 ◽  
Author(s):  
Co MCJr

BACKGROUND: After decades of decreasing incidence, the number of new tuberculosis cases started to rise again in the mid-1980s and continues to be a major public health problem in the United States. The incidence of tuberculosis and drug-resistant tuberculosis is increasing among persons infected with human immunodeficiency virus. OBJECTIVE: To review the epidemiology, pathogenesis, clinical presentation, diagnosis, drug therapy, patients' nonadherence to prescribed treatment, and nursing issues related to the care of persons dually infected with tuberculosis and human immunodeficiency virus. METHODS: Fifty references addressing important issues in tuberculosis and human immunodeficiency virus were identified by searching the Medline data base and bibliographies of relevant articles. DISCUSSION: Tuberculosis is a communicable infectious disease caused by Mycobacterium tuberculosis. It is curable and preventable but generally fatal if undiagnosed and untreated. People with human immunodeficiency virus infection are at higher risk for reactivation of latent tuberculosis infection and for developing life-threatening tuberculosis. Specific nursing interventions are formulated to guide practice when caring for HIV-infected persons with tuberculosis. Future nursing research needs are suggested. CONCLUSIONS: An understanding of the complexity of the care involved will enhance the clinical management of tuberculosis in human immunodeficiency virus-infected patients and lead to a decline in the appearance of new drug-resistant tuberculosis strains.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248017
Author(s):  
Gilbert Lazarus ◽  
Kevin Tjoa ◽  
Anthony William Brian Iskandar ◽  
Melva Louisa ◽  
Evans L. Sagwa ◽  
...  

Background Adverse events (AEs) during drug-resistant tuberculosis (DR-TB) treatment, especially with human immunodeficiency virus (HIV) co-infection, remains a major threat to poor DR-TB treatment adherence and outcomes. This meta-analysis aims to investigate the effect of HIV infection on the development of AEs during DR-TB treatment. Methods Eligible studies evaluating the association between HIV seropositivity and risks of AE occurrence in DR-TB patients were included in this systematic review. Interventional and observational studies were assessed for risk of bias using the Risk of Bias in Nonrandomized Studies of Intervention and Newcastle-Ottawa Scale tool, respectively. Random-effects meta-analysis was performed to estimate the pooled risk ratio (RR) along with their 95% confidence intervals (CIs). Results A total of 37 studies involving 8657 patients were included in this systematic review. We discovered that HIV infection independently increased the risk of developing AEs in DR-TB patients by 12% (RR 1.12 [95% CI: 1.02–1.22]; I2 = 0%, p = 0.75). In particular, the risks were more accentuated in the development of hearing loss (RR 1.44 [95% CI: 1.18–1.75]; I2 = 60%), nephrotoxicity (RR 2.45 [95% CI: 1.20–4.98], I2 = 0%), and depression (RR 3.53 [95% CI: 1.38–9.03]; I2 = 0%). Although our findings indicated that the augmented risk was primarily driven by antiretroviral drug usage rather than HIV-related immunosuppression, further studies investigating their independent effects are required to confirm our findings. Conclusion HIV co-infection independently increased the risk of developing AEs during DR-TB treatment. Increased pharmacovigilance through routine assessments of audiological, renal, and mental functions are strongly encouraged to enable prompt diagnosis and treatment in patients experiencing AEs during concomitant DR-TB and HIV treatment.


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