scholarly journals Evaluation of the Acceptability of the Medical Event Reminder Monitor for Promoting Adherence to Multidrug-Resistant Tuberculosis Therapy in Two Indian Cities: Qualitative Study of Patients and Healthcare Providers (Preprint)

Author(s):  
Beena E Thomas ◽  
J. Vignesh Kumar ◽  
Murugesan Periyasamy ◽  
Amit Subhash Khandewale ◽  
J. Hephzibah Mercy ◽  
...  
2006 ◽  
Vol 50 (8) ◽  
pp. 2621-2625 ◽  
Author(s):  
Eric Nuermberger ◽  
Ian Rosenthal ◽  
Sandeep Tyagi ◽  
Kathy N. Williams ◽  
Deepak Almeida ◽  
...  

ABSTRACT The creation of new chemotherapeutic regimens that permit shortening the duration of treatment is a major priority for antituberculosis drug development. In this study, we used the murine model of experimental tuberculosis therapy to determine whether incorporation of the investigational new nitroimidazopyran PA-824 into the standard first-line regimen has the potential to shorten the 6-month duration of treatment. As demonstrated previously, PA-824 alone had significant bactericidal activity over the first 2 months of treatment. Moreover, the substitution of PA-824 for isoniazid led to significantly lower lung CFU counts after 2 months of treatment and to more rapid culture-negative conversion compared to the standard regimen of rifampin, isoniazid, and pyrazinamide. Despite this, there was no difference in the proportion of mice relapsing after completing 6 months of therapy (2 of 19 mice treated with PA-824 in place of isoniazid relapsed versus 0 of 46 mice treated with the standard regimen). Meanwhile, no other PA-824-containing regimen tested was superior to the standard regimen on any assessment. Thus, we were unable to establish a clear role for PA-824 in a treatment-shortening regimen that includes two or more of the current first-line drugs. Future preclinical studies should include the evaluation of novel combinations of PA-824 with new drug candidates in addition to existing antituberculosis drugs for their potential to substantially improve the treatment of both drug-susceptible and multidrug-resistant tuberculosis.


Author(s):  
Ntambwe Malangu ◽  
Omotayo D. Adebanjo

Background: To date, no study has been found that described the knowledge and practices of healthcare workers surrounding multidrug-resistant tuberculosis (MDR-TB) in Lesotho.Aim and setting: This study was conducted to fill this gap by investigating the knowledge level and practices surrounding MDR-TB amongst healthcare workers at Botsabelo Hospital in Maseru, Lesotho.Method: This was a cross-sectional survey conducted by means of a questionnaire designed specifically for this study. Data collected included sociodemographic and professional details; and responses to questions about knowledge and practices regarding MDR-TB. The questions ranged from the definition of MDR-TB to its treatment. Respondents’ practices such as the use of masks, guidelines and patient education were also assessed.Results: A response rate of 84.6%(110 out of 130) was achieved. The majority of participants were women (60%), married (71.8%) and nursing staff (74.5%). Overall, less than half (47.3%) of the participants had a good level of knowledge about MDR-TB. With regard to practice, about 83%of participants stated that they used protective masks whilst attending to MDR-TB patients. About two-thirds (66.4%) reported being personally involved in educating patients about MDR-TB; whilst about 55%stated that they referred to these guidelines.Conclusion: The level of knowledge about MDR-TB amongst healthcare workers at the study site was not at an acceptable level. Unsafe practices, such as not wearing protective masks and not referring to the MDR-TB treatment guidelines, were found to be associated with an insufficient level of knowledge about MDR-TB. An educational intervention is recommended for all healthcare providers at this facility.


2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Caroline Franck ◽  
James A Seddon ◽  
Anneke C Hesseling ◽  
H Simon Schaaf ◽  
Donald Skinner ◽  
...  

The Lancet ◽  
2015 ◽  
Vol 386 ◽  
pp. S78
Author(s):  
Philip Windish ◽  
Serena Luchenski ◽  
Joe Hall ◽  
Yasmin Appleby ◽  
Lucia Possas ◽  
...  

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242542
Author(s):  
Surya Darma ◽  
Angga Ambara ◽  
Abu Tholib Aman ◽  
Luthvia Annisa ◽  
Nurrokhman ◽  
...  

Background Tuberculosis is one of the major causes of death globally. The problems become even more complicated with the rise in prevalence of multidrug resistant tuberculosis (MDR-TB). Many diseases have been reported to occur with tuberculosis making it more difficult to manage. Candida spp., which are yeast-like fungi and a constituent of normal flora in humans, are notoriously reported to be one of the most common opportunistic nosocomial infections. This study aimed to measure the proportion of presumptive MDR-TB patients colonized with Candida spp. and to characterize its susceptibility against azole group antifungal agents. Methods Sputum from presumptive MDR-TB patients were collected and examined for the presence of Mycobacterium tuberculosis and its rifampicin resistant status using GeneXpert. It was further cultured on Sabouroud’s Dextrose Agar (SDA) to isolate the Candida spp. The Candida species were determined using HiCrome™ Candidal Differential Agar. Antifungal susceptibility was tested using microbroth dilution methods. Checkerboard microdilution assays were performed to measure the interaction between rifampicin and fluconazole to C. albicans. Results There were 355 presumptive MDR-TB patients enrolled. A total of 101 (28.4%) patients were confirmed to have M. tuberculosis. There were 113 (31.8%) sputum positive for Candida spp., which corresponded to 149 Candida spp. isolates. Candida albicans was the most frequent (53.7%) species isolated from all patients. The susceptibility of Candida spp. against fluconazole, itraconazole, and ketoconazole were 38.3%, 1.3%, and 10.7% respectively. There was significant association between rifampicin exposure history and susceptibility of Candida albicans against fluconazole (Odds Ratio: 9.96; 95% CI: 1.83–54.19; p <0.01), but not for ketoconazole and itraconazole. The checkerboard microdilution assays showed that rifampicin decreased the fungicidal activity of fluconazole to C. albicans in a dose-dependent manner. Conclusion There was high frequency of azole resistant Candida spp. isolates colonizing the respiratory tract of presumptive MDR-TB patients. This presence might indicate the association of chronic exposure to rifampicin, the main drug for tuberculosis therapy, with the induction of azole resistance.


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