scholarly journals Predictors for Mortality among Multidrug-Resistant Tuberculosis Patients in Tanzania

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Edson W. Mollel ◽  
Jaffu O. Chilongola
Keyword(s):  
Cigarette Smoking ◽  
Clinical Laboratory ◽  
Significant Risk ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Policy Makers ◽  
Resistant Tuberculosis ◽  
Radiological Data ◽  
History Of

Problem. Factors related to MDRTB mortality in Tanzania have not been adequately explored and reported. Objectives. To determine demographic, clinical, radiographic, and laboratory factors associated with MDRTB mortality in a Tanzanian TB Referral Hospital. Methodology. This was a cross-sectional study with 193 participants. Demographic, clinical, laboratory, and radiological data were collected, and their associations with mortality among MDRTB patients were determined. Results and Conclusions. Cough was the commonest finding among these MDRTB patients, with 179 (92.75%) of them presenting with cough, followed by chest X-ray consolidation in 156 patients (80.83%) and history of previous TB treatment in 151 patients (78.24%). Cigarette smoking, HIV positivity, and low CD4 counts were significantly associated with MDRTB mortality, p values of 0.034, 0.044, and 0.048, respectively. Fever on the other hand was at the borderline with p value of 0.059. We conclude that cigarette smoking and HIV status are significant risk factors for mortality among MDRTB patients. HIV screening should continually be emphasized among patients and the general community for early ARTs initiation. Based on the results from our study, policy makers and public health personnel should consider addressing tobacco cessation as part of national TB control strategy.

scholarly journals Knowledge and practice of health workers about control and prevention of multidrug-resistant tuberculosis in referral hospitals, Ethiopia: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e022948 ◽  
Author(s):  
Kefyalew Addis Alene ◽  
Akilew Awoke Adane ◽  
Sisay Yifiru ◽  
Bikes Destaw Bitew ◽  
Aynishet Adane ◽  
...  
Keyword(s):  
Health Workers ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of ◽  
The Mean ◽  
Knowledge And Practice

ObjectiveThe aim of this study was to assess the knowledge and practice of health workers about multidrug-resistant tuberculosis (MDR-TB) prevention and control.Study design and settingsA cross-sectional study was conducted at Gondar University Referral Hospital and Felege Hiwot Referral Hospital.ParticipantsRandomly selected health workers (ie, medical doctor, nurse, health officer, pharmacy, medical laboratory and midwifery) were the study participants.Outcome measuresThe main outcomes were knowledge and self-reported practice of health workers about MDR-TB.ResultsA total of 377 health workers (with a response rate of 93.7%) participated in the study. The majority of respondents were nurses (52.5%, n=198) and medical doctors (15.6%, n=59). The mean knowledge score was seven out of 10; 149 (39.5%) of respondents scored seven or more which was considered as good knowledge. MDR-TB knowledge of health workers was significantly associated with having a postgraduate degree (adjusted odds ratio (AOR)=5.78; 95% CI 2.33 to 14.33), taking infection prevention training (AOR=1.79; 95% CI 1.00, to 3.17) and having a history of tuberculosis (TB) (AOR=1.85; 95% CI 1.12, to 3.03). The mean self-reported practice score was four out of seven; one-fifth (19.6%) of respondents scored four or more which was considered as good practice. Self-reported practice of health workers was significantly associated with working at internal medicine (AOR=4.64; 95% CI 1.99, to 10.81) and paediatrics (AOR=3.85; 95% CI 1.11, to 13.34) wards, being in the age groups of 26–30 years (AOR=2.70; 95% CI 1.27, to 5.76), and 30 years and above (AOR=4.42; 95% CI 1.77, to 11.00).ConclusionsThis study found low knowledge and self-reported practice score among health workers. MDR-TB knowledge of health workers was significantly associated with educational status, infection prevention training and previous history of TB. This finding highlights the potential of providing MDR-TB training for health workers to increase their knowledge about MDR-TB.

scholarly journals Use of electronic cigarettes and secondhand exposure to their aerosols are associated with asthma symptoms among adolescents: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdullah Alnajem ◽  
Abdullah Redha ◽  
Dalal Alroumi ◽  
Ahmed Alshammasi ◽  
Mohamad Ali ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Cross Sectional Study ◽  
Cigarette Use ◽  
Sectional Study ◽  
Uncontrolled Asthma ◽  
Cross Sectional ◽  
Current Asthma ◽  
The Past ◽  
Asthma Symptoms ◽  
History Of

Abstract Background Globally, a surge in electronic cigarette (e-cigarette) use has been observed in recent years, with youth being the most susceptible group. Given their recent emergence, studies assessing the health consequences of using e-cigarettes and exposure to their secondhand aerosols (SHA) are limited. Hence, this study sought to assess associations between e-cigarette use and household exposure to SHA from e-cigarettes with asthma symptoms among adolescents. Methods A school-based cross-sectional study was conducted by enrolling high school students (n = 1565; aged 16–19 years) in Kuwait. Participants self-completed a questionnaire on tobacco products use (e-cigarettes and cigarettes) and asthma symptoms. Current e-cigarette use and cigarette smoking were defined as any use in the past 30 days. Household exposure to SHA from e-cigarettes in the past 7 days was reported as none (0 days), infrequent (1–2 days), and frequent (≥ 3 days). Asthma symptoms included current (past 12 months) wheeze, current asthma (history of clinical diagnosis and current wheeze and/or medication use), and current symptoms of uncontrolled asthma (≥ 4 attacks of wheeze, ≥ 1 night per week sleep disturbance from wheeze, and/or wheeze affecting speech). Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. Results Among the analytical study sample (n = 1345), current e-cigarette use and cigarette smoking was reported by 369 (27.4%) and 358 (26.6%) participants, respectively. Compared to never e-cigarette users and never cigarette smokers, current e-cigarette users with no history of cigarette smoking had increased prevalence of current wheeze (aPR = 1.54, 95% CI 1.01–2.45) and current asthma (aPR = 1.85, 95% CI 1.03–3.41). Moreover, the frequency of exposure to household SHA from e-cigarettes was associated with asthma symptoms. For example, compared to those with no exposure to household SHA, frequent exposure to household SHA was associated with current wheeze (aPR = 1.30, 95% CI 1.04–1.59), current asthma (aPR = 1.56, 95% CI 1.13–2.16), and current uncontrolled asthma symptoms (aPR = 1.88, 95% CI 1.35–2.62). Conclusions E-cigarette use and their household SHA exposure were independently associated with asthma symptoms among adolescents. Hence, such observations indicate that e-cigarette use and passive exposure to their aerosols negatively impact respiratory health among adolescents.

scholarly journals Plasmid Derived AmpC Genotypes among the Multidrug Resistant Enterobacteriaceae Strains Isolated from Urine Samples in Southern India

2021 ◽  
Author(s):  
P Ronni Mol ◽  
Ganesan Shanthi ◽  
Khalid Bindayna
Keyword(s):  
Clinical Laboratory ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Urine Samples ◽  
Pcr Analysis ◽  
Genotype Distribution ◽  
Cross Sectional ◽  
Beta Lactamases ◽  
Hospital Infection Control ◽  
Tract Infections

Introduction: The most common pathogens causing Urinary Tract Infections (UTI) in community and hospital settings are Enterobacteriaceae. Antibiotic resistance is a major problem worldwide because of an increase in the use of antibiotics. Production of Extended Spectrum Beta-Lactamases (ESBLs) and AmpC beta-lactamases is the most common cause of resistance among Enterobacteriaceae (AmpC). Initially, AmpC β-lactamases received less attention globally, but now it has become a rising problem. Detection of AmpC β-lactamases expressing microbes is a requirement for addressing surveillance, for problems of hospital infection control, and for choosing optimal antimicrobial therapy. Aim: To study the genotype distribution of plasmid mediated AmpC β-lactamase produced in Enterobacteriaceaestrains isolated from urine samples. Materials and Methods: A cross-sectional study based on clinical laboratory surveillance was conducted from July 2019 to February 2020. Sixty Enterobacteriaceae isolates were identified by standard biochemical reactions. AmpC screening were done by cefoxitin disk diffusion and confirmed by an inhibitor-based assay using boronic acid. The presence of six plasmid mediated AmpC genes was determined by multiplex Polymerase Chain Reaction (PCR). Statistical Package for the Social Science (SPSS) version 20.0 was used to obtain descriptive data. Results: Among 60 Enterobacteriaceae isolates, 23 (38.3%) were cefoxitin-resistant isolates which contain Escherichia colistrain (n=17) while the remaining samples consist ofKlebsiella pneumoniae (n=5) and Proteus mirabilis strains (n=1). AmpC β-lactamase production was phenotypically confirmed in 12(20%) isolates and genotypically confirmed by PCR analysis in 16(26.6%) of all the urine isolates. In the present study, 3(13%), 2 (8.6%) of cefoxitin resistant isolates harboured the DHA, EBC gene and 1(4.3%) each harboured FOX and CIT gene, and 9(39.1%) harboured a combination of the genes. Conclusion: The present study suggested the predominant existence of plasmid mediated AmpC producers in Multi-Drug Resistant (MDR) Escherichia coli and Klebsiella pneumoniae. We suggest continuous surveillance is important to effectively control the spread of these strains and for optimal clinical outcome.

scholarly journals Feasibility of Identifying Household Contacts of Rifampin-and Multidrug-resistant Tuberculosis Cases at High Risk of Progression to Tuberculosis Disease

2019 ◽  
Vol 70 (3) ◽  
pp. 425-435 ◽  
Author(s):  
Amita Gupta ◽  
Susan Swindells ◽  
Soyeon Kim ◽  
Michael D Hughes ◽  
Linda Naini ◽  
...  
Keyword(s):  
High Risk ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Interferon Gamma Release Assay ◽  
Cross Sectional ◽  
Household Contacts ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background We assessed multidrug-resistant tuberculosis (MDR-TB) cases and their household contacts (HHCs) to inform the development of an interventional clinical trial. Methods We conducted a cross-sectional study of adult MDR-TB cases and their HHCs in 8 countries with high TB burdens. HHCs underwent symptom screenings, chest radiographies, sputum TB bacteriologies, TB infection (TBI) testing (tuberculin skin test [TST] and interferon gamma release assay [IGRA]), and human immunodeficiency virus (HIV) testing. Results From October 2015 to April 2016, 1016 HHCs from 284 MDR-TB cases were enrolled. At diagnosis, 69% of MDR-TB cases were positive for acid-fast bacilli sputum smears and 43% had cavitary disease; at study entry, 35% remained smear positive after a median MDR-TB treatment duration of 8.8 weeks. There were 9 HHCs that were diagnosed with TB prior to entry and excluded. Of the remaining 1007 HHCs, 41% were male and the median age was 25 years. There were 121 (12%) HHCs that had new cases of TB identified: 17 (2%) were confirmed, 33 (3%) probable, and 71 (7%) possible TB cases. The TBI prevalence (defined as either TST or IGRA positivity) was 72% and varied by age, test used, and country. Of 1007 HHCs, 775 (77%) were considered high-risk per these mutually exclusive groups: 102 (10%) were aged <5 years; 63 (6%) were aged ≥5 and were infected with HIV; and 610 (61%) were aged ≥5 years, were negative for HIV or had an unknown HIV status, and were TBI positive. Only 21 (2%) HHCs were on preventive therapy. Conclusions The majority of HHCs in these high-burden countries were at high risk of TB disease and infection, yet few were receiving routine preventive therapy. Trials of novel, preventive therapies are urgently needed to inform treatment policy and practice.

scholarly journals Assessment of Knowledge and Attitude of Tuberculosis Patients in Direct Observation Therapy Program towards Multidrug-Resistant Tuberculosis in Addis Ababa, Ethiopia: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Firew Tadesse Kusheno ◽  
Teklehaimanot Mezgebe Nguse ◽  
Gebremedhin Beedemariam Gebretekle
Keyword(s):  
Addis Ababa ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Therapy Program ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Health Centres ◽  
Mdr Tb ◽  
Knowledge And Attitude

Background. Multidrug-resistant tuberculosis (MDR-TB) is becoming a major challenge of tuberculosis (TB) control program globally but more serious in developing countries like Ethiopia. In 2013, a survey result showed that in Ethiopia, tuberculosis patients from new cases and retreatment cases had resistance to at least isoniazid and rifampicin with a significant increase over time. Inadequate knowledge and wrong perception about MDR-TB by patients were detrimental to TB control programs. The study aimed at assessing the knowledge and attitude of TB patients of direct observation therapy program towards multidrug-resistant tuberculosis in health centres of Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 health centres of Addis Ababa which were selected by simple random sampling technique. A total of 422 TB patients were included in the study, and participants from each health centres were taken proportional to the number of clients in each health centres. Data was entered and analyzed using SPSS version 20. Association between outcome and independent variables was explored using logistic regression. Results. The level of knowledge of TB patients about MDR-TB was poor and only 55.0% of TB patients attained good overall knowledge. A significant association was found between good knowledge and attending tertiary level of education (AOR=4.3, 95%CI=1.9, 9.8), gender (AOR=1.62, 95%CI=1.1, 2.4), income of respondents’ family (OR=0.4, 95%CI=0.2, 0.9), and sleeping practice (AOR=8.0, 95%CI=4.0, 15.7). Nearly three-fourths (73.5%) of TB patients had a favourable attitude towards MDR-TB. Occupational status (AOR=4.4, 95%CI=2.5, 7.6) and sleeping practices (AOR=2.4, 95%CI=1.2, 5.0) were significantly associated with the attitude of the TB patients. Conclusions. Knowledge of TB patients toward MDR-TB was poor. Although a large proportion of patients had a favourable attitude, it still needs to be improved. Hence, efforts should be made to implementing health education to improve awareness of TB patients about MDR-TB.

scholarly journals Nutritional status and childhood wheezing in rural Bangladesh

2013 ◽  
Vol 17 (7) ◽  
pp. 1570-1577 ◽  
Author(s):  
Mohammad Delwer Hossain Hawlader ◽  
Emiko Noguchi ◽  
Shams El Arifeen ◽  
Lars Åke Persson ◽  
Sophie E Moore ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Economic Status ◽  
Significant Risk ◽  
International Study ◽  
Significant Risk Factor ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Rural Bangladesh ◽  
History Of ◽  
Serum Total Ige

AbstractObjectiveTo investigate the association between current childhood nutritional status and current wheezing among pre-school children in rural Bangladesh.DesignCross-sectional study.SettingMatlab region, rural Bangladesh.SubjectsChildren (n 912) aged 4·5 years. Anthropometric measurements of the mothers and their children were taken during a 1-year period from December 2007 to November 2008. Current wheezing was identified using the International Study of Asthma and Allergies in Childhood questionnaire. Serum total IgE was measured by human IgE quantitative ELISA. IgE specific antibody to dust mites (Dermatophagoides pteronyssinus) was measured by the CAP-FEIA system (Phadia AB, Uppsala, Sweden).ResultsWheezing at 4·5 years old was significantly associated with stunting (OR = 1·58; 95 % CI 1·13, 2·22) and underweight (OR = 1·39; 95 % CI 1·00, 1·94). The association with stunting remained significant after adjustment for sex, birth weight, birth length, gestational age at birth, mother's parity, maternal BMI, family history of asthma, socio-economic status, season of birth and intervention trial arm (OR = 1·74; 95 % CI 1·19, 2·56).ConclusionsStunting was a significant risk factor for wheezing among rural Bangladeshi children. Further studies will be required to confirm the relationship between nutritional status and allergic illnesses in developing countries.

scholarly journals Prevalence of Extensively Drug Resistant Tuberculosis among Archived Multidrug Resistant Tuberculosis Isolates in Zimbabwe

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Tichaona Sagonda ◽  
Lucy Mupfumi ◽  
Rumbidzai Manzou ◽  
Beauty Makamure ◽  
Mqondisi Tshabalala ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Drug Resistance ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Second Line ◽  
Cross Sectional ◽  
Resistant Tuberculosis ◽  
Resistance Patterns ◽  
Mdr Tb ◽  
Definition Of

We conducted a cross-sectional study of second line drug resistance patterns and genetic diversity of MDR-TB isolates archived at the BRTI-TB Laboratory, Harare, between January 2007 and December 2011. DSTs were performed for second line antituberculosis drugs. XDR-TB strains were defined as MDR-TB strains with resistance to either kanamycin and ofloxacin or capreomycin and ofloxacin. Strain types were identified by spoligotyping. No resistance to any second line drugs was shown in 73% of the isolates, with 23% resistant to one or two drugs but not meeting the definition of XDR-TB. A total of 26 shared types were identified, and 18 (69%) matched preexisting shared types in the current published spoligotype databases. Of the 11 out of 18 clustered SITs, 4 predominant (>6 isolates per shared type) were identified. The most and least abundant types were SIT 1468 (LAM 11-ZWE) with 12 (18%) isolates and SIT 53 (T1) with 6 (9%) isolates, respectively. XDR-TB strains are rare in Zimbabwe, but the high proportion of “pre-XDR-TB” strains and treatment failure cases is of concern. The genetic diversity of the MDR-TB strains showed no significant association between SITs and drug resistance.

Correlates of Axial Gout: A Cross-sectional Study

2012 ◽  
Vol 39 (7) ◽  
pp. 1445-1449 ◽  
Author(s):  
RUKMINI M. KONATALAPALLI ◽  
ELENA LUMEZANU ◽  
JAMES S. JELINEK ◽  
MARK D. MURPHEY ◽  
HONG WANG ◽  
...  
Keyword(s):  
Back Pain ◽  
Clinical Laboratory ◽  
Gouty Arthritis ◽  
Cross Sectional Study ◽  
Strongly Correlated ◽  
Sectional Study ◽  
Cross Sectional ◽  
American College Of Rheumatology ◽  
History Of ◽  
Hands And Feet

Objective.A cross-sectional study was undertaken to determine the prevalence of axial gout in patients with established gouty arthritis and to analyze clinical, laboratory, and radiological correlations.Methods.Forty-eight subjects with a history of gouty arthritis (American College of Rheumatology criteria) for ≥ 3 years under poor control were included. Subjects underwent history, physical examination, laboratory testing, and imaging studies, including radiographs of the hands and feet and computerized tomography (CT) of the cervical and lumbar spines and sacroiliac joints (SIJ). Patients with characteristic erosions and/or tophi in the spine or SIJ were considered to have axial or spinal gout.Results.Seventeen patients (35%) had CT evidence of spinal erosions and/or tophi, with tophi identified in 7 of the 48 subjects (15%). The spinal location of axial gout was cervical in 7 patients (15%), lumbar in 16 (94%), SIJ in 1 (6%), and more than 1 location in 14 (82%). Duration of gout, presence of back pain, and serum uric acid levels did not correlate with axial gout. Extremity radiographs characteristic of gouty arthropathy found in 21 patients (45%) were strongly correlated with CT evidence of axial gout (p < 0.001). All patients with tophi in the spine had abnormal hand or feet radiographs (p = 0.005).Conclusion.Axial gout may be a common feature of chronic gouty arthritis. The lack of correlation with back pain, the infrequent use of CT imaging in patients with back pain, and the lack of recognition of the problem of spinal involvement in gouty arthritis suggest that this diagnosis is often missed.

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