scholarly journals Delay to initiate treatment is associated with unsuccessful treatment outcome among new pulmonary tuberculosis patients in Tigray, Northern Ethiopia: a follow up study

2021 ◽  
Author(s):  
kiros Tedla ◽  
Girmay Medhin ◽  
Gebretsadik Berhe ◽  
Afework Mulugeta ◽  
Nega Berhe
Keyword(s):  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Treatment Initiation ◽  
Statistical Significance ◽  
Northern Ethiopia ◽  
Follow Up Study ◽  
Unsuccessful Treatment ◽  
Increased Risk

Abstract Background : Previous studies in Ethiopia indicated that tuberculosis (TB) patient’s elapse long time before treatment initiation. However, there is very limited evidence on the association of delay to initiate treatment with treatment outcome. Objective : To investigate the association of time to treatment initiation delay with treatment outcomes of new adult TB patients in Tigray region of Ethiopia. Methods : We conducted a follow up study from October 2018 to April 2020 by recruiting 875 newly diagnosed Pulmonary Tuberculosis (PTB) patients from 21 randomly selected health facilities. Study participants were selected using simple random sampling technique during treatment initiation from October 1/2018 to October 30/2019. Delay to initiate treatment and treatment outcome were collected using standardized questionnaire and laboratory investigation. Adherence of TB patients to their treatment was collected using a 10 points linear visual analogue scale (VAS) at the end of treatment. The association of delay to initiate treatment with treatment outcome was modeled using log binomial regression model. Statistical significance was reported whenever p-value was less than 0.05. Data was analyzed using SPSS software version 21. Result : The median total delay to treatment initiation was 62 days with inter-quartile range of 16-221 days. A unite increase in a day to initiate treatment results in increment of risk of unsuccessful treatment outcome by 2.3. Other factors associated with unsuccessful treatment outcomes were being less adherent to the treatment, HIV co infection, being smear positive at initiation of treatment and after 2 months of treatment initiation. Conclusion : delay in a day to initiate treatment is associated with increased risk of unsuccessful treatment outcome. Any effort targeted towards reducing the negative effects of PTB should target on strategies that reduces the length of delay to initiate treatment and strengthen community engagement to improve treatment adherence of patients that have started treatment.

scholarly journals Risk of ischaemic stroke in patients with migraine: a longitudinal follow-up study using a national sample cohort in South Korea

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027701 ◽  
Author(s):  
Sang-Yeon Lee ◽  
Jae-Sung Lim ◽  
Dong Jun Oh ◽  
Il Gyu Kong ◽  
Hyo Geun Choi
Keyword(s):  
South Korea ◽  
Ischaemic Stroke ◽  
Statistical Significance ◽  
Young Patients ◽  
Haemorrhagic Stroke ◽  
Control Group ◽  
Follow Up Study ◽  
Increased Risk ◽  
Migraine Group

ObjectiveAccumulating evidence has supported the association between migraine and stroke, but the causative association remains unclear. We aimed to investigate the risks of different types of stroke in patients with migraine.DesignA longitudinal follow-up study.SettingData collected from a national cohort between 2002 and 2013 by the South Korea Health Insurance Review and Assessment.ParticipantsWe extracted the data from patients with migraine (n=41 585) and 1:4 matched controls (n=1 66 340) and analysed the occurrence of ischaemic and haemorrhagic strokes. The migraine group included participants treated for migraine (International Classification of Disease-10 (ICD-10): G43)≥2 times. Haemorrhagic stroke (I60-I62) and ischaemic stroke (I63) were determined based on the admission histories. The crude and adjusted HRs were calculated using Cox proportional hazard models, and the 95% CI were determined. Subgroup analyses stratified by age and sex were also performed.ResultsHigher rates of ischaemic stroke were observed in the migraine group (2.3% [964/41,585]) than in the control group (2.0% [3294/166 340], P<0.001). The adjusted HR for ischaemic stroke was 1.18 (95% CI=1.10 to 1.26) in the migraine group (P<0.001). Compared with control subjects, participants who reported migraine with aura and migraine without aura had increased adjusted HRs of 1.44 (95% CI=1.09 to 1.89) and 1.15 (95% CI=1.06 to 1.24), respectively, for ischaemic stroke, but no increased risk of haemorrhagic stroke. In our subgroup analysis, a strong association between migraine and ischaemic stroke was observed in young patients, specifically young women. The contribution of migraine to the occurrence of ischaemic stroke was also observed in middle-aged women and old women (each P<0.05). The risk of haemorrhagic stroke did not reach statistical significance in any age group.ConclusionMigraine is associated with an increased risk of ischaemic stroke, but not haemorrhagic stroke.

scholarly journals Treatment outcomes and relapses of pulmonary tuberculosis in Lazio, Italy, 1999–2001: a six-year follow-up study

2008 ◽  
Vol 12 (6) ◽  
pp. 611-621 ◽  
Author(s):  
Annunziata Faustini ◽  
Andrew J. Hall ◽  
Jessica Mantovani ◽  
Massimo Sangalli ◽  
Carlo A. Perucci
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Follow Up Study

scholarly journals Tuberculosis Treatment Outcome and Predictors in Africa: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (20) ◽  
pp. 10678
Author(s):  
Melese Yeshambaw Teferi ◽  
Ziad El-Khatib ◽  
Minyahil Tadesse Boltena ◽  
Azeb Tarekegn Andualem ◽  
Benedict Oppong Asamoah ◽  
...  
Keyword(s):  
High Risk ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Diagnostic Modality ◽  
Tb Treatment ◽  
Unsuccessful Treatment ◽  
Increased Risk

This review aimed to summarize and estimate the TB treatment success rate and factors associated with unsuccessful TB treatment outcomes in Africa. Potentially eligible primary studies were retrieved from PubMed and Google Scholar. The risk of bias and quality of studies was assessed using The Joanna Briggs Institute’s (JBI) appraisal criteria, while heterogeneity across studies was assessed using Cochran’s Q test and I2 statistic. Publication bias was checked using the funnel plot and egger’s test. The protocol was registered in PROSPERO, numbered CRD42019136986. A total of 26 eligible studies were considered. The overall pooled estimate of TB treatment success rate was found to be 79.0% (95% CI: 76–82%), ranging from 53% (95% CI: 47–58%) in Nigeria to 92% (95% CI: 90–93%) in Ethiopia. The majority of unsuccessful outcomes were attributed to 48% (95% CI: 40–57%) death and 47% (95% CI: 39–55%) of defaulter rate. HIV co-infection and retreatment were significantly associated with an increased risk of unsuccessful treatment outcomes compared to HIV negative and newly diagnosed TB patients with RR of 1.53 (95% CI: 1.36–1.71) and 1.48 (95% CI: 1.14–1.94) respectively. TB treatment success rate was 79% below the WHO defined threshold of 85% with significant variation across countries. Countries need to explore contextual underlining factors and more effort is required in providing TB preventive treatment, improve case screening and linkage for TB treatment among HIV high-risk groups and use confirmatory TB diagnostic modality. Countries in Africa need to strengthen counseling and follow-up, socio-economic support for patients at high risk of loss to follow-up and poor treatment success is also crucial for successful TB control programs.

scholarly journals Unsuccessful treatment outcome and associated factors among smear-positive pulmonary tuberculosis patients in Kepong district, Kuala Lumpur, Malaysia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Fadly Syah Arsad ◽  
Noor Hassim Ismail
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Kuala Lumpur ◽  
Contributing Factors ◽  
Content Type ◽  
Unsuccessful Treatment ◽  
Smear Positive Pulmonary Tuberculosis

PurposeThe purpose of this study was to assess tuberculosis (TB) treatment outcomes among new smear-positive pulmonary tuberculosis (PTB) patients and identify the risk factors of unsuccessful treatment outcomes in Kepong district, Kuala Lumpur, Malaysia.Design/methodology/approachA retrospective cohort study was conducted using registry-based data from the Tuberculosis Information System (TBIS) between 2014 and 2018. Simple random sampling was used to select 734 males and 380 females from the TBIS registry. Smear-positive PTB patient's sociodemographic, clinical and behavioral characteristics were extracted and analyzed. Logistic regression was used to find the possible independent risk factors for unsuccessful treatment outcomes.FindingsThe treatment success rate was 77.20% (n = 860) which was still below the target set by the WHO (>90%). In total, 254 patients showed an unsuccessful treatment outcome: 106 died, 99 defaulted, 47 not evaluated and 2 showed treatment failure. Unsuccessful treatment outcome was significantly associated with older age, male gender, non-citizen, unemployment and being HIV positive.Originality/valueThe study focuses on all these contributing factors of unsuccessful treatment outcome for a better risk assessment and stratification of TB patients and identify effective surveillance and management strategies to strengthen the control programs of tuberculosis in Kepong district.

scholarly journals Intermittent treatment interruption and its effect on multidrug resistant tuberculosis treatment outcome in Ethiopia

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Habteyes H. Tola ◽  
Kourosh Holakouie-Naieni ◽  
Mohammad A. Mansournia ◽  
Mehdi Yaseri ◽  
Ephrem Tesfaye ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Treatment Interruption ◽  
Multidrug Resistant ◽  
Considerable Proportion ◽  
Adjusted Risk ◽  
Successful Treatment Outcome ◽  
Resistant Tuberculosis ◽  
Unsuccessful Treatment ◽  
Poor Treatment Outcome

AbstractTreatment interruption is one of the main risk factors of poor treatment outcome and occurrence of additional drug resistant tuberculosis. This study is a national retrospective cohort study with 10 years follow up period in MDR-TB patients in Ethiopia. We included 204 patients who had missed the treatment at least for one day over the course of the treatment (exposed group) and 203 patients who had never interrupted the treatment (unexposed group). We categorized treatment outcome into successful (cured or completed) and unsuccessful (lost to follow up, failed or died). We described treatment interruption by the length of time between interruptions, time to first interruption, total number of interruption episodes and percent of missed doses. We used Poisson regression model with robust standard error to determine the association between treatment interruption and outcome. 82% of the patients interrupted the treatment in the first six month of treatment period, and considerable proportion of patients demonstrated long intervals between two consecutive interruptions. Treatment interruption was significantly associated with unsuccessful treatment outcome (Adjusted Risk Ratio (ARR) = 1.9; 95% CI (1.4–2.6)). Early identification of patients at high risk of interruption is vital in improving successful treatment outcome.

scholarly journals Subclinical Cardiac Organ Damage in Patients with Moderate to Severe Psoriasis

2021 ◽  
Vol 10 (11) ◽  
pp. 2440
Author(s):  
Anja Linde ◽  
Eva Gerdts ◽  
Kåre Steinar Tveit ◽  
Ester Kringeland ◽  
Helga Midtbø
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Treatment Initiation ◽  
Severity Index ◽  
Organ Damage ◽  
Left Ventricular ◽  
Infliximab Treatment ◽  
Increased Risk ◽  
Psoriasis Severity

We explored the association between subclinical cardiac organ damage (OD) with comorbidities and psoriasis severity in 53 psoriasis patients on infliximab treatment (age 47 ± 15 years, 30% women) and 99 controls without psoriasis (age 47 ± 11 years, 28% women). Cardiac OD was assessed by echocardiography as the presence of increased left ventricular (LV) relative wall thickness (RWT), LV hypertrophy or dilated left atrium. Psoriasis severity was graded using the psoriasis area and severity index (PASI). The prevalence of hypertension was 66% in psoriasis vs. 61% in controls (p = 0.54) and cardiac OD seen in 51 and 73%, respectively (p = 0.007). Psoriasis was associated with a lower prevalence of cardiac OD (odds ratio (OR) 0.32, 95% confidence interval (CI) 0.13–0.77, p = 0.01) independent of age, sex, smoking, body mass index, and hypertension. Among psoriasis patients, hypertension was associated with increased risk of subclinical cardiac OD (OR 6.88, 95% CI 1.32–35.98, p = 0.02) independent of age, sex, and body mass index. PASI at treatment initiation was associated with a higher RWT at follow-up, independent of sex, age, and hypertension (β 0.36, p = 0.006) while no association with current PASI was found. In conclusion, cardiac OD was less prevalent in psoriasis patients on infliximab treatment than controls. Hypertension was the major covariable for subclinical cardiac OD in psoriasis.

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