scholarly journals Treatment success for patients with tuberculosis receiving care in areas severely affected by Hurricane Matthew – Haiti, 2016

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247750
Author(s):  
Macarthur Charles ◽  
Milo Richard ◽  
Mary R. Reichler ◽  
Jean Baptiste Koama ◽  
Willy Morose ◽  
...  
Keyword(s):  
Treatment Success ◽  
Lessons Learned ◽  
Health Facilities ◽  
Hiv Status ◽  
Severe Damage ◽  
Convenience Sample ◽  
Tb Control ◽  
Tb Treatment ◽  
One Year ◽  
The Impact

Background On October 4, 2016, Hurricane Matthew struck southwest Haiti as a category 4 storm. The goal of this study was to evaluate the impact of the hurricane on tuberculosis (TB) services and patient outcomes in the three severely affected departments–Sud, Grand’Anse, and Nippes–of southwest Haiti. Methods We developed a standard questionnaire to assess a convenience sample of health facilities in the affected areas, a patient tracking form, and a line list for tracking all patients with drug-susceptible TB registered in care six months before the hurricane. We analyzed data from the national TB electronic surveillance system to determine outcomes for all patients receiving anti-TB treatment in the affected areas. We used logistic regression analysis to determine factors associated with treatment success. Results Of the 66 health facilities in the three affected departments, we assessed 31, accounting for 536 (45.7%) of 1,174 TB patients registered in care when Hurricane Matthew made landfall in Haiti. Three (9.7%) health facilities sustained moderate to severe damage, whereas 18 (58.1%) were closed for <1 week, and five (16.1%) for ≥1 week. Four weeks after the hurricane, 398 (73.1%) of the 536 patients in the assessed facilities were located. Treatment success in the affected departments one year after the hurricane was 81.4%. Receiving care outside the municipality of residence (adjusted odds ratio [aOR]: 0.46, 95% confidence interval [CI]: 0.27–0.80) and HIV positivity (aOR: 0.31, 95% CI: 0.19–0.51) or unknown HIV status (aOR: 0.49, 95% CI: 0.33–0.74) were associated with significantly lower rates of treatment success. Conclusions Despite major challenges, a high percentage of patients receiving anti-TB treatment before the hurricane were located and successfully treated in southwest Haiti. The lessons learned and results presented here may help inform policies and guidelines in similar settings for effective TB control after a natural disaster.

scholarly journals Assessing the Impact of COVID-19 on TB and HIV Programme Services in Selected Health Facilities in Lilongwe, Malawi: Operational Research in Real Time

2021 ◽  
Vol 6 (2) ◽  
pp. 81
Author(s):  
Pruthu Thekkur ◽  
Hannock Tweya ◽  
Sam Phiri ◽  
James Mpunga ◽  
Thokozani Kalua ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Real Time ◽  
Negative Impact ◽  
Treatment Success ◽  
Health Facilities ◽  
Case Detection ◽  
Monthly Data ◽  
Tb Treatment ◽  
Set Up ◽  
The Impact

When the COVID-19 pandemic was announced in March 2020, there was concern that TB and HIV programme services in Malawi would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in eight health facilities in Lilongwe to see if it was possible to counteract the anticipated negative impact on TB case detection and treatment and HIV testing. Aggregate data were collected monthly during the COVID-19 period (March 2020–February 2021) using an EpiCollect5 application and compared with monthly data collected during the pre-COVID-19 period (March 2019–February 2020); these reports were sent monthly to programme directors. During COVID-19, there was an overall decrease in persons presenting with presumptive pulmonary TB (45.6%), in patients registered for TB treatment (19.1%), and in individuals tested for HIV (39.0%). For presumptive TB, children and females were more affected, but for HIV testing, adults and males were more affected. During COVID-19, the TB treatment success rate (96.1% in pre-COVID-19 and 96.0% during COVID-19 period) and referral of HIV-positive persons to antiretroviral therapy (100% in pre-COVID-19 and 98.6% during COVID-19 period) remained high and largely unchanged. Declining trends in TB and HIV case detection were not redressed despite real-time monthly surveillance.

scholarly journals Predictors of Adverse TB Treatment Outcome among TB/HIV Patients Compared with Non-HIV Patients in the Greater Accra Regional Hospital from 2008 to 2016

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Kenneth Mawuta Hayibor ◽  
Delia Akosua Bandoh ◽  
Adwoa Asante-Poku ◽  
Ernest Kenu
Keyword(s):  
Treatment Outcome ◽  
Treatment Success ◽  
Regional Hospital ◽  
Hiv Status ◽  
Hiv Patients ◽  
Related Factors ◽  
Factors Associated ◽  
Tb Treatment ◽  
Outcome Monitoring ◽  
The Impact

Introduction. The convergence of TB and HIV dual epidemics is a major public health challenge in Ghana as well as many developing countries. Treatment outcome monitoring is a vital part of the surveillance needed to successfully eliminate TB. The impact of HIV status and demographic and treatment-related factors on adverse TB treatment outcome has not been studied in the Greater Accra Regional Hospital. This study determined factors associated with TB treatment outcome in patients with TB-HIV coinfection and TB-only infection in the hospital. Method. A cross-sectional study was carried out in the Greater Accra Regional Hospital. We reviewed TB treatment cards of patients who received treatment for tuberculosis in the hospital from 2008 to 2016. Data on treatment outcome and sociodemographic and clinical characteristics were extracted on TB-only-infected and TB/HIV-coinfected patients. The chi-squared test and binary and multiple logistic regression models were used to assess factors associated with adverse treatment outcome. Results. Out of the 758 patient records analyzed, 174 (22.9%) were TB-HIV-coinfected patients. Overall treatment success for all TB patients was 88.1% (668/758). About 11.9% (90/758) of the patients had an adverse treatment outcome, including treatment failure 0.9% (7/758), defaulting 0.9% (7/758), and death 10.0% (76/758). TB-HIV-coinfected patients’ treatment success was 78.1% (136/174). TB-only patients’ treatment success was 91.4% (532/582). Independent predictors of adverse treatment outcome were found to be as follows: being HIV positive (aOR: 3.85, 95% CI: 2.19-6.75; p<0.01); aged 65 and above (aOR: 1.76, 95% CI: 1.44-1.54; p=0.01); and previously failed TB treatment (aOR: 5.02, 95% CI: 2.09-28.87; p<0.01). Conclusion. Treatment outcome for TB-HIV-coinfected patients is below the WHO target. HIV status, age, and category of patient of the TB patients were associated with adverse treatment outcome. Strengthening the TB/HIV collaborative efforts by stakeholders is required for good treatment outcomes.

scholarly journals Operational Research to Assess the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Health Facilities in Harare, Zimbabwe

2021 ◽  
Vol 6 (2) ◽  
pp. 94
Author(s):  
Pruthu Thekkur ◽  
Kudakwashe C. Takarinda ◽  
Collins Timire ◽  
Charles Sandy ◽  
Tsitsi Apollo ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Treatment Outcomes ◽  
Real Time ◽  
Treatment Success ◽  
Health Facilities ◽  
Case Detection ◽  
Monthly Data ◽  
Hiv Services ◽  
Tb Treatment ◽  
Set Up

When COVID-19 was declared a pandemic, there was concern that TB and HIV services in Zimbabwe would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in 10 health facilities in Harare to capture trends in TB case detection, TB treatment outcomes and HIV testing and use these data to facilitate corrective action. Aggregate data were collected monthly during the COVID-19 period (March 2020–February 2021) using EpiCollect5 and compared with monthly data extracted for the pre-COVID-19 period (March 2019–February 2020). Monthly reports were sent to program directors. During the COVID-19 period, there was a decrease in persons with presumptive pulmonary TB (40.6%), in patients registered for TB treatment (33.7%) and in individuals tested for HIV (62.8%). The HIV testing decline improved in the second 6 months of the COVID-19 period. However, TB case finding deteriorated further, associated with expiry of diagnostic reagents. During the COVID-19 period, TB treatment success decreased from 80.9 to 69.3%, and referral of HIV-positive persons to antiretroviral therapy decreased from 95.7 to 91.7%. Declining trends in TB and HIV case detection and TB treatment outcomes were not fully redressed despite real-time monthly surveillance. More support is needed to transform this useful information into action.

scholarly journals Treatment outcome of tuberculosis at Dilla Referral Hospital, Gedeo Zone, southern Ethiopia: A retrospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249369
Author(s):  
Endrias Markos Woldesemayat ◽  
Zewtir Azeze
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Success Rate ◽  
Treatment Success ◽  
Referral Hospital ◽  
Treatment Success Rate ◽  
Southern Ethiopia ◽  
Hiv Status ◽  
Hospital Data ◽  
Tb Treatment

Background Tuberculosis (TB) is one of the major public health problems in Ethiopia. Determining treatment outcome of TB cases could help to understand the effectiveness of TB control efforts. The objective of this study was to assess TB treatment outcome and associated factors and determine the risk factors of death among TB cases who were on Directly Observed Treatment Short course (DOTS). Methodology We analyzed a retrospective data for TB cases who were on DOTS at Dilla Referral Hospital from July 2011- June 2016. The study population was TB cases with known HIV status and whose treatment outcome was evaluated at the Hospital. Data were entered, cleaned and analyzed using statistical package SPSS for windows, version 20. Result Out of 899 registered TB cases, 731 included in this analysis. Of these cases, 424 (58.0%) were male and 334 (45.7%) were in the age group of below 25 years. Treatment success rate of TB was 675 (92.3%) and death rate was 18 (2.5%). Treatment outcome showed statistically significant variation by HIV status (P < 0.001). HIV status of the TB cases and pretreatment weight were associated with TB treatment outcome. HIV status of the TB cases was associated with death of the TB cases (Adjusted Odds Ratio (AOR) 5.0; CI 95%: 1.8–13.5). Conclusion TB treatment success rate found in this study was high. Patient’s weight and HIV status were associated with treatment outcome. Moreover, HIV status predicted death of TB cases. Cautious treatment follow-up and defaulter tracing mechanisms for TB cases with these risk factors were suggested.

scholarly journals The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil

2019 ◽  
Vol 4 (1) ◽  
pp. e001029 ◽  
Author(s):  
Daniel J Carter ◽  
Rhian Daniel ◽  
Ana W Torrens ◽  
Mauro N Sanchez ◽  
Ethel Leonor N Maciel ◽  
...  
Keyword(s):  
Success Rate ◽  
Social Protection ◽  
Treatment Success ◽  
Cash Transfer ◽  
Treatment Success Rate ◽  
Sensitivity Analyses ◽  
Data Set ◽  
Tb Treatment ◽  
Quasi Experimental ◽  
The Impact

BackgroundEvidence suggests that social protection policies such as Brazil’s Bolsa Família Programme (BFP), a governmental conditional cash transfer, may play a role in tuberculosis (TB) elimination. However, study limitations hamper conclusions. This paper uses a quasi-experimental approach to more rigorously evaluate the effect of BFP on TB treatment success rate.MethodsPropensity scores were estimated from a complete-case logistic regression using covariates from a linked data set, including the Brazil’s TB notification system (SINAN), linked to the national registry of those in poverty (CadUnico) and the BFP payroll.ResultsThe average effect of treatment on the treated was estimated as the difference in TB treatment success rate between matched groups (ie, the control and exposed patients, n=2167). Patients with TB receiving BFP showed a treatment success rate of 10.58 percentage points higher (95% CI 4.39 to 16.77) than patients with TB not receiving BFP. This association was robust to sensitivity analyses.ConclusionsThis study further confirms a positive relationship between the provision of conditional cash transfers and TB treatment success rate. Further research is needed to understand how to enhance access to social protection so to optimise public health impact.

scholarly journals The impact of COVID-19 on oncology professionals – one year on: lessons learned from the ESMO Resilience Task Force survey series

ESMO Open ◽  
2021 ◽  
pp. 100374
Author(s):  
Kok Haw Jonathan Lim ◽  
Krithika Murali ◽  
Eleanor Thorne ◽  
Kevin Punie ◽  
Konstantinos Kamposioras ◽  
...  
Keyword(s):  
Task Force ◽  
Lessons Learned ◽  
One Year ◽  
The Impact

scholarly journals Assessing the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Selected Health Facilities in Nairobi, Kenya

2021 ◽  
Vol 6 (2) ◽  
pp. 74
Author(s):  
Irene Mbithi ◽  
Pruthu Thekkur ◽  
Jeremiah Muhwa Chakaya ◽  
Elizabeth Onyango ◽  
Philip Owiti ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Real Time ◽  
Treatment Success ◽  
Health Facilities ◽  
Hiv Positive ◽  
Case Detection ◽  
Monthly Data ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
Set Up

There was concern that the COVID-19 pandemic would adversely affect TB and HIV programme services in Kenya. We set up real-time monthly surveillance of TB and HIV activities in 18 health facilities in Nairobi so that interventions could be implemented to counteract anticipated declining trends. Aggregate data were collected and reported monthly to programme heads during the COVID-19 period (March 2020–February 2021) using EpiCollect5 and compared with monthly data collected during the pre-COVID period (March 2019–February 2020). During the COVID-19 period, there was an overall decrease in people with presumptive pulmonary TB (31.2%), diagnosed and registered with TB (28.0%) and in those tested for HIV (50.5%). Interventions to improve TB case detection and HIV testing were implemented from August 2020 and were associated with improvements in all parameters during the second six months of the COVID-19 period. During the COVID-19 period, there were small increases in TB treatment success (65.0% to 67.0%) and referral of HIV-positive persons to antiretroviral therapy (91.2% to 92.9%): this was more apparent in the second six months after interventions were implemented. Programmatic interventions were associated with improved case detection and treatment outcomes during the COVID-19 period, suggesting that monthly real-time surveillance is useful during unprecedented events.

Factors Affecting Self-Eruption of Displaced Permanent Maxillary Canines

Medicina ◽  
2011 ◽  
Vol 47 (3) ◽  
pp. 22
Author(s):  
Dalia Smailienė ◽  
Antanas Šidlauskas ◽  
Kristina Lopatienė ◽  
Vesta Guzevičienė ◽  
Gintaras Juodžbalys
Keyword(s):  
Characteristic Curve ◽  
Treatment Success ◽  
Vertical Position ◽  
Dental Arch ◽  
Factors Affecting ◽  
Significant Difference ◽  
One Year ◽  
Unerupted Teeth ◽  
The Impact

The aim of this study was to examine the possibility of the spontaneous eruption of displaced unerupted maxillary canines after the extraction of the deciduous canine and dental arch expansion and to determine the impact of initial canine position on treatment success rate. Materials and Methods. The study sample included 50 patients (mean age, 13.5 years [SD, 2.2]) with unilaterally displaced unerupted maxillary canines. Deciduous canines were extracted, and the space for displaced canine was created at the beginning of the study. The follow-up period for the spontaneous eruption was 12 months. The initial vertical, horizontal, labio-palatal position and angle of inclination to the midline of the displaced canine were assessed on panoramic radiographs. Results. Only 42% of displaced canines erupted spontaneously within one-year period (52.9% of labially displaced canines and 36.4% of palatally displaced canines). A significant difference of inclination was determined between spontaneously erupted and unerupted teeth in the labially displaced canine group (P<0.01), with no difference in the palatally displaced canine group. The receiver operating characteristic curve analysis showed that the critical angle of inclination for the spontaneous eruption of the retained canine was 20º (sensitivity 0.759; specificity 0.571; P<0.05). The majority of unerupted canines (75.9%) were inclined more than 20º. The initial height of canine was crucial for spontaneous eruption (sensitivity 0.966; specificity 0.81; P<0.001). This was true for both palatal and labial cases. Conclusions. The initial vertical position of the labially and palatally displaced canines and the inclination of the labially displaced canines were the most important predictors for spontaneous eruption of the cuspid.

scholarly journals Nurses’ Roles and Experiences with Enhancing Adherence to Tuberculosis Treatment among Patients in Burundi: A Qualitative Study

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Marie Carlsson ◽  
Stina Johansson ◽  
Remy-Paul Bosela Eale ◽  
Berthollet Bwira Kaboru
Keyword(s):  
Treatment Adherence ◽  
Treatment Process ◽  
Treatment Success ◽  
Critical Role ◽  
Treatment Compliance ◽  
Qualitative Approach ◽  
Tb Control ◽  
Tb Treatment ◽  
Poor Treatment ◽  
Critical Resources

Background. In TB control, poor treatment adherence is a major cause of relapse and drug resistance. Nurses have a critical role in supporting patients in TB treatment process. Yet, very little research has been done to inform policymakers and practitioners on nurses’ experiences of treatment adherence among patients with TB.Aim. To describe nurses’ experiences of supporting treatment adherence among patients with tuberculosis in Burundi.Method. The study adopted qualitative approach with a descriptive design. A purposive sampling was performed. Eight nurses were selected from two TB treatment centers in Burundi. Content analysis was used to analyze the data.Result. According to the nurses, most patients complete their treatment. Educating patients, providing the medication, observing and following up treatment, and communicating with the patients were the key tasks by nurses to support adherence. Causes for interruption were medication-related difficulties, poverty, and patients’ indiscipline. Treatment adherence could also be affected by patients’ and nurses’ feelings. Providing transportation and meals could enhance treatment compliance.Conclusion. Nurses are critical resources to TB treatment success. In a poverty stricken setting, nurses’ work could be facilitated and adherence further could be enhanced if socioeconomic problems (transportation and nutritional support) were alleviated.

scholarly journals Discontinuation of tuberculosis treatment among children in the Kampala Capital City Authority health facilities: a mixed-methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonard Kibirige ◽  
Jonathan Izudi ◽  
Stephen Okoboi
Keyword(s):  
Healthcare Providers ◽  
Health Facilities ◽  
Capital City ◽  
Sub Saharan Africa ◽  
Tuberculosis Treatment ◽  
Directly Observed Therapy ◽  
City Authority ◽  
Tb Control ◽  
Tb Treatment ◽  
Provider Perspectives

Abstract Introduction Discontinuation of tuberculosis treatment (DTT) among children in sub-Saharan Africa is a major obstacle to effective tuberculosis (TB) control and has the potential to worsen the emergence of multi-drug resistant TB and death. DTT in children is understudied in Uganda. We examined the level and factors associated with DTT among children at four large health facilities in Kampala Capital City Authority and documented the reasons for DTT from treatment supporters and healthcare provider perspectives. Methods We conducted a retrospective analysis of records for children < 15 years diagnosed and treated for TB between January 2018 and December 2019. We held focus group discussions with treatment supporters and key informant interviews with healthcare providers. We defined DTT as the stoppage of TB treatment for 30 or more consecutive days. We used a stepwise generalized linear model to assess factors independently associated with DTT and content analysis for the qualitative data reported using sub-themes. Results Of 312 participants enrolled, 35 (11.2%) had discontinued TB treatment. The reasons for DTT included lack of privacy at healthcare facilities for children with TB and their treatment supporters, the disappearance of TB symptoms following treatment initiation, poor implementation of the community-based directly observed therapy short-course (CB-DOTS) strategy, insufficient funding to the TB program, and frequent stock-outs of TB drugs. DTT was more likely during the continuation phase of TB treatment compared to the intensive phase (Adjusted odds ratio (aOR), 5.22; 95% Confidence Interval (CI), 1.76–17.52) and when the treatment supporter was employed compared to when the treatment supporter was unemployed (aOR, 3.60; 95% CI, 1.34–11.38). Conclusion Many children with TB discontinue TB treatment and this might exacerbate TB morbidity and mortality. To mitigate DTT, healthcare providers should ensure children with TB and their treatment supporters are accorded privacy during service provision and provide more information about TB symptom resolution and treatment duration versus the need to complete treatment. The district and national TB control programs should address gaps in funding to TB care, the supply of TB drugs, and the implementation of the CB-DOTS strategy.

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