Factors influencing the length of hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: A retrospective follow up study

Abstract Background: The length of hospital stay is the duration of hospitalization and reflects disease severity and resource utilization indirectly. Generally, tuberculosis considered as an ambulatory disease able to be treated at DOTs clinics, however, hospitalization remains an important component for clinical stabilization of patients. Hence, this study aimed to identify factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia.Methods: An institution-based retrospective follow-up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda, and Debremarkos referral from September 2010 to December 2016 (n=432). Data were extracted from hospital admission/discharge logbooks and individual patient medical charts. Logistic regression analysis was used to identify factors associated with longer hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment.Result: Most patients (93.5%) had a pulmonary form of multidrug-resistant tuberculosis and 26.2% had /TB/HIV co-infections. The median length of hospital stay was 62 (interquartile range 36 to 100) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.47, 95% confidence interval [CI]; 1.31 to 9.16), functional status of bedridden (AOR= 2.88, 95%CI; 1.29 to 6.43), and reported adverse drug effects (AOR=2.11, 95%CI; 1.35 to 3.30) were significant predictors of extended hospital stays.Conclusion: The study revealed that the length of hospital-stay differed significantly between the hospitals. The pulmonary form of tuberculosis decreased functional status at admission and reported adverse drug reactions were determinants of longer hospital stays. This underscores the importance of early case detection and prompt treatment of adverse drug effects.

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Factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: A retrospective follow up study

10.21203/rs.3.rs-15610/v3 ◽

2020 ◽

Author(s):

koku Sisay Tamirat ◽

Gashaw Andargie ◽

Yaregal Animut Babel

Keyword(s):

Hospital Stay ◽

Drug Effects ◽

Length Of Hospital Stay ◽

Multidrug Resistant ◽

Tuberculosis Treatment ◽

Intensive Phase ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Hospital Stays

Abstract Background: The length of hospital stay is the duration of hospitalization, which reflects disease severity and resource utilization indirectly. Generally, tuberculosis is considered an ambulatory disease that could be treated at DOTs clinics; however, admission remains an essential component for patients' clinical stabilization. Hence, this study aimed to identify factors influencing hospital stay length during the intensive phase of multidrug-resistant tuberculosis treatment.Methods: A retrospective follow-up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda, and Debremarkos referral hospitals from September 2010 to December 2016 (n=432). Data extracted from hospital admission/discharge logbooks and individual patient medical charts. A binary logistic regression analysis was used to identify factors associated with more extended hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment.Result: Most patients (93.5%) had a pulmonary form of multidrug-resistant tuberculosis and 26.2% had /TB/HIV co-infections. The median length of hospital stays was 62 (interquartile range from 36 to 100) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.47, 95% confidence interval [CI]; 1.31 to 9.16), bedridden functional status (AOR= 2.88, 95%CI; 1.29 to 6.43), and adverse drug effects (AOR=2.11, 95%CI; 1.35 to 3.30) were factors associated with extended hospital stays.Conclusion: This study revealed that the length of hospital-stay differed significantly between the hospitals. The pulmonary form of tuberculosis decreased functional status at admission and reported adverse drug reactions were determinants of more extended hospital stays. These underscore the importance of early case detection and prompt treatment of adverse drug effects.

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Factors influencing length of hospital stay during the intensive phase of multidrug resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: retrospective follow up study

10.21203/rs.3.rs-15610/v1 ◽

2020 ◽

Author(s):

Koku Sisay Tamirat ◽

Gashaw Andargie ◽

Yaregal Animut Babel

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Multidrug Resistant ◽

Tuberculosis Treatment ◽

Intensive Phase ◽

Follow Up Study ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Hospital Stays

Abstract Background: Tuberculosis (TB) generally considered as an ambulatory disease. However, hospitalization remains an important component for isolation and medical stabilization of patients. Hence, this study aimed to identify factors influencing the length of hospital stay during the intensive phase of multidrug resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: retrospective follow up study.Methods: An institution based retrospective follow up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda and Debremarkos referral from September 2010 to December 2016 (n=465). Data were extracted from hospital admission/discharge logbooks and individual patient medical charts. Logistic regression was used to identify factors associated with longer hospital stays during the intensive phase of multidrug resistant tuberculosis treatment.Result: Most patients (92.5%) had a pulmonary form of multidrug resistant tuberculosis and a quarter of them HIV co-infections. The median length of hospital stay was 61 (interquartile range 34 to 101) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.20, 95% confidence interval [CI]; 1.28 to 7.96), treated at the University of Gondar (AOR= 2.11, 95%CI; 1.02 to 4.41) and Borumeda Hospital (AOR= 3.59, 95%CI; 1.67 to 7.72), functional status of ambulatory (AOR=2.25, 95% CI; 1.19 to 4.27) and bedridden (AOR= 3.39, 95%CI; 1.57 to 7.35), and reported adverse drug reactions (AOR=2.54, 95%CI; 1.60 to 4.02) were significant predictors of extended hospital stays.Conclusion: The study revealed that longer hospital stay and significant differences were observed among hospitals. Decreased functional status at admission, pulmonary form of tuberculosis and reported adverse drug reactions were determinants of longer hospital stays. This underscores the importance of early case detection and prompt treatment of adverse effects.

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Factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara regional state hospitals, Ethiopia: a retrospective follow up study

BMC Public Health ◽

10.1186/s12889-020-09324-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Koku Sisay Tamirat ◽

Gashaw Andargie ◽

Yaregal Animut Babel

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Multidrug Resistant ◽

Intensive Phase ◽

State Hospitals ◽

Follow Up Study ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Factors Influencing

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INFLUENCE OF GENOTYPIC VARIABILITY OF M. TUBERCULOSIS ON THE COURSE OF TUBERCULOSIS WITH MULTIPLE DRUG RESISTANCE

International Medical Journal ◽

10.37436/2308-5274-2020-1-15 ◽

2020 ◽

pp. 68-71

Author(s):

V. S. Krutko ◽

L. H. Nikolaieva ◽

T. V. Maistat ◽

O. A. Oparin ◽

Anton Viktorovych Rohozhyn

Keyword(s):

Clinical Laboratory ◽

Multiple Drug Resistance ◽

Multidrug Resistant ◽

Multiple Drug ◽

Genotypic Variability ◽

Intensive Phase ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Promising Area ◽

Infection Source

Tuberculosis is infectious and socially dependent disease, being now one of the most pressing issues in practical health care. As well the usual types of tuberculosis infection, chemoresistant tuberculosis is spreading rapidly in the world. The WHO estimates that about 500,000 people on the planet are infected with M. tuberculosis, which is resistant to standard anti−tuberculosis drugs. The probability of successful treatment decreases with emergence of new genotypes of M. tuberculosis with total resistance. In the modern epidemiology of tuberculosis, it is important to identify genotypes on certain signs, allowing to address issues such as their origin, identification of the infection source, possible routes and factors of transmission, as well as to reveal cases and spread of resistance to anti−tuberculosis drugs. To evaluate the therapy efficiency of multidrug−resistant tuberculosis patients with revealed genotypic variability during treatment, 10 patients with chemoresistant pulmonary tuberculosis having M. tuberculosis genotypic variability were treated. In these patients, the clinical, laboratory and radiological dynamics of disease in intensive phase of treatment were studied. Analysis of treatment results for patients with chemoresistant tuberculosis with genotypic variability of M. tuberculosis was evaluated by the intoxication syndrome dynamics of, the timing of closure of the decay cavities and cessation of bacterial excretion. The study found that the genotypic variability of M. tuberculosis is characterized by the change of less virulent genotypes of M. tuberculosis to more virulent. Signs of intoxication have been shown to change from less virulent M. tuberculosis genotypes to M. tuberculosis Beijing genotypes. Genotypic variability of mycobacteria in hospital suggests that hospitalization in tuberculosis facilities is a risk of exogenous tuberculosis superinfection. Studying the influence of genotypic variability of M. tuberculosis on the course of multidrug−resistant tuberculosis requires more extensive research, being a very relevant and promising area in phthisiology. Key words: Mycobacterium tuberculosis, genotypic variability, VNTR−genotyping, treatment.

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