scholarly journals Assessment of the Isoniazid Preventive Therapy Uptake and Associated Characteristics: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Francine Mwayuma Birungi ◽  
Stephen Graham ◽  
Jeannine Uwimana ◽  
Brian van Wyk

Objective. To assess the uptake of isoniazid preventive therapy (IPT) by eligible children in Kigali, Rwanda, and associated individual, households, and healthcare systems characteristics. Methods. A cross-sectional study was conducted among child contacts of index cases having sputum smear-positive pulmonary tuberculosis. Data were collected from 13 selected primary health centres. Descriptive statistics were used to generate frequency tables and figures. Logistic regression models were performed to determine characteristics associated with IPT uptake. Results. Of 270 children (under 15 years), who were household contacts of 136 index cases, 94 (35%) children were less than 5 years old and eligible for IPT; and 84 (89%, 95% CI 81–94) were initiated on IPT. The reasons for not initiating IPT in the remaining 10 children were parents/caregivers’ lack of information on the need for IPT, refusal to give IPT to their children, and poor quality services offered at health centres. Factors associated with no uptake of IPT included children older than 3 years, unfriendly healthcare providers, HIV infected index cases, and the index case not being the child’s parent. Conclusion. The National Tuberculosis Program’s policy on IPT delivery was effectively implemented. Future interventions should find strategies to manage factors associated with IPT uptake.

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 878
Author(s):  
Mohamed A. Baraka ◽  
Amany Alboghdadly ◽  
Samar Alshawwa ◽  
Asim Ahmed Elnour ◽  
Hassan Alsultan ◽  
...  

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians’ decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients’ clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber’s choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians’ choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician’s prescription (i.e., self-medication) represent key factors which contribute to AMR from participants’ perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.


2019 ◽  
Vol 47 (2) ◽  
pp. 83-88
Author(s):  
Zain Hadifah ◽  
Yanri Wijayantri Subronto ◽  
M Robikhul Ikhsan

Sputum smear conversion at the end of the intensive phase of tuberculosis treatment is positif of the patients response to treatment. This study aimed to determine factors associated to sputum smear non-conversion at the end of the intensive phase treatment. This cross sectional study was perform in Yogyakarta distric by collecting medical record in primary health care, from 2011-2016. Of 722 pulmonary tuberculosis (PTB) patient, 21,05 %  patients were identified as non-converted of the intensive phase of treatment with the median age was 41 years and 58.5 % were male. The factors were associated with sputum smear non-conversion of insentive phase treatment : male, age ≥50, pre-treatment smears graded ≥2+, nonadherence to tuberculosis after 2 months treatment. Multivariate analysis indicated that Pre-treatment smears graded ≥2+and nonadherent to tuberculosis after 2 months treatment were a count highest contribution with sputum smear non-conversion. Patients with these factors non-conversion after two months of treatment should be given a fully supervised treatment to prevent in treatment default. Abstrak Konversi BTA pada akhir pengobatan fase intensif merupakan  salah satu indiaktor respon pasien terhadap pengobatan TB. Tujuan penelitian adalah menentukan faktor risiko yang berhubungan dengan kegagalan konversi BTA setelah pengobatan TB fase intensif. Penelitian ini merupakan penelitian cross sectional berdasarkan data rekam medis di puskesmas, Kota Yogyakarta tahun 2011-2016. Dari 722 pasien TB paru, sebanyak 21,05% adalah gagal konversi setelah pengobatan fase intensif dengan median umur adalah 41 tahun dan sebanyak 58,5% adalah laki-laki. Faktor yang berhubungan dengan gagal konversi setelah pengobatan fase intensif adalah jenis kelamin laki-laki, umur ≥50 tahun, gradasi BTA ≥2+, ketidakteraturan menelan obat. Analisa multivariable menunjukkan gradasi BTA sebelum pengobatan ≥ 2+  dan ketidakteraturan pengobatan sebagai faktor yang paling berkontribusi dengan gagal konversi. Pasien dengan gagal konversi setelah 2 bulan .


2019 ◽  
Vol 70 (3) ◽  
pp. 436-445
Author(s):  
Nishi Suryavanshi ◽  
Matthew Murrill ◽  
Amita Gupta ◽  
Michael Hughes ◽  
Anneke Hesseling ◽  
...  

Abstract Background Household contacts (HHCs) of individuals with multidrug-resistant tuberculosis (MDR-TB) are at high risk of infection and subsequent disease. There is limited evidence on the willingness of MDR-TB HHCs to take MDR-TB preventive therapy (MDR TPT) to decrease their risk of TB disease. Methods In this cross-sectional study of HHCs of MDR-TB and rifampicin-resistant tuberculosis (RR-TB) index cases from 16 clinical research sites in 8 countries, enrollees were interviewed to assess willingness to take a hypothetical, newly developed MDR TPT if offered. To identify factors associated with willingness to take MDR TPT, a marginal logistic model was fitted using generalized estimating equations to account for household-level clustering. Results From 278 MDR-TB/RR-TB index case households, 743 HHCs were enrolled; the median age of HHCs was 33 (interquartile range, 22–49) years, and 62% were women. HHC willingness to take hypothetical MDR TPT was high (79%) and remained high even with the potential for mild side effects (70%). Increased willingness was significantly associated with current employment or schooling (adjusted odds ratio [aOR], 1.83 [95% confidence interval {CI}, 1.07–3.13]), appropriate TB-related knowledge (aOR, 2.22 [95% CI, 1.23–3.99]), confidence in taking MDR TPT (aOR, 7.16 [95% CI, 3.33–15.42]), and being comfortable telling others about taking MDR TPT (aOR, 2.29 [95% CI, 1.29–4.06]). Conclusions The high percentage of HHCs of MDR-TB/RR-TB index cases willing to take hypothetical MDR TPT provides important evidence for the potential uptake of effective MDR TPT when implemented. Identified HHC-level variables associated with willingness may inform education and counseling efforts to increase HHC confidence in and uptake of MDR TPT.


2020 ◽  
Vol 103 (5) ◽  
pp. 465-471

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia


2020 ◽  
Vol 5 (15) ◽  
pp. 185-192
Author(s):  
Nor Jannah Nasution Raduan ◽  
Mohd Razali Salleh ◽  
Ghazali Ahmad ◽  
Zaleha Ismail

Depression and cognitive impairment are the most common complications of patients on hemodialysis. The objective of this study is to identify contributing factors to depression and cognitive impairment in hemodialysis patients. This is a cross-sectional study involving 110 hemodialysis patients in Hospital Kuala Lumpur. The samples were recruited through universal sampling. Patients were assessed with the Beck Depression Inventory and Montreal Cognitive Assessment. This study found that 18.2% of patients had depression, and 48.2% had cognitive impairment. Factors associated with depression were unmarried status, low education level, and cognitive impairment. Factors associated with cognitive impairment were low education level, depression, and unemployment. Keywords: hemodialysis, depression, cognitive, ESRD eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i15.2468.


Sign in / Sign up

Export Citation Format

Share Document