scholarly journals Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Kellen Nyamurungi ◽  
Surabhi Joshi ◽  
Yvonne Olando ◽  
Hadii M. Mamudu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Health Workers ◽  
High Volume ◽  
Health Facilities ◽  
Hospital Treatment ◽  
Management Support ◽  
Tobacco Use Cessation ◽  
Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

scholarly journals Health Workers’ Perceptions on Where and How to Integrate Tobacco use Cessation Services into Tuberculosis Treatment; A Qualitative Exploratory Study in Uganda

2020 ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Kellen Nyamurungi ◽  
Surabhi Joshi ◽  
Yvonne Olando ◽  
Hadii M. Mamudu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Health Workers ◽  
High Volume ◽  
Health Facilities ◽  
Treatment Programs ◽  
Tobacco Use Cessation ◽  
Tb Treatment ◽  
Routine Basis ◽  
Referral Hospitals ◽  
The Media

Abstract Background: Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda.Methods: Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis to identify themes.Results: Participants indicated that tobacco use cessation activities should be integrated in TB treatment starting from communities when people are still healthy. Cessation should also be implemented in health facilities including referral facilities, and be extended to those who have been healed as they go back to communities. This calls for collaborations beyond health workers to TB treatment supporters, peers and the media. Conclusions: Tobacco use cessation should take place in communities as well as health facilities. Partnerships with media and families are needed. Health system challenges need to be addressed to support effective implementation.

scholarly journals Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda

2020 ◽  
Author(s):  
Stella Zawedde-Muyanja ◽  
Achilles Katamba ◽  
Adithya Cattamanchi ◽  
Barbara Castelnuovo ◽  
Yukari C Manabe
Keyword(s):  
Public Health ◽  
Health Facility ◽  
High Volume ◽  
Health Facilities ◽  
High Rate ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Factors Associated ◽  
Tb Treatment

Abstract Background: In 2018, Uganda started only 65% of persons with incident tuberculosis on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods: At ten public health facilities, laboratory register data was used to identify patients aged 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results:From January to June 2018, 510 patients (61.2% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within two weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93-13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09-3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69-11.29) and were significantly associated with pretreatment loss to follow up. Conclusion: In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.

scholarly journals Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stella Zawedde-Muyanja ◽  
Achilles Katamba ◽  
Adithya Cattamanchi ◽  
Barbara Castelnuovo ◽  
Yukari C. Manabe
Keyword(s):  
Public Health ◽  
Health Facility ◽  
High Volume ◽  
Health Facilities ◽  
High Rate ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Factors Associated ◽  
Tb Treatment

Abstract Background In 2018, Uganda started only 65% of persons with incident tuberculosis on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods At ten public health facilities, laboratory register data was used to identify patients aged ≥ 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results From January to June 2018, 510 patients (61.2% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within 2 weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93–13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09–3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69–11.29) and were significantly associated with pretreatment loss to follow up. Conclusion In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.

scholarly journals Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda 

2020 ◽  
Author(s):  
Stella Zawedde-Muyanja ◽  
Achilles Katamba ◽  
Adithya Cattamanchi ◽  
Barbara Castelnuovo ◽  
Yukari C Manabe
Keyword(s):  
Public Health ◽  
Health Facility ◽  
High Volume ◽  
Health Facilities ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Factors Associated ◽  
Tb Treatment ◽  
Incident Cases

Abstract Background: In 2018, Uganda only 65% of incident cases of tuberculosis were started on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods: At ten public health facilities, laboratory register data was used to identify patients aged 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results:From January to June 2018, 510 patients (61.2% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within two weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93-13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09-3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69-11.29) and were significantly associated with pretreatment loss to follow up. Conclusion: In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.

scholarly journals Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda

2019 ◽  
Author(s):  
Stella Zawedde-Muyanja ◽  
Achilles Katamba ◽  
Adithya Cattamanchi ◽  
Barbara Castelnuovo ◽  
Yukari C Manabe
Keyword(s):  
Public Health ◽  
Health Facility ◽  
High Volume ◽  
Health Facilities ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Factors Associated ◽  
Tb Treatment ◽  
Incident Cases

Abstract Background: In 2017, Uganda only 53% of incident cases of tuberculosis were started on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods: At ten public health facilities, laboratory register data was used to identify patients aged 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results: From January to June 2018, 510 patients (61% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within two weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93-13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09-3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69-11.29) and were significantly associated with pretreatment loss to follow up. Conclusion: In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.

Attitude of Dental Students, Interns and Practicing Dentists Towards Tobacco Use Cessation

2011 ◽  
Vol 5 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Varun Gupta ◽  
Anmol Mathur ◽  
Amit Tirth ◽  
TL Ravishankar ◽  
Pradeep S. Tangade
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Response Rate ◽  
Dental Students ◽  
Scope Of Practice ◽  
Dental Practice ◽  
Tobacco Use Cessation ◽  
Dental Office ◽  
Dental Setting

ABSTRACT Objective To compare dental students’, Interns’, and Practicing Dentist's attitude towards tobacco cessation promotion in dental setting. Methods The study was conducted on BDS 3rd year students, Interns and practicing dentists of Moradabad city. A 23-item written survey was administered to all the participants. Questions focused on dental students’, Interns’, and practicing dentist's attitude towards the dental professional's responsibilities and scope of practice in promotion of tobacco cessation. Results Response rate was more than 90 percent (199/220). Respondents were 52 percent males and 48 percent females. There were 47 percent dental students, 32 percent interns and 21 percent doctors. Eighty-four percent agreed that it is within the scope of dental practice to advise patients to quit using tobacco and 82 percent agreed that tobacco cessation counseling in the dental office could impact patient's quitting. Nearly one-fifth (18 percent) were slightly or not interested in receiving tobacco cessation training. Conclusion Attitudes of the participants appear to be positive regarding the dental professional's responsibility to educate patients about the risk of tobacco use. However, some have reservations about the extent to which tobacco cessation services fit within the scope of dental practice, the efficiency of such services and the patient receptiveness.

scholarly journals Socialization of self-care guidelines for tuberculosis patients at UPT Pulmonary Health Services in West Kalimantan Province

2021 ◽  
Vol 6 (11) ◽  
pp. 2058-2062
Author(s):  
Tri Wahyuni ◽  
Parliani Parliani ◽  
Tutur Kardiatun ◽  
Prasetyo Aji Nugroho ◽  
Al Fikri ◽  
...  
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Self Care ◽  
Psychosocial Problems ◽  
Intensive Phase ◽  
West Kalimantan ◽  
Tb Treatment ◽  
Service Activity ◽  
Care Guidelines

Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which can harm the lungs and attack other organs. This will result in nursing issues, the risk of infection spreading to other organs and people, ineffective airway clearance, impaired gas exchange, nutritional disorders, and psychosocial problems. Efforts are made to overcome nursing problems by increasing the participation of patients and families, who serve as the primary supporters. The intervention performed by the patient as an agent for himself is known as self-care. Self-care is concerned with an individual's ability to care for and maintain his or her own health. Treatment, family support, and nutritional fulfillment are all part of TB treatment. The outcomes of service activity at UPT Pulmonary Health Services includes teaching health workers about self-care for TB patients, as well as conducting follow-up discussions about TB patients with anxiety in the intensive phase.

scholarly journals International Translation of Project EX: A Teen Tobacco Use Cessation Program

2012 ◽  
Vol 58 (5) ◽  
pp. 317-325 ◽  
Author(s):  
Steve Sussman
Keyword(s):  
Tobacco Use ◽  
Language Translation ◽  
The United States ◽  
Tobacco Use Cessation ◽  
Wait List Control ◽  
School Based ◽  
Program Effects ◽  
Motivation Enhancement ◽  
Behavioral Motivation

Aims: There are relatively few documented teen tobacco use cessation efforts outside the United States (U. S.). Project EX is an evidence-based program that consists of eight sessions, as a school-based clinic tobacco cessation-only version and a classroom-based prevention and cessation version. This paper provides a ‘snapshot’ of progress on international translation of Project EX pilot study work in eight countries that have been approached thus far. The program was implemented in Wuhan, China; Israel and partners; Bashkortostan, Russia; and Elche, Spain. Implementation is planned for Vienna, Austria; Mumbai, India; and Bangkok, Thailand. This work will lead eventually to a greater understanding regarding preference for type of programming (e. g., clinic versus classroom modality), challenges in recruitment and retention, program receptivity, and short-term (approximately 3-month post-program) quit rates. Protocol and Interim Results of International Translation of Project EX: Convenience samples are being recruited based on previous contacts with each location. A protocol was sent to each location, proposing a controlled design, in which subjects enter cessation groups or become a wait-list control, with an immediate pretest, posttest, and 3-month follow-up. Language translation of program materials was completed in seven of the eight locations. Several variations in design and implementation were demanded though. For example, youth fear of reporting tobacco publicly mandated to researchers that the prevention/cessation classroom version be implemented in some locations (Israel and partners, and India). Program effects are suggested across countries. Conclusions: Ongoing partnerships with parties actively involved in tobacco control facilitate pilot testing of teen tobacco use cessation programming. The Project EX curriculum appears quite translatable, though having flexibility in implementation modality eased being able to pilot test the program. Research on this cognitive-behavioral, motivation enhancement approach continues.

Evaluation of a dedicated institutional tobacco cessation service for thoracic clinic cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1603-1603
Author(s):  
Katharine Ann Dobson Amato ◽  
Michael Zevon ◽  
Pat Hysert ◽  
Robert Hysert ◽  
Stephanie Segal ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Participation Rate ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Therapeutic Outcomes ◽  
High Risk Cancer ◽  
First Contact

1603 Background: Tobacco use by cancer patients is associated with poor therapeutic outcomes including increased toxicity, decreased quality of life, and decreased survival. Though recommendations provide for tobacco assessment and cessation for cancer patients, few oncologists provide cessation support. Presented are data from universal tobacco assessment and cessation program for patients presenting at a thoracic oncology clinic in a NCI Designated Comprehensive Cancer Center. Methods: A standard set of evidence based tobacco assessment questions were incorporated into an automated electronic medical record based system delivered by nursing at initial consult and at follow-up. Patients eligible for tobacco cessation support (i.e. patients self-reporting tobacco use within 30 days) were automatically referred to a dedicated tobacco cessation service. All referred patients are sent a standardized packet of cessation materials with telephone-based follow-up by trained cessation counselors. Results: A total of 980 new thoracic clinic patients were referred to the cessation service from January 2011 and October 2012. Two-thirds of the patients referred (n=728) referred into the system were current smokers and the remainder had quit in the 30 days prior to assessment. Among the 788 patients with contact attempts by the cessation service, 81.2% (n=640) were successfully contacted and only 2.5% (n=20) refused the offer of cessation support. At first contact, 75.6% (n=484) of patients reported continued current tobacco use. Follow-up calls were placed for 53.1% (n=340) of those who participated in the first contact an average of 39 days after the first successful contact. The follow-up had a 93.2% (n=317) participation rate which revealed that 33.3% (n=106) reported not smoking, an 8.9% increase since the first cessation service telephone call. Conclusions: Data demonstrate that an automated tobacco assessment and cessation service for thoracic oncology patients can effectively generate a large mandatory referral base with high patient interest in cessation, and that cessation support can be implemented and maintained in high risk cancer patients.

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