scholarly journals An Evaluation of Treatment Outcomes in a Cohort of Clients on the DOTS Strategy, 2012–2016

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ato Kwamena Tetteh ◽  
Edward Agyarko ◽  
Joseph Otchere ◽  
Langbong Bimi ◽  
Irene Ayi
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Age Groups ◽  
Sputum Smear ◽  
Hiv Coinfection ◽  
Sociodemographic Determinants ◽  
Hiv Infection Prevention ◽  
The Difference ◽  
Lost To Follow Up ◽  
First Time

We present, for the first time, an evaluation of treatment outcomes in a cohort at a TB referral centre in the Central Region of Ghana. Of the 213 clients placed on DOTS, 59.2% (126/213) were sputum smear-positive. An overall cure rate of 90.2% (51.6% cured + 37.6% completed) and a death rate of 8.5% (18/213) were estimated. Of the number of clients who died, 5.7% (12/213) were males (χ2 = 2.891, p=0.699; LR = 3.004, p=0.699). Deaths were only recorded among clients who were > 19 years old (χ2 = 40.319, p=0.099; LR = 41.244, p=0.083). Also, 0.9% (2/213) was lost to follow-up, while 1.4% (3/213) had treatment failure. In total, 13.6% (7.0%, 15/213 males, and 6.6%, 14/213 females) of clients who were placed on DOTS were HIV seropositive. Ages of 40–49 years had the highest number, 13/213 (6.1%), infected with HIV, though the difference among the remaining age groups was not statistically significant (χ2 = 9.621, p=0.142). Furthermore, 7.0% (15/213) had TB/HIV coinfection. Out of them, 9 were cured and 5 died at home, while 1 had treatment failure. Tuberculosis/HIV infection prevention advocacy and interventions that address sociodemographic determinants of unfavourable treatment outcomes are urgently required to augment national efforts towards control.

scholarly journals Comparison of first-line tuberculosis treatment outcomes between previously treated and new patients: a retrospective study in Machakos subcounty, Kenya

2020 ◽  
Author(s):  
Johannes Ndambuki ◽  
Joseph Nzomo ◽  
Lucy Muregi ◽  
Chris Mutuku ◽  
Francis Makokha ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Adverse Outcome ◽  
Previous Treatment ◽  
First Line ◽  
Adherence Support ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Lost To Follow Up

Abstract Background Since 2016, patients with rifampicin-susceptible tuberculosis (TB) have been treated with the 6-month first-line regimen, regardless of treatment history. We assessed treatment outcomes of previously treated and new patients in Machakos subcounty, Kenya. Methods We performed a retrospective cohort study in patients started on first-line treatment between 2016 and 2017. Firth's logistic regression was used to estimate the effect of previous treatment on having a programmatic adverse outcome (either lost to follow-up, death, failure) and treatment failure vs treatment success (either cure or completion). Results Of 1024 new and 79 previously treated patients, 88.1% and 74.7% were treated successfully, 6.5% and 7.6% died, 4.2% and 10.1% were lost to follow-up and 1.2% and 7.6% had treatment failure, respectively. Previous treatment predicted having a programmatic adverse outcome (adjusted odds ratio [aOR] 2.4 [95% confidence interval {CI} 1.4 to 4.2]) and treatment failure (aOR 7.3 [95% CI 2.6 to 20.4]) but not mortality. Similar correlations were found in 334 new and previously treated patients with confirmed baseline rifampicin susceptibility. Conclusion Previously treated patients were more at risk of experiencing a poor treatment outcome, mainly lost to follow-up and treatment failure. Adherence support may reduce lost to follow-up. Rifampicin drug susceptibility testing coverage should increase. More robust retreatment regimens may reduce treatment failure.

scholarly journals Evaluation of buprenorphine/naloxone dose and use of sedating supportive medication on treatment outcomes in veterans with opioid use disorder

2017 ◽  
Vol 7 (6) ◽  
pp. 271-275 ◽  
Author(s):  
Amber Kapuganti ◽  
Traci Turner ◽  
Christopher J. Thomas
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Treatment Response ◽  
Opioid Use Disorder ◽  
Urine Drug Screen ◽  
Opioid Use ◽  
Time To Treatment ◽  
Time To Treatment Failure ◽  
Urine Drug ◽  
Lost To Follow Up

Abstract Introduction: This retrospective cohort study evaluated effects of buprenorphine/naloxone dose and concomitant use of selected sedating medications on treatment outcomes in patients with opioid use disorder. Methods: Patients enrolled in the buprenorphine/naloxone clinic at the study institution from 2009 until April 2013 were included. There were no exclusion criteria. Part 1 assessed treatment failure within 6 months and time to treatment failure with buprenorphine doses >8 mg and ≤8 mg. Part 2 assessed for treatment failure within 6 months and time to treatment failure with use of selected sedating medications. Sedating medications were cyproheptadine, hydroxyzine, quetiapine, and trazodone. Treatment failure was defined as documentation of illicit opioid use per patient report, urine drug screen showing opioid use, or patient lost to follow-up. Results: There were 132 patients included in this study, but 163 separate encounters due to multiple enrollments. Treatment failure was experienced within 6 months 51 times a patient was prescribed ≤8 mg (66.2%) and 26 times a patient was prescribed >8 mg (33.8%) (P = .0005). Average time to treatment failure was 5.1 months with ≤8 mg and 8.4 months with >8 mg. The 48% of patients who received sedating medications did not demonstrate any significant differences in treatment response at 6 months (P = .2746) or time to treatment failure (P = .2209). Discussion: Doses of buprenorphine/naloxone >8 mg demonstrated better treatment response and prolonged time to treatment failure. Concomitant sedating medications did not have a statistically significant effect on treatment response or time to treatment failure.

scholarly journals Prevalence, Predictors, and Successful Treatment Outcomes of Xpert MTB/RIF–identified Rifampicin-resistant Tuberculosis in Post-conflict Eastern Democratic Republic of the Congo, 2012–2017: A Retrospective Province-Wide Cohort Study

2019 ◽  
Vol 69 (8) ◽  
pp. 1278-1287 ◽  
Author(s):  
André N H Bulabula ◽  
Jenna A Nelson ◽  
Eric M Musafiri ◽  
Rhoderick Machekano ◽  
Nadia A Sam-Agudu ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Democratic Republic ◽  
Drug Event ◽  
Sputum Smear ◽  
Resistant Tuberculosis ◽  
Post Conflict ◽  
Adherence Support ◽  
Mdr Tb ◽  
Republic Of The Congo

Abstract Background Multidrug-resistant tuberculosis (MDR-TB) jeopardizes global TB control. The prevalence and predictors of Rifampicin-resistant (RR) TB, a proxy for MDR-TB, and the treatment outcomes with standard and shortened regimens have not been assessed in post-conflict regions, such as the South Kivu province in the eastern Democratic Republic of the Congo (DRC). We aimed to fill this knowledge gap and to inform the DRC National TB Program. Methods of adults and children evaluated for pulmonary TB by sputum smear microscopy and Xpert MTB/RIF (Xpert) from February 2012 to June 2017. Multivariable logistic regression, Kaplan–Meier estimates, and multivariable Cox regression were used to assess independent predictors of RR-TB and treatment failure/death. Results Of 1535 patients Xpert-positive for TB, 11% had RR-TB. Independent predictors of RR-TB were a positive sputum smear (adjusted odds ratio [aOR] 2.42, 95% confidence interval [CI] 1.63–3.59), retreatment of TB (aOR 4.92, 95% CI 2.31–10.45), and one or more prior TB episodes (aOR 1.77 per episode, 95% CI 1.01–3.10). Over 45% of RR-TB patients had no prior TB history or treatment. The median time from Xpert diagnosis to RR-TB treatment initiation was 12 days (interquartile range 3–60.2). Cures were achieved in 30/36 (83%) and 84/114 (74%) of patients on 9- vs 20/24-month MDR-TB regimens, respectively (P = .06). Predictors of treatment failure/death were the absence of directly observed therapy (DOT; adjusted hazard ratio [aHR] 2.77, 95% CI 1.2–6.66) and any serious adverse drug event (aHR 4.28, 95% CI 1.88–9.71). Conclusions Favorable RR-TB cure rates are achievable in this post-conflict setting with a high RR-TB prevalence. An expanded Xpert scale-up; the prompt initiation of shorter, safer, highly effective MDR-TB regimens; and treatment adherence support are critically needed to optimize outcomes.

scholarly journals To Discuss the Different Music Materials for Learners and Analyze the Difference Between Individual and Group Teaching

2020 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Mingyue Zhou
Keyword(s):  
Age Groups ◽  
Music Teaching ◽  
Teaching Materials ◽  
The Difference ◽  
First Time ◽  
Senior Students

Beginning tutor books are preparing for students who exposed to music for the first time. It is the simplest and most basic music teaching materials. Piano beginners can divide into different age groups, such as young beginners, teenagers, and adults. The young beginners about six to ten years old, the teenagers are usually senior students, about thirteen to eighteen, and an adult is a person over the age of eighteen. People of all age groups can become piano beginners, and beginners at different age groups should use different kinds of music textbooks. In this essay, the musical materials for the piano beginner at different age groups are presenting below. 

Age Differences in Eye Movements During Reading: Degenerative Problems or Compensatory Strategy?

2019 ◽  
Vol 24 (4) ◽  
pp. 297-311
Author(s):  
José David Moreno ◽  
José A. León ◽  
Lorena A. M. Arnal ◽  
Juan Botella
Keyword(s):  
Eye Movements ◽  
Eye Movement ◽  
Meta Analysis ◽  
Age Groups ◽  
Behavioral Changes ◽  
Aging Effects ◽  
Movement Data ◽  
Sentence Reading ◽  
The Difference ◽  
Eye Movements During Reading

Abstract. We report the results of a meta-analysis of 22 experiments comparing the eye movement data obtained from young ( Mage = 21 years) and old ( Mage = 73 years) readers. The data included six eye movement measures (mean gaze duration, mean fixation duration, total sentence reading time, mean number of fixations, mean number of regressions, and mean length of progressive saccade eye movements). Estimates were obtained of the typified mean difference, d, between the age groups in all six measures. The results showed positive combined effect size estimates in favor of the young adult group (between 0.54 and 3.66 in all measures), although the difference for the mean number of fixations was not significant. Young adults make in a systematic way, shorter gazes, fewer regressions, and shorter saccadic movements during reading than older adults, and they also read faster. The meta-analysis results confirm statistically the most common patterns observed in previous research; therefore, eye movements seem to be a useful tool to measure behavioral changes due to the aging process. Moreover, these results do not allow us to discard either of the two main hypotheses assessed for explaining the observed aging effects, namely neural degenerative problems and the adoption of compensatory strategies.

Managing the Transition to Edentulousness Using Partial Transitional Dentures for First Time Prosthodontic Patients: Addressing Unrealistic Expectations – A Case Report

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Case Report ◽  
Treatment Outcomes ◽  
Treatment Planning ◽  
Clinical Relevance ◽  
Treatment Plan ◽  
Sequential Treatment ◽  
Aesthetic Result ◽  
Abutment Teeth ◽  
First Time ◽  
Unrealistic Expectations

Aim: The aim of this report is to describe the management of a prosthodontic patient expressing unrealistic expectations with respect to the transition to edentulousness. Objectives: To outline (1) the diagnosis and explicit expectations of the patient on presentation (2) considerations made during treatment planning to address the wishes of the first time prosthodontic patient (3) a sequential treatment plan utilizing transitional partial removable dentures to manage the change to edentulousness (4) functional and aesthetic result achieved. Results: Delivery of immediate removable partial dentures retaining key abutment teeth in upper and lower arches was a viable prosthodontic solution in the transition to edentulousness of a patient expecting unrealistic treatment outcomes. Conclusions: Addressing impractical expectations and devising a treatment plan amenable to both clinician and patient is difficult. Strategies to manage these wishes in prosthodontic dentistry can include transitional partial dentures. Clinical relevance: Practitioners who encounter similar situations may consider this report valuable.

Strategies for Oral Delivery of Metal-Saturated Lactoferrin

2019 ◽  
Vol 20 (11) ◽  
pp. 1046-1051 ◽  
Author(s):  
Przemysław Gajda-Morszewski ◽  
Klaudyna Śpiewak-Wojtyła ◽  
Maria Oszajca ◽  
Małgorzata Brindell
Keyword(s):  
Biological Activity ◽  
Oral Delivery ◽  
Therapeutic Potential ◽  
Structure And Function ◽  
The Difference ◽  
And Function ◽  
First Time

Lactoferrin was isolated and purified for the first time over 50-years ago. Since then, extensive studies on the structure and function of this protein have been performed and the research is still being continued. In this mini-review we focus on presenting recent scientific efforts towards the elucidation of the role and therapeutic potential of lactoferrin saturated with iron(III) or manganese(III) ions. The difference in biological activity of metal-saturated lactoferrin vs. the unmetalated one is emphasized. The strategies for oral delivery of lactoferrin, are also reviewed, with particular attention to the metalated protein.

Nokhri, Ger, and the Art of Separation in the Hebrew Bible

2018 ◽  
Author(s):  
Adi Ophir ◽  
Ishay Rosen-Zvi
Keyword(s):  
Hebrew Bible ◽  
Biblical Literature ◽  
The Difference ◽  
First Time

This chapter traces the developments of various terms denoting “others” in biblical literature. In much of the biblical corpus, Israel is still one goy among many, and the difference between it and its Others is neither binary nor stable. After a brief analysis of the dynamics of familial and ethnwic separations in Genesis and Exodus, this chapter concentrates on the priestly and Deuteronomistic modes of separating peoples, examines the novelty and limitedness of the Deuteronomistic legislation, where the nokhri (stranger) is systematically contrasted for the first time with the Israelite (referred to as “your brother”), and follows the various modes of separations and their rationales.

scholarly journals Tower Running—Participation, Performance Trends, and Sex Difference

2020 ◽  
Vol 17 (6) ◽  
pp. 1902 ◽  
Author(s):  
Daniel Stark ◽  
Stefania Di Gangi ◽  
Caio Victor Sousa ◽  
Pantelis Nikolaidis ◽  
Beat Knechtle
Keyword(s):  
Sex Differences ◽  
Statistical Model ◽  
Sex Difference ◽  
Random Effects ◽  
Age Groups ◽  
Repeated Measurements ◽  
Stair Climbing ◽  
Age Group ◽  
Performance Trends ◽  
The Difference

Though there are exhaustive data about participation, performance trends, and sex differences in performance in different running disciplines and races, no study has analyzed these trends in stair climbing and tower running. The aim of the present study was therefore to investigate these trends in tower running. The data, consisting of 28,203 observations from 24,007 climbers between 2014 and 2019, were analyzed. The effects of sex and age, together with the tower characteristics (i.e., stairs and floors), were examined through a multivariable statistical model with random effects on intercept, at climber’s level, accounting for repeated measurements. Men were faster than women in each age group (p < 0.001 for ages ≤69 years, p = 0.003 for ages > 69 years), and the difference in performance stayed around 0.20 km/h, with a minimum of 0.17 at the oldest age. However, women were able to outperform men in specific situations: (i) in smaller buildings (<600 stairs), for ages between 30 and 59 years and >69 years; (ii) in higher buildings (>2200 stairs), for age groups <20 years and 60–69 years; and (iii) in buildings with 1600–2200 stairs, for ages >69 years. In summary, men were faster than women in this specific running discipline; however, women were able to outperform men in very specific situations (i.e., specific age groups and specific numbers of stairs).

Status and Determinants of Treatment Outcomes Among New Tuberculosis Patients in South Korea: A Retrospective Cohort Study

2021 ◽  
pp. 101053952110005
Author(s):  
Hyunjin Son ◽  
Jeongha Mok ◽  
Miyoung Lee ◽  
Wonseo Park ◽  
Seungjin Kim ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Korea ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Care Facilities ◽  
Tuberculosis Patients ◽  
Lost To Follow Up

This is a retrospective cohort study using notification data in South Korea. We evaluated the nationwide status, regional differences, and the determinants of treatment outcomes among tuberculosis patients. Treatment success rate improved from 77.0% in 2012 to 86.0% in 2015. The lost to follow-up rate was higher among older people, males, and foreign nationals. Health care facilities designated for the Public-Private Mix (PPM) project showed higher success rate and lower rate of lost to follow-up. Moreover, municipalities with low regional deprivation index had higher PPM project coverage. Since there is a large regional difference in the coverage of the PPM project, an additional community-based support program should be implemented, especially for tuberculosis patients residing in region with low PPM project coverage.

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