scholarly journals Pharmacovigilance of first line anti-tubercular therapy in category I patients of pulmonary tuberculosis

2017 ◽  
Vol 6 (3) ◽  
pp. 643
Author(s):  
Rahul Agarwal ◽  
Ashok Goel ◽  
Jaswant Rai ◽  
Nirmal Chand Kajal
Keyword(s):  
Pulmonary Tuberculosis ◽  
Visual Disturbance ◽  
Severity Assessment ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Medical College ◽  
High Incidence ◽  
Anti Tubercular Therapy ◽  
Health Programme ◽  
Probable Category

Background: Study was done to determine incidence of ADR’s in sputum positive, pulmonary TB patients, on DOTS category I and to determine the effect of ADR’s on sputum conversion.Methods: Open, prospective, observational, non-comparative study conducted in the Department of Pharmacology in collaboration with Department of Tuberculosis and Chest Diseases, Government Medical College, Amritsar for the duration of 18 months (March 2015 to September 2016). One hundred sputum positive patients of pulmonary tuberculosis on DOTS category I, of either sex, in age group of 14 years to 65 years, were recruited and followed up during intensive phase of therapy at end of 1st and 2nd month. Causality and Severity assessment were done by using WHO-UMC causality scale and Hartwig’s severity scale respectively.Results: Out of 100 patients 84 (84%) developed one or more ADR’s and a total of 118 ADR’s occurred in our study. The most common ADR was GI upset 45(38.13%), followed by hepatitis 42 (35.59%), rash 12 (10.16%), CNS 8 (6.77%), arthritic symptoms 5 (4.23%), visual disturbance 2 (1.69%), bleeding problems 2 (1.69%), hyperuricemia 1 (0.84%) and peripheral neuropathy 1 (0.84%). Causality assessment revealed that most of ADR’s(60) were in probable category and severity assessment revealed that most of ADR’s(55) belonged to level 4 (Moderate severity). Most of the ADR’s occurred within 30 days of the start of treatment (84.74%).Conclusions: With such a high incidence of ADR’s there is a need of incorporating pharmacovigilance programme into this vital health programme for more comprehensive monitoring of tuberculosis patients on DOTS for timely prevention, detection, and management of ADR’s. This will decrease non-adherence and dropouts, and thus result in better treatment outcomes.

Knowledge of Pulmonary Tuberculosis among the Patients under Anti- Tubercular Therapy

2018 ◽  
Vol 5 (1) ◽  
pp. 27-31
Author(s):  
Golam Sagir ◽  
Rafiqul Islam ◽  
Md Mamnur Rashid ◽  
Mohammad Akter Hossain ◽  
Mohammad Ashraful Haque
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Short Course ◽  
Chest Disease ◽  
Directly Observed Treatment ◽  
The Mean ◽  
Disease Hospital ◽  
Anti Tubercular Therapy

Background: Knowledge on tuberculosis is very important among the patients under anti-tubercular therapy for proper management.Objective: The purpose of the present study was to assess the knowledge about tuberculosis among patients attending the DOTS (directly observed treatment, short course) corner.Methodology: This cross sectional study was conducted in the DOTs corner of Sylhet MAG Osmani Medical College, Sylhet, Bangladesh and Sylhet Chest Disease Hospital, Sylhet, Bangladesh during the period from June 2011 to November 2011 for a period of six (6) months. All the patients who were diagnosed as case of pulmonary tuberculosis and were treated with anti-tubercular drugs at DOTs corner who attended in the both Hospitals, Sylhet were selected as study population.Result: The age of the patients ranged from 18 to 70 years with the mean age of 41.2 (SD+ 12.4) years. The age of the male patients were ranging from 18 to 70 years with the mean age of 42.1 (SD: 12.8) years. Among the 194 patients, 90(46.4%) patients had good knowledge and 104(53.6%) patients had poor knowledge about tuberculosis.Conclusion: In conclusion, greater efforts therefore need to be undertaken to improve TB control among TB patients through appropriate and sustainable health education.Bangladesh Journal of Infectious Diseases 2018;5(1):27-31

scholarly journals Trends in sputum smear conversion among smear-positive pulmo-nary tuberculosis patients

2015 ◽  
Vol 4 (1) ◽  
pp. 24-33
Author(s):  
SEK Acquah ◽  
L Quaye ◽  
W Walana ◽  
EK Vicar ◽  
YN Osei ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Significant Proportion ◽  
Response To Therapy ◽  
Sputum Smear ◽  
Patient Response ◽  
Important Indicator ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Conversion Rates

Sputum smear conversion during pulmonary tuberculosis treatment is an important indicator of patient response to therapy and as such determines the direction of TB patient care. This retro-spective review assessed the trends in sputum smear evaluation and conversion rates among follow up pulmonary tuberculosis patients presenting to the Tamale Teaching Hospital from January 2004 to December 2012. A total of 8,238 sputum smear cases comprising of 6,892 (83.7%) diagnoses and 1,346 (16.3%) follow-up cases were recorded. The 1,346 follow-up cases comprised of 57.8% (778/1346) males and 42.2% (568/1346) females. The percentage proportion of follow up cases that had their month of follow up, residential addresses, ages and smear results reported are 93.8% (1262/1346), 95.2% (1281/1346), 98.2% (1322/1346) and 97.8% (1309/1346) respectively. The cumula-tive median age was 43years (IQR: 30 to 55years) with the minimum and maximum ages being 14 and 80 years recorded in 2008 and 2012 respectively. Thirty eight percent (511/1,346) of follow-up cases were from the intensive phase (month 2) evaluation period. One hundred and eleven (111) of the follow up cases were smear positive representing a cumulative positivity rate of 8.5% (111/1309). This comprised of 75(67.6 %) males and 36(32.4%) females. Generally males were observed to be significantly more likely to delay smear conversion during treatment (OR = 1.560; p = 0.035, 95% CI=1.032- 2.359) compared to females. The ages of the positive cases ranged from 14 to 75 years with a median age of 45.5 years. The intensive phase (month 2) positivity rate was 8.1% (63/776) representing a conversion rate of 91.9%. Significant proportion (15.4%) of males were smear posi-tive and were more likely to remain positive after two months of therapy compared to their female counterparts (OR = 2, p = 0.02, CI = 0.098 – 1.299). Periodic surveillance of regional sputum smear late/non conversion among PTB patients on treatment would be useful in supporting Tb manage-ment in Ghana.Keywords: Mycobacterium tuberculosis, follow up, microscopy, acid fast bacilli, Ghana

scholarly journals SEROPREVALENCE OF HIV INFECTION IN PULMONARY TUBERCULOSIS PATIENTS.

2020 ◽  
pp. 1-3
Author(s):  
K.G.R. Mallan ◽  
A. Fathahudeen ◽  
Manjula V.D.
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sputum Smear ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Pulmonary Tb ◽  
Medical College ◽  
Elimination Programme ◽  
Kerala State

Aim : To Determine the seroprevalence of Human immunodeficiency virus infection among Pulmonary Tuberculosis patients in a tertiary care teaching institution, in Ernakulam district of Kerala state in India. Methods : Study was conducted in Respiratory medicine department and integrated counselling and testing centre (ICTC) of Government Medical College, Ernakulam With approval of IEC after getting written informed consent , a cross sectional study was conducted among 384 pulmonary TB patients who were registered under the National TB elimination Programme (RNTCP). Result :The prevalence of HIV among study population was 1.3 %. There was no gender difference while the highest age group less than 30 followed by 30-60. The major respiratory pathology among study subjects was consolidation (42.7%) followed by fibrosis(25.3%).Consolidation was a predominant presenting pathology seen in female pulmonary TB patients.The sensitivity of sputum smear against CBNAAT was 60.4% and specificity was 83%. Conclusion : The prevalence is low compared with the national average of 3 to 3.4 % HIV co infection among Tuberculosis patients during the study period.

scholarly journals ASUPAN ZAT GIZI MAKRO DAN MIKRO PENDERITA TUBERKULOSIS PARU RAWAT JALAN SEBELUM DAN SESUDAH TERAPI FASE INTENSIF DISERTAI KONSELING GIZI

2019 ◽  
Vol 41 (1) ◽  
pp. 55-64
Author(s):  
Made Dewi Susilawati ◽  
Yunita Diana Sari ◽  
Rika Rachmawati ◽  
Elisa Diana Julianti
Keyword(s):  
Vitamin D ◽  
Vitamin E ◽  
Pulmonary Tuberculosis ◽  
Primary Data ◽  
Nutrition Counseling ◽  
Nutritional Counseling ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Micronutrient Intake ◽  
Before And After

ABSTRACT The highest tuberculosis (TB) mortality and morbidity occured in developing countries, including Indonesia. In terms of nutrition, WHO expects TB research conducted nationwide to provide scientific evidence that all important tuberculosis patients are assessed nutritional status and given nutritional counseling in all health facilities. There also need an operational standard in the treatment of malnutrition due to TB. The aims of this study were to identify nutrient intake and blood micronutrient level in TB patients before and after 2 months of therapy with nutritional counseling. The pre-experimental pretest posttest 1 group study was conducted in 10 Puskesmas in Bogor District in 68 pulmonary tuberculosis patients aged 15-55 years. Primary data were collected through interviews, anthropometric measurements and laboratory checks. Results of BTA examination showed that most patients were TB patients with BTA 1 + 49.1% and 35.8% with BTA 3 +, the rest of BTA 2+ and scanty. There were significant differences in macro and micronutrient intake before and after intensive phase therapy accompanied by nutritional counseling (p <0.05). The levels of retinol, selenium, vitamin D and vitamin E in the blood also showed significant differences before and after intensive phase therapy (p <0.05). The macro and micronutrient intake after intensive phase therapy was higher than before. Most of patients experienced an increase in dietary intake in almost all food group, as well as micronutrient levels (retinol, selenium, vitamin D and vitamin E) in the blood increased after intensive phase therapy with nutrition counseling. Keyword: nutrition intake, pulmonary tuberculosis,  nutrition counseling   ABSTRAK Angka kesakitan dan kematian TB tertinggi ada di negara berkembang, termasuk di Indonesia. Dari segi nutrisi, WHO mengharapkan  penelitian TB yang dilakukan di seluruh negara dapat memberikan bukti ilmiah bahwa semua pasien TB penting dinilai status gizinya dan diberikan konseling gizi di semua sarana kesehatan dan perlunya ditetapkan standar operasional dalam  penanganan malnutrisi akibat TB. Penelitian ini bertujuan untuk mengidentifikasi asupan gizi dan kadar mikronutrien pasien TB sebelum dan sesudah terapi 2 bulan dengan konseling gizi. Desain penelitian pra-eksperimental pretest posttest 1 kelompok dilakukan di 10 Puskesmas di Kabupaten Bogor pada 68 pasien TB paru, berusia antara 15-55 tahun. Data primer dikumpulkan melalui wawancara, pengukuran antropometri dan pemeriksaan laboratorium. Hasil pemeriksaan BTA menunjukkan bahwa pasien terbanyak adalah pasien TB dengan BTA 1 + sebesar 49,1 % dan 35,8 % dengan BTA 3 + sisanya BTA 2+ dan scanty. Terdapat perbedaan bermakna pada asupan makro dan mikronutrien sebelum dan setelah terapi fase intensif yang disertai konseling gizi (p<0.05). Kadar retinol, selenium, vitamin D dan vitamin E dalam darah juga menunjukkan perbedaan bermakna sebelum dan sesudah terapi fase intensif (p<0.05). Rerata asupan makro dan mikronutrien sesudah terapi fase intensif lebih tinggi dibandingkan sebelum terapi. Sebagian besar pasien mengalami peningkatan pola konsumsi makan pada hampir semua golongan bahan makanan, begitu juga dengan kadar mikronutrien (retinol, selenium, vitamin D dan vitamin E) dalam darah mengalami peningkatan sesudah terapi fase intensif yang telah disertai konseling gizi.   Kata kunci: asupan gizi, tuberkulosis paru,  konseling gizi

scholarly journals Analysis of treatment outcomes for destructive pulmonary tuberculosis in patients with multiple drug resistance of M. tuberculosis

2020 ◽  
Vol 98 (10) ◽  
pp. 23-27
Author(s):  
Yu. A. Sheyfer ◽  
I. S. Gelberg
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Clinical Cure ◽  
Multiple Drug Resistance ◽  
Group Versus ◽  
Multiple Drug ◽  
Continuation Phase ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Sputum Conversion

The objective of the study: to analyze treatment outcomes in patients with pulmonary destructive MDR tuberculosis who completed the intensive phase of treatment and had healed or persisting cavities.Subjects and methods. Treatment outcomes were retrospectively analyzed in 191 patients suffering from destructive pulmonary MDR tuberculosis who underwent the intensive phase of chemotherapy in in-patient settings in 2009-2012 and 2013-2015 (treated by different regime ns);  in each of those cohorts, groups were formed depending on persistence/healing of destruction (cavities) during the intensive phase of chemotherapy:  (CV-) ‒ the destruction healed, (CV+) – the destruction persisted.Results. In 24 months, treatment was found to be effective only in 19/68 (27.9%) in the (CV+) group versus 31/40 (77.5%) in the (CV-) group, p < 0.05 (cohort 2009-2012); 17/42 (40.5%) versus 29/41 (70.7%), respectively, p < 0.05 (2013-2015 cohort). Within 48 months, treatment outcomes were as follows: clinical cure in the (CV+) group was 38.2% (26/68 people), and in the (CV-) group – 72.7% (29/40 people), p < 0.05 (2009- 2012) and 23/42 (54.7%) and 33/41 (80.5%), respectively, p < 0.05 (2013-2015 cohort).Conclusion. Considering the above, when assessing treatment in the intensive phase of chemotherapy in destructive pulmonary tuberculosis patients, it is necessary to take into account the rate of cavity healing but not being limited to sputum conversion. Patients with persisting cavities should not be transferred to the continuation phase, the surgery or collapse treatment should be considered for such patients.

scholarly journals Sputum Smears Conversion in Daily Versus Intermittent Treatment Regimen in New Sputum Smear Positive Pulmonary Tuberculosis Patients - A Retrospective Study

2021 ◽  
Vol 10 (42) ◽  
pp. 3617-3622
Author(s):  
Dhondiba Haribhau Bhise
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Regimen ◽  
Sputum Smear ◽  
Patient Death ◽  
Continuation Phase ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
National Tuberculosis ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Negative Conversion

BACKGROUND Sputum smear conversion is the negative conversion of the sputum smear at the end of the second month of treatment regimen under the National Tuberculosis Elimination Program (NTEP). When the acid-fast bacillus (AFB) smear comes negative at the end of an intensive phase, the treatment regimen can shift to the continuation phase that indicates bacillary load is a minimum. Although some authors consider the conversion of cultures when the AFB smear is negative, two potent drugs in the continuation phase are sufficient to kill the remaining bacilli. The drug that can kill bacteria in the first 2 days of treatment is called early bactericidal activity (EBA). This can be assessed by the percentage of negative conversion of cultures at the end of the intensive phase of the treatment regimen. EBA is very essential because it reduces the transmission in the community and chances of patient death. When the purpose is to kill as many bacilli as possible in the first few days and weeks of treatment, it is very important to include bactericidal drugs in the treatment regimen so that it reduces the chances of patient death and infectiousness and the negative conversion of the cultures after 2-month treatment regimen is an indication of the bactericidal capacity of the drug. The purpose of this study was to compare sputum smear conversion in daily versus intermittent treatment regimens in diagnosed cases of new sputum smear-positive pulmonary tuberculosis patients. METHODS This retrospective observational study was carried out in the Department of Respiratory medicine and nodal drug resistance tuberculosis centre (DR-TB) at the Government medical college and hospital, Akola. In this study, a total of 120 new patients were taken. 60 patients were given daily and intermittent regimens respectively under NTEP. RESULTS Out of 120 patients, 56 (93.33 %) patients in intermittent and 53 (88.33 %) patients in daily regimen were sputum smear-negative at the end of 2nd month (intensive phase) and at the end of 6th month (continuation phase). 1 patient (1.6 %) remained sputum smear-positive after the intensive phase. That patient was given 1 month of extension of anti-tuberculosis treatment (AKT) in the intensive phase and the patient became sputum negative after 1 month of extension. CONCLUSIONS It was concluded in this study, daily regimens and intermittent regimens were equally effective in negative conversion of the sputum smear at the end of the intensive phase and the end of the continuation phase. Negative conversion of the sputum smear is quite important because the bacillary load will be so low at the end of 2nd month that reduces the chances of patient death and transmission in the community. KEY WORDS Pulmonary Tuberculosis (PTB), Drug-Resistant TB (DR-TB), National Tuberculosis Programme (NTP), Revised National TB Control Program (RNTCP), Intensive Phase (IP), continuation Phase (CP), National Tuberculosis Elimination Program (NTEP).

Sign in / Sign up

Export Citation Format

Share Document