scholarly journals Tuberculosis Treatment Outcome in Patients with TB-HIV Coinfection in Kuala Lumpur, Malaysia

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Diana Safraa Selimin ◽  
Aniza Ismail ◽  
Norfazilah Ahmad ◽  
Rohani Ismail ◽  
Nurul Farhana Mohd Azman ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Healthcare Providers ◽  
Risk Groups ◽  
National Database ◽  
Kuala Lumpur ◽  
Treatment Rate ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Hiv Coinfection

Background. Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). This study aimed to identify the characteristics, unsuccessful TB treatment rate, and determinants of unsuccessful TB treatment outcome among patients with TB-HIV coinfection in Kuala Lumpur. Methods. This was a cross-sectional study. The data of all patients with TB-HIV in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018. Results. Out of 235 randomly selected patients with TB-HIV, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed, or lost to follow-up). Patients who did not receive DOTS (directly observed treatment, short course) (adjusted odds ratio: 21.71; 95% confidence interval: 5.36–87.94) and those who received shorter treatment duration of <6 months (aOR: 34.54; 95% CI: 5.97–199.93) had higher odds for unsuccessful TB treatment outcome. Conclusions. Nearly half of the patients with TB-HIV had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV to gain treatment adherence and for better rates of successful TB treatment.

 Tuberculosis Treatment Outcome In Patients With Tb-Hiv Co-Infection In Kuala Lumpur, Malaysia

2019 ◽  
Author(s):  
Diana Safraa Selimin ◽  
Aniza Ismail ◽  
Norfazilah Ahmad ◽  
Rohani Ismail ◽  
Nurul Farhana Mohd Azman ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Healthcare Providers ◽  
Risk Groups ◽  
Health Department ◽  
Cross Sectional Study ◽  
National Database ◽  
Kuala Lumpur ◽  
Treatment Rate ◽  
Cross Sectional ◽  
Tb Treatment

Abstract Background Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). This study aimed to identify the characteristics, unsuccessful TB treatment rate and determinants of unsuccessful TB treatment outcome among patients with TB-HIV co-infection in Kuala Lumpur.Methods This was a cross-sectional study. The data of all patients with TB-HIV in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018.Results Out of 235 randomly selected patients with TB-HIV, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed or defaulted treatment). Patients who did not receive DOTS (directly observed treatment, short course) (adjusted odds ratio [aOR] 21.71; 95% confidence interval [CI]: 5.36–87.94) and those who received shorter treatment duration of <6 months (aOR 34.54; 95% CI: 5.97–199.93) had higher odds for unsuccessful TB treatment outcome.Conclusions Nearly half of the patients with TB-HIV had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV to gain treatment adherence and for better rates of successful TB treatment.

scholarly journals Tuberculosis Treatment Outcome in Patients with Tb-hiv Co-infection in Kuala Lumpur, Malaysia

2020 ◽  
Author(s):  
Diana Safraa Selimin ◽  
Aniza Ismail ◽  
Norfazilah Ahmad ◽  
Rohani Ismail ◽  
Nurul Farhana Mohd Azman ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Treatment Adherence ◽  
Healthcare Providers ◽  
Risk Groups ◽  
National Database ◽  
Sputum Smear ◽  
Kuala Lumpur ◽  
Treatment Rate ◽  
Cross Sectional ◽  
Tb Treatment

Abstract Background: Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). Directly observed treatment, short course (DOTS) is one of many efforts done as part of ending TB, in which all confirmed TB sputum smear positive cases properly given treatment and monitored by the healthcare providers or family members to ensure treatment adherence. This study aimed to identify the characteristics, to determine the rate of unsuccessful TB treatment rate and to determine determinants of unsuccessful TB treatment outcome among patients with TB-HIV co-infection in Kuala Lumpur.Methods: This was a cross-sectional study. The data of all patients with TB-HIV co-infection in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018.Results: Out of 235 randomly selected patients with TB-HIV co-infection, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed or defaulted treatment). Patients who did not receive DOTS (adjusted odds ratio [aOR] 21.71; 95% confidence interval [CI]: 5.36–87.94) and those who received shorter treatment duration of <6 months (aOR 34.54; 95% CI: 5.97–199.93) had higher odds for unsuccessful TB treatment outcome.Conclusions: Nearly half of the patients with TB-HIV co-infection had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV co-infection to gain treatment adherence and for better rates of successful TB treatment.

scholarly journals Reasons patients leave their nearest healthcare service to attend Karen Park Clinic, Pretoria North

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Agnes T. Masango- Makgobela ◽  
Indiran Govender ◽  
John V. Ndimande
Keyword(s):  
Healthcare Provider ◽  
Waiting Time ◽  
Healthcare Service ◽  
Waiting Times ◽  
Healthcare Providers ◽  
Descriptive Study ◽  
Staff Attitudes ◽  
Quality Service ◽  
Cross Sectional

Background: Many patients move from one healthcare provider or facility to another, disturbing the continuity that enhances holistic patient care.Objectives: To investigate the reasons given by patients for attending Karen Park Clinic rather than the clinic nearest to their homes.Methods: A cross-sectional descriptive study was conducted during 2010. Three hundred and fifty patients attending Karen Park Clinic were given questionnaires to complete, with the following variables: place of residence; previous attendance at the clinic nearest their home; services available at their nearest clinic; and their willingness to attend their nearest clinic in future.Results: Respondents were from Soshanguve (153; 43.7%), Mabopane (92; 26.3%), Garankuwa (29; 8.3%) and Hebron (20; 5.7%) and most were women (271; 77.4%) aged 26–45 (177; 50.6%). Eighty per cent (281) of the patients had visited their nearest clinic previously and 54 of these (19.2%) said they would not return. The reasons for this were: long waiting time (88; 25.1%); long queues (84; 24%); rude staff (60; 17%); and no medication (39; 11.1%).Conclusion: The majority of patients who had attended their nearest clinic were adamant that they would not return. It is necessary to reduce waiting times, thus reducing long queues. This can be achieved by having adequate, satisfied healthcare providers to render a quality service and by organising training for management. Patients can thus be redirected to their nearest clinic and the health centre’s capacity can be increased by procuring adequate drugs. There is a need to follow up on patients’ complaints about staff attitudes.

scholarly journals Incidence of depression in people with newly diagnosed tuberculosis in Ethiopia: a cohort study

2020 ◽  
Vol 7 ◽  
Author(s):  
Fentie Ambaw ◽  
Rosie Mayston ◽  
Charlotte Hanlon ◽  
Atalay Alem
Keyword(s):  
Protective Factor ◽  
Treatment Guidelines ◽  
Incidence Rates ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Primary Care Settings ◽  
Tb Treatment ◽  
Patient Health ◽  
Probable Depression

Abstract Background Cross-sectional studies show that the prevalence of comorbid depression in people with tuberculosis (TB) is high. The hypothesis that TB may lead to depression has not been well studied. Our objectives were to determine the incidence and predictors of probable depression in a prospective cohort of people with TB in primary care settings in Ethiopia. Methods We assessed 648 people with newly diagnosed TB for probable depression using Patient Health Questionnaire, nine-item (PHQ-9) at the time of starting their anti-TB medication. We defined PHQ-9 scores 10 and above as probable depression. Participants without baseline probable depression were assessed at 2 and 6 months to measure incidence of depression. Incidence rates per 1000-person months were calculated. Predictors of incident depression were identified using Poisson regression. Results Two hundred and ninety-nine (46.1%) of the participants did not have probable depression at baseline. Twenty-two (7.4%) and 26 (8.7%) developed depression at 2 and 6 months of follow up. The incidence rate of depression between baseline and 2 months was 73.6 (95% CI 42.8–104.3) and between baseline and 6 months was 24.2 (95% CI 14.9–33.5) per 1000 person-months respectively. Female sex (adjusted β = 0.22; 95% CI 0.16–0.27) was a risk factor and perceived social support (adjusted β = −0.14; 95% CI −0.24 to −0.03) was a protective factor for depression onset. Conclusion There was high incidence of probable depression in people undergoing treatment for newly diagnosed TB. The persistence and incidence of depression beyond 6 months need to be studied. TB treatment guidelines should have mental health component.

Extremes in Otolaryngology Resident Surgical Case Numbers: An Update

2017 ◽  
Vol 156 (6) ◽  
pp. 1060-1066 ◽  
Author(s):  
Tiffany P. Baugh ◽  
Christine B. Franzese
Keyword(s):  
National Database ◽  
Cross Sectional Survey ◽  
Case Volume ◽  
Cross Sectional ◽  
Residency Programs ◽  
Key Indicator ◽  
Resident Surgeon ◽  
The Mean ◽  
Minimum Numbers

Objectives The purpose of this study is to examine the effect of minimum case numbers on otolaryngology resident case log data and understand differences in minimum, mean, and maximum among certain procedures as a follow-up to a prior study. Study Design Cross-sectional survey using a national database. Setting Academic otolaryngology residency programs. Subjects and Methods Review of otolaryngology resident national data reports from the Accreditation Council for Graduate Medical Education (ACGME) resident case log system performed from 2004 to 2015. Minimum, mean, standard deviation, and maximum values for total number of supervisor and resident surgeon cases and for specific surgical procedures were compared. Results The mean total number of resident surgeon cases for residents graduating from 2011 to 2015 ranged from 1833.3 ± 484 in 2011 to 2072.3 ± 548 in 2014. The minimum total number of cases ranged from 826 in 2014 to 1004 in 2015. The maximum total number of cases increased from 3545 in 2011 to 4580 in 2015. Multiple key indicator procedures had less than the required minimum reported in 2015. Conclusion Despite the ACGME instituting required minimum numbers for key indicator procedures, residents have graduated without meeting these minimums. Furthermore, there continues to be large variations in the minimum, mean, and maximum numbers for many procedures. Variation among resident case numbers is likely multifactorial. Ensuring proper instruction on coding and case role as well as emphasizing frequent logging by residents will ensure programs have the most accurate data to evaluate their case volume.

scholarly journals Prevalence, Awareness, Treatment and Control of Hypertension in Northern China: a Cross-Sectional Study

2020 ◽  
Author(s):  
Xiaoqian Xu ◽  
Han Bao ◽  
Zixuan Tian ◽  
Hao Zhu ◽  
Lige Zhu ◽  
...  
Keyword(s):  
Northern China ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Treatment Rate ◽  
Early Screening ◽  
Cross Sectional ◽  
Current Drinker ◽  
Optimal Blood Pressure ◽  
And Control

Abstract Background: Hypertension has always been a worldwide health concern. The purpose of this study was to investigate the prevalence, awareness, treatment, and control rates of hypertension among adult residents of northern China, where people usually have a high-fat, high-salt diet and heavy alcohol consumption.Methods: Through the Early Screening and Comprehensive Intervention Project for High Risk Groups of Cardiovascular Diseases in the Inner Mongolia Autonomous Region of northern China, we collected data of 70,380 residents, from September 2015 to June 2017. We assessed the prevalence, awareness, treatment, and control of hypertension in the total population and subpopulations.Results: Among participants, only 13.4% had optimal blood pressure levels. About 55.7% (95% confidence interval (CI): 55.3%–56.1%) of the participants had hypertension. The national standardized and the regional standardized prevalence rate was 49.4% and 55.4%, respectively. Multivariate logistic regression showed that old age, male, Han, living in rural, farmer, current drinker, not married, diabetes, obesity and dyslipidemia were associated with hypertension. In addition, the awareness, treatment, control and control under treatment rate of hypertension were 52.8% (95% CI: 52.3%–53.3%), 43.3% (95% CI: 42.8%–43.8%), 8.6% (95% CI: 8.3%–8.9%) and 19.8% (95% CI: 19.2%–20.4%), respectively. And the 70,380 population subgroups varied with respect to hypertension prevalence (range 32.6%-73.4%), awareness (35.1%-76.2%), treatment (24.9%-64.6%), control (3.9%-20.4%), and control under treatment (11.2%-31.6%). Controlled hypertension were less common in those younger age, Mongol, not married, farmer and current drinker. Conclusion: Most patients of hypertension are going undetected and uncontrolled in northern China. Even if patients with hypertension are under treatment, hypertension can remain inadequately controlled.

scholarly journals Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018

2019 ◽  
Author(s):  
Peter Okpeh Amede ◽  
Elizabeth Adedire ◽  
Aishat Usman ◽  
Celestine A. Ameh ◽  
Faruk S. Umar ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Tracking System ◽  
Treatment Success ◽  
Incidence Rates ◽  
Prison Inmates ◽  
Successful Treatment Outcome ◽  
Tb Treatment ◽  
Hiv Negative

Abstract Background: Tuberculosis (TB) is a contagious disease and its transmissibility potential is increased in congregate settings like the prisons. TB incidence rates are five to fifty times higher among prison inmates than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its predictors in Nigerian prisons. We therefore assessed TB treatment outcomes among prison inmates in Bauchi State, Nigeria. Method: We conducted a retrospective data analysis of inmates with TB in the five main prisons in Bauchi State. We extracted sociodemographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a standardized checklist. We estimated the TB treatment success rate (TSR) and explored the relationship between the TSR and sociodemographic and clinical characteristics. Related variables were modelled in multivariate logistic regression to identify predictors of TSR at 5% level of significance. Results: All 216 inmates were male with mean age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 48 (22.2%) were lost to follow-up, 17 (7.9%) were transferred out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Odds of successful treatment outcome were age; 20-29 years (AOR=10.5; 95% CI: 3.2-35.1), 30-39 years (AOR=4.2; 95% CI: 1.3-13.1), pretreatment weight; 50-59 kg (AOR= 9.6; 95% CI: 1.4-65.6), ≥60 kg (AOR= 18.6; 95% CI: 2.5-140.1) and being HIV negative (AOR=3.3; 95% CI:1.4-7.8). Conclusion: The predictors of successful TB treatment outcome were being less than 40 years of age, having a pretreatment body weight of or greater than 50 kg, imprisonment for less than 2 years, and being HIV negative. We recommended that to improve TB TSR among prison inmates; age, duration of imprisonment, weight and TB/HIV coinfection should be the major consideration during drugs adherence, psychological and nutritional counselling and a tracking system be developed by the prisons authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated. Key words: Tuberculosis, Treatment outcomes, Prison inmates, Predictors, Bauchi State, Nigeria

scholarly journals Regional coordinators of Sao Paulo State prisons in tuberculosis and HIV coinfection care

2020 ◽  
Vol 73 (suppl 6) ◽  
Author(s):  
Nanci Michele Saita ◽  
Daniele Maria Pelissari ◽  
Rubia Laine de Paula Andrade ◽  
Pedro Augusto Bossonario ◽  
Mariana Gaspar Botelho Funari de Faria ◽  
...  
Keyword(s):  
Multiple Correspondence Analysis ◽  
Cross Sectional Study ◽  
Sao Paulo ◽  
Antiretroviral Drugs ◽  
São Paulo ◽  
Cross Sectional ◽  
Hiv Coinfection ◽  
Low Performance ◽  
State Prisons

ABSTRACT Objectives: to analyze the care provided to individuals with Tuberculosis (TB)-HIV coinfection in prison units in the state of São Paulo, according to the regional coordination of prisons. Methods: cross-sectional study conducted between 2016 and 2018. A structured questionnaire was applied to 112 directors or health professionals from 168 prison units. Data were analyzed by frequency distribution and multiple correspondence analysis. Results: 92.9% of participants reported active search for respiratory symptoms, 89.3% offer the directly observed treatment (DOT) for all TB cases, 95.5% anti-HIV testing for all inmates, 92.9% offer HIV follow-up in specialized care services and 59.8% antiretroviral drugs for cases of coinfection. An association was identified between the Northwest and Central regional coordinations and deficient human resources and low performance of actions for the diagnosis and follow-up of cases. Conclusions: although most prison units perform planned actions for the care of coinfected persons, some places need support to guarantee access to these actions.

scholarly journals Canadian Women's Experience of Postnatal Care: A Mixed Method Study

2021 ◽  
pp. 084456212110521
Author(s):  
Justine Dol ◽  
Brianna Hughes ◽  
Gail Tomblin Murphy ◽  
Megan Aston ◽  
Douglas McMillan ◽  
...  
Keyword(s):  
Postnatal Care ◽  
Online Survey ◽  
Healthcare Providers ◽  
Postnatal Period ◽  
Cross Sectional ◽  
Family Doctors ◽  
Appropriate Care ◽  
Cross Sectional Design ◽  
Qualitative Responses

Background The postnatal period remains unstandardized in terms of care and postnatal visits with a dearth of information on the experience from Canadian women. Purpose To explore (1) with whom and how often women receive postnatal follow-up visits and (2) the postnatal care experiences of Canadian mothers. Methods Using a cross-sectional design, women who had given birth within the past 6 months were recruited to complete an online survey. Frequencies were computed for quantitative outcomes and thematic analysis was used for qualitative responses. Results A total of 561 mothers completed the survey. Women saw on average 1.9 different postnatal healthcare providers, primarily family doctors (72.4%). 3.2% had no postnatal visits and 37.6% had 4  or more within 6 weeks. 76.1% women were satisfied with their postnatal care. Women's satisfactory care in the postnatal period was associated with in-person and at home follow-ups, receiving support, and receiving timely, appropriate care for self and newborn. Unsatisfactory care was associated with challenges accessing care, experiencing gaps in follow-up visits, and having unsatisfactory assessment for their own recovery. Conclusion There is considerable variation in the timing and frequency of postnatal visits. While many women are experiencing satisfactory care, women are still reporting dissatisfaction and are facing challenges.

scholarly journals Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018

2020 ◽  
Author(s):  
Peter Okpeh Amede ◽  
Elizabeth Adedire ◽  
Aishat Usman ◽  
Celestine A. Ameh ◽  
Faruk S. Umar ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Tracking System ◽  
Treatment Success ◽  
Incidence Rates ◽  
Prison Inmates ◽  
Successful Treatment Outcome ◽  
Tb Treatment ◽  
Hiv Negative

Abstract Background : Tuberculosis (TB) is a contagious disease and its transmissibility potential is increased in congregate settings like the prisons. TB incidence rates are five to fifty times higher among prison inmates than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its predictors in Nigerian prisons. We therefore assessed TB treatment outcomes among prison inmates in Bauchi State, Nigeria. Method: We conducted a retrospective data analysis of inmates with TB in the five main prisons in Bauchi State. We extracted sociodemographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a standardized checklist. We estimated the TB treatment success rate (TSR) and explored the relationship between the TSR and sociodemographic and clinical characteristics. Related variables were modelled in multiple logistic regression to identify predictors of TSR at 5% level of significance. Results: All 216 inmates were male with mean (SD) age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 48 (22.2%) were lost to follow-up, 17 (7.9%) were transferred out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Predictors of successful treatment outcome were age; 20-29 years (AOR=10.5; 95% CI: 3.2-35.1), 30-39 years (AOR=4.2; 95% CI: 1.3-13.1), pretreatment weight; ≥ 55kg (AOR= 13.3; 95% CI: 6.0-29.6), imprisonment for ≤ 2 years (AOR= 2.6; 95% CI: 1.3-5.4) and being HIV negative (AOR=3.3; 95% CI:1.4-7.8). Conclusion: The predictors of successful TB treatment outcome were being less than 40 years of age, having a pretreatment body weight of or greater than 55 kg, imprisonment for less than 2 years, and being HIV negative. We recommended that to improve TB TSR among prison inmates; age, duration of imprisonment, weight and TB/HIV co-infection should be the major consideration during pretreatment, psychological and nutritional counselling and a tracking system be developed by the prisons authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated.

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