scholarly journals Identification and attribute analysis of key stakeholders who influence multidrug-resistant tuberculosis prevention and control in China

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Bin Chen ◽  
Hongdan Bao ◽  
Xinyi Chen ◽  
Kui Liu ◽  
Ying Peng ◽  
...  
Keyword(s):  
Service Providers ◽  
Stakeholder Analysis ◽  
Multidrug Resistant ◽  
Tb Control ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Key Stakeholders ◽  
Mdr Tb ◽  
Control And Prevention ◽  
And Control

Abstract Background There could be various stakeholders who influencing multidrug-resistant tuberculosis (MDR-TB) policy development and implementation, yet their attributes and roles remain unclear in practice. This study aimed to identify key stakeholders in the process of policy-making for MDR-TB control and prevention and to analyse the attributes and relationships of the stakeholders, providing evidence for further policy research on MDR-TB control. Methods This study was conducted from October 2018 to March 2019 and applied the stakeholder analysis guidelines and domestic stakeholder analysis. An initial candidate stakeholder list was developed by policy scanning. Ten experts were invited to identify these candidate stakeholders. The major attribute of these stakeholders were analysed using the Michell scoring method. Based on these results, the intertwined relationships among groups of stakeholders were analysed and mapped through a systematic scan of the policy and literature on MDR-TB control, as well as information obtained from the interviews. Results A list of 21 types of candidate stakeholders was developed after a literature review and policy scanning, of which 11 received 100% approval. After expert evaluation and identification (the total expert authority was 0.80), 19 categories of stakeholders were approved and included in the stakeholder analysis. We categorized all of the stakeholders into three groups: (i) definitive stakeholders who are mainly involved in administrative departments and the Provincial Center for Disease Control and Prevention (CDC); (ii) expectant stakeholders who are mainly involved with MDR-TB patients, clinical departments of TB hospitals at different levels, community health care facilities, prefectural CDC and charity organizations; and (iii) latent stakeholders who mainly involved family members and neighbours of MDR-TB patients and TB related products manufacturers. Government departments and higher-level CDCs have strong decision-making power in developing MDR-TB control policies whereas the recommendations from service providers and the concerns of patients should be considered. Conclusions The MDR-TB prevention system was a multistakeholder cooperation system that was mainly led by government stakeholders. Enhancing communications with front-line service providers and patients on their unmet needs and evidence-based suggestions would highly benefit policy-making of MDR-TB prevention and control. Graphical abstract

scholarly journals Prevalence of Multidrug-Resistant Tuberculosis and Associated Factors in Ethiopia: A Systematic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Solomon Weldegebreal Asgedom ◽  
Mebrahtu Teweldemedhin ◽  
Hailay Gebreyesus
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Associated Factors ◽  
Multidrug Resistant ◽  
Previous Exposure ◽  
Tb Control ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Antituberculosis Treatment ◽  
Mdr Tb

Background. Multidrug-resistant tuberculosis (MDR-TB) has continued to be a challenge for tuberculosis (TB) control globally. Ethiopia is one of the countries with high MDR-TB burden. Objective. The main purpose of this study was to determine the prevalence of MDR-TB and associated factors in Ethiopia. Methods. A systematic review of the literatures on prevalence of MDR-TB and associated factors was conducted in the country. Results. In our electronic search, 546 citations were depicted. Among the total 546 citations described, a total of 22 articles met eligibility criteria and were included in the review article. According to our review, the prevalence of MDR-TB ranged from 0 to 46.3%. The average mean rate of MDR-TB in Ethiopia was found to be 12.6±15.9%. The overall prevalence of MDR-TB in all TB cases was estimated to be 1.4%. From a total of 3849 patients studied, 527 had MDR-TB. Previous exposure to antituberculosis treatment was the most commonly identified risk factor of MDR-TB in Ethiopia. Conclusion. Despite relative decline in incidence of MDR-TB, the distribution and prevalence of MDR-TB continued to be a serious challenge for TB control in Ethiopia. Previous exposure to antituberculosis treatment was also the most common risk factor for MDR-TB. Therefore, strong TB and MDR-TB treatment along with tight introduction of follow-up strategies should be applied for better TB control.

scholarly journals Task-shifting directly observed treatment and multidrug-resistant tuberculosis injection administration to lay health workers: stakeholder perceptions in rural Eswatini

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ernest Peresu ◽  
J. Christo Heunis ◽  
N. Gladys Kigozi ◽  
Diana De Graeve
Keyword(s):  
Healthcare Workers ◽  
Health Workers ◽  
Multidrug Resistant ◽  
Task Shifting ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Key Stakeholders ◽  
Mdr Tb ◽  
Directly Observed Treatment

Abstract Background Eswatini is facing a critical shortage of human resources for health (HRH) and limited access to multidrug-resistant tuberculosis (MDR-TB) treatment in rural areas. This study assessed multiple stakeholders’ perceptions of task-shifting directly observed treatment (DOT) supervision and administration of intramuscular MDR-TB injections to lay health workers (LHWs). Methods A mixed methods study comprising a cross-sectional survey using a semi-structured questionnaire with community treatment supporters (CTSs) and a focus group discussion with key stakeholders including representatives from the Eswatini Ministry of Health (MOH), donor organisations, professional regulatory institutions, nursing academia, civil society and healthcare providers was conducted in May 2017. Descriptive statistics, thematic content analysis and data triangulation aided in the interpretation of results. Results A large majority of CTSs (n = 78; 95.1%) were female and 33 (40.2%) were older than 50 years. Most (n = 7; 70.0%) key stakeholders had over 10 years of work experience in policy-making, advocacy in the fields of HRH or day-to-day practice in MDR-TB management. Task-shifting of MDR-TB injection administration was implemented without national policy guidance and regulation. Stakeholders viewed the strategy to be driven by the prevailing shortage of professional frontline HRH and limited access to MDR-TB treatment. Task-shifting was perceived to improve medication adherence, and reduce stigma and transport-related MDR-TB treatment access barriers. Frontline healthcare workers and implementing donor partners fully supported task-shifting. Policy-makers and other stakeholders accepted task-shifting conditionally due to fears of poor standards of care related to perceived incompetence of CTSs. Appropriate compensation, adequate training and supervision, and non-financial incentives were suggested to retain CTSs. A holistic task-shifting policy and collaboration between the MOH, academia and nursing council in regulating the practice were recommended. Conclusions Stakeholders generally accepted the delegation of DOT supervision and administration of intramuscular MDR-TB injections to LHWs as a strategy to increase access to treatment, albeit with some apprehension. Findings from this study stress that task-shifting is not a panacea for HRH shortages, but a short-term solution that must form part of an overall simultaneous strategy to train, attract and retain adequate numbers of professional healthcare workers in Eswatini. To address some of the apprehension and ambivalence about expanding access to MDR-TB services through task-shifting, attention should be paid to important aspects such as competence-based training, certification and accreditation, adequate supportive on-the-job supervision, recognition, compensation, and expediting policy and regulatory support for LHWs.

scholarly journals WHO publishes the third edition of guidelines for the prevention and control of air-travel-associated tuberculosis

2008 ◽  
Vol 13 (23) ◽  
Author(s):  
I Abubakar ◽  
K Fernandez de la Hoz
Keyword(s):  
Multidrug Resistant ◽  
Air Travel ◽  
Public Health Agencies ◽  
The Public ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Published Evidence ◽  
Health Agencies ◽  
Mdr Tb ◽  
And Control

Air travel has increased over the last few decades resulting in greater risk of the spread of infectious diseases carried by infectious travellers. The risk of transmission of pathogens is particularly important for airborne organisms raising concern among public health agencies and the public. Despite limited research on the risk of tuberculosis associated with air travel, several reports have published evidence of the transmission of tuberculosis infection, including multidrug-resistant tuberculosis (MDR-TB) [1, 2].

Health System and Policy Perspectives of Multidrug-resistant Tuberculosis (MDR-TB) Control in India

2017 ◽  
Vol 3 (1) ◽  
pp. 1-15
Author(s):  
Janmejaya Samal
Keyword(s):  
Decision Making ◽  
Surveillance System ◽  
Epidemiological Studies ◽  
Multidrug Resistant ◽  
Control Programme ◽  
Tb Control ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
The Right

Despite the lack of reliable information on multidrug-resistant tuberculosis (MDR-TB) epidemiology, research shows an increasing trend of MDR-TB incidence in India. Of several determinants attributable to the rising trend of MDR-TB, health systems and policy (HSP) determinants play a pivotal role. With this article, an attempt has been made to unravel the HSP challenges for the control of MDR-TB and recommend strategies to overcome that. Ten different strategies have been recommended in this article that includes operations research (OR), molecular epidemiological studies, drug susceptibility test (DST), surveillance system, advocacy communication and social mobilisation (ACSM), nutrition and livelihood support, contribution of private practitioners (PPs), human resources for health (HRH), social determinants of health and information systems. Methods of OR with the right technical expertise can help in decision-making and evaluation of the TB control programme. Molecular epidemiological studies further help identify the right strain and can help in institutionalising the right therapeutic regimen. Similarly, the DST allows extended treatment strategies, including second-line drugs. A proper surveillance system can enable the availability of the right information for public health decision-making. Communication enables and empowers the community in accessing health services and helps policymakers take informed decisions. Nutrition and livelihood support are essential in TB control as it mostly affects the poor and people in the productive age group. Further, tapping PPs is equally important as more than 50 per cent of TB patients visit them. Proper orientation of the PPs about the TB control programme is non-negotiable given these facts. The HRH issues are pertinent—staff members lack the required motivation owing to delay in payment of salaries and the lack of job promotion. The HRH form the backbone of any health system, as the mere presence of drugs, technologies and infrastructure do not suffice for the provision of healthcare. Attention on the neglected social determinants of health is required as well. Finally, all these suggestions need to be implemented in coordination with each other to bring down the scourge of MDR-TB in India.

scholarly journals Model Tatalaksana Komprehensif Tuberculosis Multidrug-Resistant (TB-MDR) Melalui Pendekatan Provider Pelayanan Kesehatan

2020 ◽  
Vol 1 (2) ◽  
pp. 51-57
Author(s):  
Okky Haidar Yahya Irawansa ◽  
Yudha Bhaskoro ◽  
Ahmad Rizki Maulana ◽  
Febri Endra Budi Setyawan
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Providers ◽  
Health Workers ◽  
Multidrug Resistant ◽  
Health Service Provider ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Long Term Treatment ◽  
Mdr Tb

Introduction: Tuberculosis is a highly contagious disease and requires long-term treatment and large amounts of medication. This can affect the high risk of Multidrug-Resistant Tuberculosis (MDR-TB). A health service approach in providing comprehensive management including promotive, preventive, curative, and rehabilitative is very necessary to overcome these cases. Aim of study: This article aims to determine interventions that can be carried out by health services in preventing the occurrence of multidrug-resistant tuberculosis (MDR-TB). Method: The method used is a literature review through national to international journals that examine the interventions that can be carried out by health services in preventing MDR-TB. The articles or data sources that have been obtained will be compared with one another so that the factors that most influence the occurrence of MDR-TB can be found. Results and Discussion: The literature search results show that health workers, especially doctors, have an important role in managing MDR-TB cases. Management of MDR-TB in a comprehensive manner is carried out through promotive, preventive, curative, and rehabilitative programs through a health service provider approach. Educational activities regarding TB, MDR-TB, or the possibility of drug resistance are important to do to prevent new cases of MDR-TB. Curative treatment is carried out to improve mental and social health. Furthermore, rehabilitative efforts are carried out as a means to improve health status recovery for MDR-TB sufferers. Conclusion: Health service providers can improve facilities, they can carry out promotive, curative rehabilitative management to reduce the incidence of MDR-TB.

scholarly journals The Role of IL-6 Gene Polymorphism in Multidrug-Resistant Tuberculosis Patients in Iraq

2020 ◽  
Vol 10 (01) ◽  
pp. 81-84
Author(s):  
Diyar K. Flaifel ◽  
Ibtisam H. Al-Azawi
Keyword(s):  
Gene Polymorphism ◽  
Multidrug Resistant ◽  
Multi Drug Resistance ◽  
Control Group ◽  
First Year ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Significant Difference ◽  
Mdr Tb ◽  
And Control

Background: Tuberculosis (TB) remains to be a leading cause of morbidity and mortality in developing countries, and the incidence of the disease is increasing in developed. One-third of the world’s population is infected by Mycobacterium tuberculosis (Mtb). Still, only about 5% of infected individuals develop the disease within the first year of infection, and another 5% develop the disease later in life. Aim of the study: Is to investigate the relationship between the levels of Interleukin 6 (IL-6) and detection of multidrug-resistant tuberculosis (MDR-TB) in Al-Diwaniyah population. Patients and methods: The current study included 120 patients with tuberculosis who were classified into two groups. The first group included 60 TB patients who were sensitive to anti TB drugs and 60 patients with multi-drug resistance (MDR) based on gene Xpert. The study also included 60 healthy individuals serving as a control group. Demographic characteristics of study and control groups were retrieved. IL-6 (-572G/C) genotype polymorphism was carried out using polymerase chain reaction (PCR) and according to the instruction of the providing company. Serum level of IL-6 was also measured by ELISA according to the instruction of the providing company. Results: It has been observed that genotype CC was more frequent in sensitive TB patients than both MDR TB patients and control subjects, 73.3 % versus 60 % and 61.7 %, respectively. Serum IL-6 level was significantly higher in MDR TB patients than in control group (p = 0.007), and there was no significant difference in its level between sensitive and MDR TB patients (p = 0.284). Conclusion: IL-6 gene polymorphism is not associated with multidrug resistance in TB patients; however, Serum IL-6 level was significantly higher in MDR TB patients than in the control group.

scholarly journals Factors associated with multi-drug-resistant tuberculosis in Dakar, Senegal, 2010-2016

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Mbouna Ndiaye ◽  
Pauline Kiswendsida Yanogo ◽  
Bernard Sawadogo ◽  
Fadima Diallo ◽  
Simon Antara ◽  
...  
Keyword(s):  
Previous Treatment ◽  
Multidrug Resistant ◽  
World Health ◽  
Factors Associated ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Health Organization ◽  
And Control

According to the World Health Organization, multidrug-resistant tuberculosis (MDR-TB) represents a major obstacle towards successful TB treatment and control. In Dakar, MDR-TB management began in 2010 with the strengthening of diagnostic resources. The objective of this study was to identify the factors associated with multidrug-resistant tuberculosis in Dakar between 2010 and 2016. We conducted a case-control study from January 10 to February 28, 2017 in tuberculosis centers in Dakar. of 169 cases and 507 controls. We used logistic regression with Epi-info version 7.2.1. to estimate the odds ratios of association. Factors significantly associated with MDR-TB were: residing in a periurban area (ORa=1.8; 95% CI (1.5-4.9); p=0.024), presence of MDR-TB in the entourage of patient (ORa=7.0; 95% CI (6.1-9.5); p=0.002), previous treatment failure (ORa=29.5; 95% CI (27.3-30.1); p=0.000), treatment not directly observed by a health care provider (ORa=4.3; 95% CI (4.1-7,2); p=0.000) and irregularity of treatment (ORa=1.7; 95% CI (0.5-5.4); p=0.037). Focusing interventions on population at-risk will prevent MDR-TB.

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