scholarly journals Factors Associated with Unsuccessful Treatment of Tuberculosis in Arsi-Robe Hospital, Arsi Zone, Ethiopia: A Retrospective Study

Author(s):  
Addisu Assefa ◽  
Ararsa Girma ◽  
Helmut Kloos

Abstract Background: Tuberculosis remains a major global health problem and ranks along with the human immunodeficiency virus (HIV) as a leading cause of mortality worldwide. The aim of this study was to investigate the treatment outcome of tuberculosis, and factors associated with treatment outcome of tuberculosis in TB patients enrolled in Arsi-Robe Hospital, Oromia regional state, South eastern Ethiopia between January 2013 to December 2017. Methods: An Institutional-based retrospective study was conducted in Arsi-Robe Hospital from 2013 to 2017 in study patients who had all forms of TB in DOTS clinic. The predictors of treatment outcomes were analyzed through bivariate and multivariable logistic regression analysis and a P-value < 0.05 were considered statistically significant. Results: Out of the 257 registered TB patients, most of them were males (57.9%), from rural areas (62.6%) and in age of 15-24 category (39.3%). PTB-, PTB+ and EPTB were recorded in 48.2%, 32% and 19.8% of the patients, respectively. Among all cases, 8.6% had TB-HIV co-infection. Among all TB cases, 84.0% had successful treatment outcome. TB patients from urban areas (AOR: 3.34, 95% CI: 1.33­8.38, P = 0.01), with failure treatment (AOR: 6.66, 95% CI = 1.12- 39.57; P = 0.037) and HIV positive (AOR: 4.92, 95% CI = 1.38-17.51; P = 0.014) had higher odd of unsuccessful treatment outcome of tuberculosis. However, TB patients with PTB+ (AOR: 0.1470, 95% CI = 0.031-0.687; P = 0.015) and EPTB (AOR: 0.194, 95% CI = 0.054-0.688; P = 0.011) had significantly lesser odd of unsuccessful treatment outcome. Conclusions: Being urban resident, treatment failure and HIV positive considerably challenge the treatment outcome of tuberculosis, but being PTB+ and EPTB were associated with higher treatment success rate of TB. Continuous follow-up of patients with unsuccessful treatment outcome of tuberculosis with strengthened implementation of the DOTs strategies are suggested. Trial Registered: retrospectively registered

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5253 ◽  
Author(s):  
Madeeha Laghari ◽  
Syed Azhar Syed Sulaiman ◽  
Amer Hayat Khan ◽  
Naheed Memon

Background Regardless of the advancement in medical technologies, the diagnosis of tuberculosis (TB) in children has remained a challenge. Childhood TB is rampant and an important cause of morbidity and mortality. The objective of this study was to determine the trend of TB and treatment outcomes in children aged ≤14 years registered for TB treatment under DOTS course in three districts of Sindh, Pakistan. Methods For this retrospective study, records of TB children (≤14 years) registered for the treatment of TB from January 2011 to December 2015 in three districts of Pakistan, were collected. Demographic data, baseline weight, clinical manifestations, radiography, histopathology results and treatment outcomes were collected from TB unit registers. Results A total of 2,167 children were treated for TB during the study period. Of these, 1,199 (55.3%) were females and 1,242 (57.3%) were from urban areas. Over three-quarter of patients (76.9%) had pulmonary TB with 13.3% of sputum smear positive cases. The overall treatment success rate was 92.4%. In multivariate analysis, rural residents (OR: 2.146, p < 0.001), sputum smear positive cases (OR: 3.409, p < 0.001) and re-treated patients (OR: 5.919, p < 0.001), were significantly associated with unsuccessful treatment outcomes. However, age group ≤2 years, male and those who were underweight were found to have the highest risk of pulmonary tuberculosis (OR: 1.953, p < 0.001; OR: 1.262, p = 0.028; OR: 1.342, p = 0.008), respectively. Conclusion Patients at risk of treatment failure must be given particular attention. Moreover, strategies are needed to further improve the diagnosis and treatment of TB among children and improve the recording system.


2019 ◽  
Author(s):  
Bezunesh Tsegaye ◽  
Zufan Bedewi ◽  
Solomon Asnake

Abstract Objective This institution based retrospective study was conducted to determine the treatment outcome of TB patients and investigate and associated risk factors among TB patients registered at Adare general Hospital, Southern Ethiopia. Result Among 1122 cases 620 (55.3%) were male, 748(66.7%) were from urban areas, 319 (28.4%) were smear positive, 352 (31.4%) were smear negative and 451 (40.2%) were extra pulmonary patients. Of the 1122 284 (25.3%) were cured, 753(67.1%) completed treatment, 29(2.6%) defaulted, 53(4.7%) died and 3 (0.3%) had treatment failure. The overall mean treatment success rate was 92.4%. The risk of unsuccessful TB treatment outcome was significantly higher among TB patients from rural areas (AOR = 0.435, 95% CI: 0.279, 0.679); patients with extra pulmonary TB (AOR = 0.877, 95% CI; 0.671, 1.146), and HIV positive TB patients (AOR = 5.478, 95% CI; 3.474, 8.639) were more likely to have poor treatment outcomes as compared to their counter parts. Key words: TB treatment outcome, Tuberculosis, DOTS, Treatment success rate.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingjing Ge ◽  
Xiaxia Sun ◽  
Hongdao Meng ◽  
Punam Ghimire Risal ◽  
Danping Liu

Abstract Background Self-medication in children is one of the greatest threats to children health in China. Objectives The purpose of this study was to examine the potential factors associated with self-medication in children and explore rural-urban disparities. Methods A total of 2798 children enrolled in the study. Informed consent was obtained from each primary caregiver following a detail explanation about the purpose of the study. Multivariable logistic regression analysis and Oaxaca–Blinder decomposition analysis were used. Results The results showed that 38.2% primary caregivers of rural areas self-medicated their children, compared to 18.7% of those in urban areas. The urban primary caregivers with college or above education were more likely to self-medicate their children, while rural primary caregivers with college or above education were less likely to self-medicate their children. Children having unhealthy eating habits were more likely to have been self-medicated by their primary caregivers in urban and rural areas. Urban primary caregivers who spend more than 10 min from home to the nearest medical institution were more likely to self-medicate their children. In rural areas, children aged 3–6 years old, primary caregivers with monthly household income per capita of 1001–3000 Yuan, and children with chronic diseases are another set of enabling factors which impacted on self-medication. Unhealthy eating habits of children were the largest contributor to the rural-urban self-medication gap. Conclusions Children’s factors explained the largest portion of the rural-urban difference in self-medication among children. The evidence presented in this study suggests that public health policies addressing rural-urban differences in children’ s factors could serve as an effective method for reducing rural-urban disparities in self-medication among children.


2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.


Author(s):  
Shamsul Azhar Shah ◽  
Nazarudin Safian ◽  
Saharuddin Ahmad ◽  
Wan Abdul Hannan Wan Ibadullah ◽  
Zulkefley bin Mohammad ◽  
...  

Happiness is an essential component to experience healthy ageing. Hence, understanding the factors that contribute to happiness is important. This study aimed to determine the factors associated with happiness among the elderly population in Malaysia. In this study, 1204 respondents were recruited from urban and rural areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria include Malaysians who are 60-years old and above and can converse in the Malaysian language. Those who encounter less than seven scores for the Abbreviated Mental Test were excluded from the study. Among the 1204 respondents, 953 (79.2%) were happy. Sociodemographic characteristics showed that being a men, age of 60 to 74 years, and living in urban areas were significantly associated with happiness. A logistic regression model showed that locality (aOR 1.61), income category (Bottom 40% aOR 0.49; Middle-class group 40% aOR 1.40), social engagement (active aOR 1.77; less active aOR 1.25), receiving emotional support (aOR 2.11) and handgrip strength (aOR 1.02) were significantly associated with happiness. Thus, ensuring the elderly population in receiving emotional support and active social engagement among them can enhance their happiness level.


2018 ◽  
Vol 12 (05) ◽  
pp. 373-379 ◽  
Author(s):  
Stéphanie Jupsa-Mbiandou ◽  
Samuel Fosso ◽  
Edimo Billé ◽  
Tito T Mélachio-Tanekou ◽  
Gideon Ajeagah-Aghaindum ◽  
...  

Introduction: Blastocystis spp. is a protist found in humans. Although usually the most frequent protozoa found in stool samples of both symptomatic and healthy subjects, its pathogenic or rather opportunistic role is yet to be clearly elucidated. To attempt to fill this gap, a cross-sectional study was conducted to compare the frequency of Blastocystis spp. in HIV positive (HIV+) versus HIV negative (HIV-) individuals in four health facilities of the Center Region of Cameroon. Methodology: Stool samples were collected from 283 HIV positive and 245 HIV negative subjects and analyzed using direct diagnostic tests. Results: A total of 46 (8.7%) individuals were found infected with Blastocystis spp., including 6.7% HIV positive and 11.0% HIV negative. This species was more frequent in urban and semi-urban areas than in rural areas, but evenly distributed among genders and age groups as well as among all sectors of activity. The prevalence of Blastocystis spp. (11.3%) was higher in HIV+ patients with a CD4 count ≥ 500 cells / mm3, but no significant difference was found among HIV clinical stages. Likewise prevalence, the mean number of cysts per gram of stool was similar between HIV positive and HIV negative individuals. People infected with Blastocystis spp. showed diverse clinical signs, but only flatulence was significantly more prevalent. The frequencies of these clinical signs were not related to HIV status. Conclusion: No clear relationship links the infection with Blastocystis spp. to HIV, although its presence was associated with digestive disorder, suggesting that this parasite might not be opportunist.


2018 ◽  
Vol 8 (3) ◽  
pp. 468-480 ◽  
Author(s):  
Abraham Geremew ◽  
Bezatu Mengistie ◽  
Esayas Alemayehu ◽  
Daniele Susan Lantagne ◽  
Jonathan Mellor ◽  
...  

Abstract Point-of-use water chlorination is one of the most effective means to prevent diarrhea in under-five children although challenges remain in its adoption and effective use. In Ethiopia, evidence of point-of-use water chlorination among households with under-five children in rural and urban settings that is verified with water testing is scarce. A comparative cross-sectional study was conducted among urban and rural households with under-five child in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia from June to August, 2016. Data were collected from a caregiver of systematically selected households and analyzed using multivariable logistic regression. A total of 1,912 households were included in the analysis with a 96.5% response rate. In rural areas, 4.6% of caregivers were reportedly chlorinating water at point-of-use and 1.2% were confirmed with free residual chlorine. In urban areas, 17.1% of caregivers were reportedly chlorinating water and 6.6% were confirmed to have free residual chlorine. In two settings, caregivers' point-of-use water chlorination was associated with chlorine taste and water quality perception. Inaccessibility to treatment products in rural areas and use of bottled water in urban areas were among the reasons to discontinue point-of-use water chlorination. Behavior changing interventions with proper distribution and marketing is needed for sustainable point-of-use chlorination.


2019 ◽  
Vol 28 (2) ◽  
pp. 283-290 ◽  
Author(s):  
Alexandre Dias Munhoz ◽  
Monia Andrade Souza ◽  
Sonia Carmen Lopo Costa ◽  
Jéssica de Souza Freitas ◽  
Aísla Nascimento da Silva ◽  
...  

Abstract The aim of this study was to determine the frequency and factors associated with Toxoplasma gondii in naturally infected equids in northeastern Brazil. Serum samples from 569 equids (528 horses, 8 mules and 33 donkeys) were subjected to the indirect fluorescent antibody test. Generalized linear models were used to evaluate associated factors. Among the 569 animals sampled, 118 (30.6%) living in rural areas and 14 (26.42%) in urban areas were seropositive (p>0.05). Seropositive animals were observed on 95% of the farms and in all the municipalities. Donkeys/mules as the host, presence of domestic cats and rats on the farm, ingestion of lagoon water and goat rearing remained in the final model as factors associated with infection. Preventive measures such as avoiding the presence of domestic cats close to rearing areas, pastures and sources of water for the animals should be adopted. The wide-ranging distribution of positive animals also indicated that infection in other domestic animals and in humans, through the contaminated environment, was possible. It should be highlighted that there was the possibility that donkeys and mules would continue to have detectable titers for longer, thus explaining the prevalence found. Further studies are needed to confirm this possibility.


2020 ◽  
Vol 114 (10) ◽  
pp. 733-741
Author(s):  
Muhammad Atif ◽  
Wajiha Ahmad ◽  
Nafees Ahmad ◽  
Iram Malik ◽  
Sajjad Sarwar

Abstract Background This study aims to evaluate the treatment outcomes and factors associated with unsuccessful treatment outcomes among multidrug-resistant TB (MDR-TB) patients. Method This was a retrospective observational study conducted at the Bahawal Victoria Hospital, Bahawalpur, Pakistan. The sociodemographic, clinical and treatment-related data of MDR-TB patients registered at the study site between June 2014 and December 2016 were retrospectively collected. Patients’ treatment outcomes were categorized on the basis of WHO-recommended criteria. Multivariate binary logistic regression analysis was used to find the independent factors associated with unsuccessful treatment outcomes. Results Out of 179 MDR-TB patients, 106 (59.2%) completed their treatment successfully. The remaining 73 patients (40.8%) had unsuccessful treatment outcomes, among whom 45 (25.1%) died, while 18 (10.1%) were lost to follow-up. Factors associated with unsuccessful treatment outcomes included age ≥40 y (AOR 4.310; p = 0.006), unsuccessful interim treatment outcomes (AOR 5.810; p = 0.032), occurrence of adverse events (AOR 0.290; p = 0.029) and ofloxacin resistance (AOR 2.952; p = 0.042). Conclusion The treatment success rate among the selected cohort of MDR-TB patients was less than the target of ≥75% set by the WHO in the End TB Strategy. The lower treatment success rate at the study site requires urgent attention from clinicians and program managers.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Daniel Chukwunweolu Oshi ◽  
Sarah Nakalema Oshi ◽  
Isaac Alobu ◽  
Kingsley Nnanna Ukwaja

Background. Few studies have evaluated the rate of tuberculosis (TB)/human immunodeficiency virus (HIV) coinfection and the determinants of its treatment outcomes in Africa. We aimed to determine the predictors of unsuccessful treatment outcomes in HIV-infected tuberculosis patients in Nigeria.Methods. A retrospective cohort study design was used to assess adult TB/HIV patients who registered for TB treatment in two health facilities in Ebonyi State, Southeast Nigeria, between January 2011 and December 2012. Predictors of unsuccessful treatment outcomes were determined using multivariable logistic regression analysis.Results. Of 1668 TB patients, 342 (20.5%) were HIV coinfected. Of these, 195 (57%) had smear-negative pulmonary TB and 11 (3.2%) had extrapulmonary TB. Overall, 225 (65.8%) patients achieved successful outcomes, while 117 (34.2%) had unsuccessful outcomes. The unsuccessful treatment outcomes were due to “default” (9.9%), “death” (19%), “treatment failure” (1.5%), and “transferring out” (3.8%). Independent determinants for unsuccessful outcomes were receiving care at a public facility and noninitiation of antiretroviral therapy.Conclusion. There is need for the reevaluation of the quality of public sector treatment services provided for TB/HIV patients as well as further expansion of TB/HIV collaborative activities in rural areas, and interventions to reduce mortality and default rates among TB/HIV patients are urgently needed in Nigeria.


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