scholarly journals Tendency of Malnutrition in Intensive Phase Pulmonary Tuberculosis Patients with Low Macro Nutrient Adequacy

2021 ◽  
Vol 5 (4) ◽  
pp. 326
Author(s):  
Esti Trihanifah ◽  
Stefania Widya Setyaningtyas
Keyword(s):  
Pulmonary Tuberculosis ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Nutrient Adequacy

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 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).

The multicenter observational non-interventional study of combination anti-tuberculosis drugs used in treatment of pulmonary tuberculosis patients

2020 ◽  
Vol 98 (8) ◽  
pp. 46-56
Author(s):  
T. E. Tyulkova ◽  
I. V. Mokhireva ◽  
A. A. Starshinova ◽  
P. K. Yablonskiy ◽  
L. I. Аkhilgova ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Single Case ◽  
Transaminase Level ◽  
Drug Induced ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Primary Drug Resistance ◽  
Sputum Conversion ◽  
Level Elevation

The objective of the study: to run a multicenter non-interventional observational study to assess treatment outcomes in tuberculosis patients receiving combination drugs with fixed doses, and to evaluate tolerability and safety of these drugs.Subjects and methods. 13 TB units participated in this study which lasted from 2016 to 2018. The primary population (PP) included of 489 patients, after applying the exclusion criteria – the subpopulation (subPP) included 267 patients with newly detected pulmonary tuberculosis and relapses who received treatment as per chemotherapy regimen I or III. Descriptive statistics methods were used for statistical data processing.Results. Of all PP, 267 (54.6%) completed the main course of chemotherapy. (subPP). Out of 489 patients, treatment was discontinued in 118 (24.1%) of them. Primary drug resistance was detected in 30 (6.1%) patients out of 489 patients, secondary drug resistance – in 74 (15.1%) of 489. In subPP, by the end of the intensive phase the sputum conversion was achieved in 78 (96.3%) of 81 patients. Clinical and X-ray changes had been observed in this subgroup for 106.2 to 63.3 days (median 90). The duration of the intensive phase in the subPP made 107.9 ± 50.5 days. In safety assessment, 191 adverse events (AE) were registered in 149 (30.5%) of 489 patients. By severity, most AEs were minor (164 out of 191), moderate AEs were less frequent (20 out of 191), and there were 7 cases of serious AEs. 61 AEs in 57 (38.2%) out of 149 patients were confidently associated with in-take of the studied drugs. The structure of those AEs, transient transaminase level elevation prevailed (45 (73.8%) of 61 AEs, but there was a single case (1.6%) drug-induced hepatitis). Among the serious AEs, two cases were safely resolved by the end of the protocol, two of them were fatal in TB/HIV co-infection, and three cases were diagnosed with cancer.

scholarly journals GAMBARAN KADAR ASAM URAT PADA PENDERITA TUBERKULOSIS PARU YANG MENERIMA TERAPI OBAT ANTI TUBERKULOSIS DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JULI 2014 – JUNI 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Irwanto Kondo ◽  
M. C. P. Wongkar ◽  
Jeffrey Ongkowijaya
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Uric Acid ◽  
Pulmonary Tuberculosis ◽  
Female Ratio ◽  
Intensive Phase ◽  
Antituberculosis Drugs ◽  
Tuberculosis Patients ◽  
Male Female Ratio ◽  
Amino Salicylic Acid ◽  
Using Data

Abstract: Pulmonary tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. There are 6 kinds of essential drugs which have been used: isoniazid, amino salicylic acid, streptomycin, ethambutol, rifampicin, and pyrazinamide. As reported, pyrazinamide and ethambutol can cause increased levels of uric acid. This study aimed to obtain the uric acid profile in tuberculosis patients treated with antituberculosis drugs in Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using data of the Medical Record Department of Prof. Dr. R. D. Kandou Hospital Manado. Of 25 tuberculosis patients treated with antituberculosis drugs, the uric acid levels were as follows: high in 15 patients (60%), normal in 9 patients (36%), and low in 1 patient (4%). The highest proportion of tuberculosis patients who had hyperuricemia after treated with antituberculosis drugs were male (73.33%) and age 46-65 years (46.67%). The increased uric acid level mainly occurred in the intensive phase of treatment (0-2 months), and in patients taking the combination of pyrazinamide and ethambutol. The most common comorbid disease was anemia (53.33%). Conclusion: Hyperuricemia was found in 60% of TB patients receiving antituberculosis drugs with a male : female ratio 2.75:1, mainly occurred in the intensive phase of treatment (0-2 months) and in patients who used a combination of pyrazinamide and ethambutol.Keywords: pulmonary tuberculosis, anti-tuberculosis drugs, uric acid Abstrak: Tuberkulosis (TB) paru adalah suatu penyakit infeksi kronik yang disebabkan Mycobacterium tuberculosis. Terdapat 6 macam obat esensial yang telah dipakai, yaitu: isoniazid (H), para amino salisilik asid, streptomisin, etambutol, rifampisin, dan pirazinamid. Pirazinamid dan etambutol dilaporkan dapat menyebabkan peningkatan kadar asam urat. Penelitian ini bertujuan untuk mendapatkan gambaran kadar asam urat pada pasien TB paru yang menerima obat antituberkulosis (OAT) di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ini deskriptif retrospektif dengan mengambil data sekunder di Instalasi Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil pemeriksaan laboratorium dari 25 pasien TB yang menjalani terapi OAT memperlihatkan 15 pasien (60%) dengan kadar asam urat tinggi, 9 pasien (36%) normal, dan 1 pasien (4%) kadar asam urat rendah. Proporsi tertinggi pasien TB yang mengalami hiperurisemia setelah menerima OAT ialah laki-laki (73,33%), rentang umur 46-65 tahun (46,67%). Peningkatan terutama terjadi pada fase intensif pengobatan (0-2 bulan), dan pada pasien yang mengonsumsi kombinasi pirazinamid dan etambutol. Penyakit komorbid terbanyak ialah anemia (53,33%). Simpulan: Hiperurisemia ditemukan pada 60% pasien TB yang menjalani terapi OAT, jenis kelamin laki-laki lebih banyak dari perempuan (2,75:1), peningkatan terutama terjadi pada pengobatan fase intensif (0-2 bulan), dan pada pasien yang menggunakan kombinasi pirazinamid dan etambutol. Kata kunci: tuberkulosis paru, obat anti tuberkulosis, asam urat

scholarly journals Change in body weight and treatment outcome in sputum positive pulmonary tuberculosis patients treated under directly observed treatment short-course

2018 ◽  
Vol 5 (6) ◽  
pp. 2431
Author(s):  
Malangori A. Parande ◽  
Pradip S. Borle ◽  
Vinay S. Tapare ◽  
Sudhakar W. More ◽  
Susmita S. Bhattacharya
Keyword(s):  
Body Weight ◽  
Treatment Outcome ◽  
Weight Gain ◽  
Pulmonary Tuberculosis ◽  
Prognostic Significance ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
End Of Treatment ◽  
Significant Difference

Background: Patients with tuberculosis often suffer from severe weight loss and is used as useful marker to predict TB treatment outcome. Hence a study was planned with an objective to determine the change of patient’s body weight over time throughout treatment and to determine whether there was any association with treatment outcome.Methods: This was a retrospective cohort study, planned to be conducted among all smear positive pulmonary tuberculosis patients registered in a Tuberculosis Unit of Pune corporation, during the period of January to December 2015. Body weights of patients were recorded from TB treatment cards at the time of diagnosis, after 2 months of intensive phase of treatment and at the end of treatment. Total 344 cases were enrolled. Chi-Square test and Fisher’s exact test and repeated measure ANOVA test was used for analysis.Results: A bad outcome was more likely among the category II cases as compared to category I, among non-adherent to treatment cases in continuation phase and higher sputum grading at the time of diagnosis i. e. in 3+ sputum smear grading. The weights of the patients at the time of diagnosis, at end of intensive phase and at end of treatment showed statistical significant difference (p<0.0001). The weight gain, more so at end of treatment was significantly associated with good outcome.Conclusions: Weight gain has prognostic significance in patients with tuberculosis and should be considered as a surrogate marker to monitor response to TB treatment especially in developing countries where extensive laboratory tests are not feasible. 

scholarly journals Association of psychological status with first diagnosed pulmonary tuberculosis in men

2021 ◽  
pp. 24-30
Author(s):  
Maryna Koсhuieva ◽  
Vasyl Kushnir ◽  
Ivan Hrek
Keyword(s):  
Pulmonary Tuberculosis ◽  
Trait Anxiety ◽  
State Anxiety ◽  
Depressive Disorders ◽  
Clinical Laboratory ◽  
Psychological Status ◽  
Anxiety And Depression ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Anxiety Depression

The aim. Assessment of the initial psychological status of men with first diagnosed pulmonary tuberculosis and the study of its associations with the clinical course of the disease. Materials and methods. The study involved 54 men with first diagnosed pulmonary tuberculosis. Patients had a dynamic complex clinical, laboratory and instrumental examination with an assessment of the psychological status according to the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI). Results. The evaluating of initial psychological status in patients with first diagnosed pulmonary tuberculosis, depressive states of varying severity were found in 47.05 % of patients, moderate state anxiety – in 74.51 % of patients, moderate trait anxiety – in 35.29 %. We revealed associations of the levels of anxiety and depression with the degree of bacterial excretion and the duration of the intensive phase of therapy. Conclusions. To assess the psychological status of patients with first diagnosed infiltrative pulmonary tuberculosis, it is advisable to use the STAI and the BDI. Patients with first diagnosed infiltrative pulmonary tuberculosis in 100 % of cases have psychological status disorders with a predominance of moderate state anxiety and the absence of depressive disorders in only half of them. More expressed violations of the psychological status (anxiety, depression) identifies patients who are married and have a steady job. In patients with first diagnosed infiltrative pulmonary tuberculosis, an increase in the severity of anxiety and depression is associated with more expressed bacterial excretion, decrease in body weight, greater frequency of destruction of lung tissue, prevalence of the tuberculosis process by more than 2 lung segments, decrease in the effectiveness of standard therapy and prolongation intensive phase of treatment.

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