scholarly journals Do private doctors follow national guidelines for managing pulmonary tuberculosis in Pakistan?

2003 ◽  
Vol 9 (4) ◽  
pp. 776-788
Author(s):  
S. K. Shah ◽  
H. Sadiq ◽  
M. Khalil ◽  
A. Noor ◽  
G. Rasheed ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
National Guidelines ◽  
Medical Practitioners ◽  
Main Symptom ◽  
Pulmonary Tb ◽  
Tb Control ◽  
Tb Treatment ◽  
Sputum Microscopy ◽  
Knowledge And Practice

As private medical practitioners play a major role of in providing care to pulmonary tuberculosis [TB] patients, a survey was made of knowledge and practice in 2 cities in Pakistan. Only 1 of the 245 physicians was aware that cough > 3 weeks alone is the main symptom suggesting pulmonary TB. The majority diagnosed [80%] and treated [83%] cases themselves without referral. Less than 1% relied on sputum microscopy alone for diagnosis. None of the practitioners were following National TB Control guidelines for prescribing drugs and none ensured compliance with anti-TB treatment under supervision of a doctor/health worker. Only 3% kept records of pulmonary TB patients. None of the physicians assessed the effectiveness of treatment with sputum microscopy alone; the majority [76%] used only clinical assessment

scholarly journals Factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in Cali, Colombia

2019 ◽  
Vol 43 ◽  
pp. 1
Author(s):  
Cindy Córdoba ◽  
Lucy Luna ◽  
Diana M. Triana ◽  
Freddy Perez ◽  
Lucelly López
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Initiation ◽  
Control Program ◽  
Diagnosis And Treatment ◽  
Individual Treatment ◽  
Tb Control ◽  
Factors Associated ◽  
Tb Treatment ◽  
Tuberculosis Diagnosis ◽  
Tb Control Program

Objective.To determine factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in the city of Cali, Colombia.Methods.This was a retrospective cohort study of cases of tuberculosis (TB) reported in the TB control program of Cali between January and December 2016. The information was collected from the databases of the TB control program, individual treatment cards, and clinical histories. The variables considered were sociodemographic factors, clinical factors, substance use, and performance of the health service.Results.A total of 623 cases were identified, of which 57.0% were male. The median age was 42 years (interquartile range (IQR): 27–60). The median time from onset of symptoms to TB diagnosis was 57 days (IQR: 21–117), and from onset of symptoms to TB treatment initiation was 72 days (IQR: 35–145). A factor associated with longer time from the onset of symptoms to TB treatment was being a previously treated TB patient (coefficient: 123.8 days, 95% confidence interval (CI): 48.3 to 199.3). In contrast, being incarcerated was a protective factor for earlier TB treatment initiation (coefficient: -57.3 days; 95% CI: -92.4 to -22.3).Conclusions.Our results provide important information concerning risk factors that are associated with delays in the diagnosis and treatment of tuberculosis, and that are subject to future interventions. Health insurance program managers must work together with health care providers on issues that include patient care, health promotion, and updating TB protocols and standards.

scholarly journals Squamous Cell Carcinoma in the Post Tuberculosis Lung after 30 Years of Treatment Completion

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Arulprashanth Arulanantham ◽  
Umesh Jayarajah ◽  
Rohitha Dharmasiri ◽  
Rasarathinam Jeyanthakumar ◽  
Kamila Niroshan Siriwardena ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Pulmonary Tuberculosis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Left Lung ◽  
Klebsiella Pneumonia ◽  
Pulmonary Tb ◽  
Tb Treatment

Pulmonary tuberculosis (TB) and lung cancer are becoming increasingly prevalent especially in developing countries. The occurrence of lung cancer after 30 years of completed pulmonary TB treatment is rare. We report a rare occurrence of a squamous cell carcinoma (SCC) in the post TB lung after 30 years of completed pulmonary tuberculosis treatment. A 60-year-old male, an apparently healthy nonsmoker, presented with a community-acquired Klebsiella pneumonia. Imaging revealed a destroyed left lung with cavities with air-fluid levels. An enhancing lesion was noted at the left upper lobe, and a guided biopsy revealed a SCC. He was fit for surgery and underwent an open left pneumonectomy. The left lung was destroyed and cavitatory due to the previous tuberculosis. A peripherally located tumor was noted in the left upper lobe. Histology revealed a moderately differentiated keratinizing type SCC (pT4N0Mx). The negative cultures and histology excluded an active pulmonary tuberculosis. The postsurgical lung function at 1 month showed satisfactory improvement with good functional capacity. He was then referred to the oncologist for adjuvant therapy. The occurrence of post-TB lung cancer after 30 years in an otherwise healthy male without active TB suggests an increased long-term risk of cancer even in the absence of other robust risk factors. Therefore, the chronic inflammatory process in the diseased lung is probably the cause for lung cancer in the absence of active TB. Thus, we suggest long-term surveillance after completed pulmonary TB treatment even in otherwise healthy asymptomatic individuals.

scholarly journals The effect of multi-vitamin/mineral supplementation on mortality during treatment of pulmonary tuberculosis: a randomised two-by-two factorial trial in Mwanza, Tanzania

2006 ◽  
Vol 95 (4) ◽  
pp. 762-770 ◽  
Author(s):  
Nyagosya Range ◽  
John Changalucha ◽  
Henrik Krarup ◽  
Pascal Magnussen ◽  
Âse B. Andersen ◽  
...  
Keyword(s):  
Weight Gain ◽  
Pulmonary Tuberculosis ◽  
Randomised Trial ◽  
Pulmonary Tb ◽  
Survival Status ◽  
Tb Treatment ◽  
Mineral Supplementation ◽  
Supplementation Period ◽  
Factorial Trial ◽  
Combined Intervention

Malnutrition is common in pulmonary tuberculosis (TB), and may impair survival. The objective of this study was to assess effects of multi-vitamin/mineral (MVM) and zinc (Zn) supplementation during TB treatment on mortality. Patients diagnosed with sputum-positive pulmonary TB in Mwanza, Tanzania, were randomised, using a two-by-two factorial design, to Zn (45mg) or placebo, and MVM (vitamins A, B, C, D, E, and selenium and copper) or placebo. Survival status was ascertained at the end of the 8-month TB treatment and supplementation period. Of 499 TB patients, 213 (43%) had HIV. The mean weight gain at 7 months was 6·88kg (95% CI 6·36, 7·41). Zn and MVM combined, but neither alone (interaction, p=0·03), increased weight gain by 2·37kg (95% CI 0·91, 3·83), irrespective of HIV status. Survival status at 8 months was determined for 422 patients (84·6%), of which fifty-two (12·3%) had died. Among fifty-two deaths, there were no effects of MVM (relative risk (RR) 0·73; 95% CI 0·43, 1·23) and Zn (RR 0·76; 95% CI 0·46, 1·28). However, among HIV co-infected patients, marginally significant effects of both MVM (RR 0·60; 95% CI 0·34, 1·05) and Zn (RR 0·63, 95% CI 0·37, 1·08) were seen, and MVM and Zn combined reduced mortality (RR 0·29; 95% CI 0·10, 0·80; interaction ratio 0·52). In conclusion, supplementation with MVM, including Zn, during treatment of pulmonary TB may reduce mortality in those co-infected with HIV. A randomised trial of the effect of the combined intervention used in this study should be conducted in a different setting to confirm the finding.

scholarly journals RISK FACTORS IN PULMONARY TUBERCULOSIS TREATMENT FAILURE

2021 ◽  
Vol 16 (1) ◽  
pp. 12
Author(s):  
Dyan Kunthi Nugrahaeni ◽  
Lala Rosmalaningrum
Keyword(s):  
Risk Factors ◽  
Medication Adherence ◽  
Pulmonary Tuberculosis ◽  
Nutritional Status ◽  
Treatment Failure ◽  
Family Support ◽  
Tuberculosis Treatment ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
Nutritional Guidance

Pulmonary tuberculosis (TB) is a global health problem and has become the leading cause of death. Tuberculosis eradication is inhibited due to the tendency of patients to not complete the TB treatment. The purpose of this study was to determine the relationship between knowledge, nutritional status, oral medication adherence, and family support as risk factors for pulmonary tuberculosis treatment failure. The design of this study is that of case-control, and this study involved samples of pulmonary TB patients who were declared not cured after treatment (14 people), and control samples of pulmonary TB patients who were declared cured (28 people). The data were obtained through measurements of nutritional status and interviews, while treatment failure was based on data from the TB 01 form. Data was analysed using univariable and bivariable analyses, and the magnitude of risk factors was based on the odds ratio (OR) and 95% confidence interval (CI). The results showed that the factors associated with failure of pulmonary TB treatment are knowledge (p = 0.022; OR = 6.6; 95% CI = 1.48 - 29.36), nutritional status (p = 0.005; OR = 9.16; 95% CI = 2.11 - 39.85), and medication adherence (p = 0.003; OR =11.0; 95% CI = 2.37 - 54.14), whereas the unrelated factor is family support (p = 0.47). It is recommended to provide counselling, nutritional guidance, medication assistance, and family support to patients during the treatment period for pulmonary tuberculosis.                                                                                                                        Keywords: treatment failure, knowledge, nutritional status, compliance

scholarly journals Biomarkers of Oxidative Stress and Personalized Treatment of Pulmonary Tuberculosis: Emerging Role of Gamma-Glutamyltransferase

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Etienne Mokondjimobe ◽  
Benjamin Longo-Mbenza ◽  
Jean Akiana ◽  
Ulrich Oswald Ndalla ◽  
Regis Dossou-Yovo ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Pulmonary Tuberculosis ◽  
Oxidative Markers ◽  
Tb Treatment ◽  
Normal Ranges ◽  
Independent Association ◽  
Design And Methods ◽  
The Impact ◽  
The Relationship

Background. The objectives were (i) to evaluate the impact of acute pulmonary tuberculosis (PTB) and anti-TB therapy on the relationship between AST, ALT, and GGT levels in absence of conditions related to hepatotoxicity; (ii) to evaluate the rate and the time of alterations of AST, ALT, and GGT.Design and Methods. A prospective followup of 40 adults (21 males; mean age of34.7±5.8years) with active PTB on initial phase and continuation phase anti-TB.Results. Only 3% (n=1) developed a transient and benign ADR at day 30 without interruption of anti-TB treatment. Within normal ranges, GGT decreased significantly from day 0 to day 60, while AST and ALT increased significantly and respectively. During day 0–day 60, there was a significant, negative, and independent association between GGT and AST.Conclusion. The initial two months led to significant improvement of oxidative stress. Values of oxidative markers in normal ranges might predict low rate of ADR.

scholarly journals Role of Diabetes in the Prognosis and Therapeutic Outcome of Tuberculosis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Syed Azhar Syed Suleiman ◽  
Daud M. Ishaq Aweis ◽  
Ali Jimale Mohamed ◽  
Abdul RazakMuttalif ◽  
Mohamed A. A. Moussa
Keyword(s):  
Mortality Rate ◽  
Sputum Smear ◽  
Diabetic Patients ◽  
Anatomical Site ◽  
Prevalence Rates ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
Duration Of Infection ◽  
The Impact

Background. Increased susceptibility of diabetic mellitus (DM) patients to infection, including tuberculosis (TB), is well documented. The prevalence of DM in Malaysia is reaching epidemic proportions. In this study, we sought to assess risk factors for TB and the impact of DM on the outcome of TB treatment.Methods. TB patients, diabetic patients, and diabetic patients with TB were divided into three groups of 200 subjects each. Data were obtained from patients’ medical files at the beginning and end of the study period. Prevalence rates of DM and HIV among TB patients were assessed. Prognosis, TB-related complications, anatomical site of infection, and duration of infection and diabetes were also examined.Results. The prevalence rates of HIV and DM amongst TB patients were 7.7 and 30%, respectively. The diabetic TB patient group contained more males (72%) and smokers (45.5%) compared to the nondiabetic group (58.3% and 33.5%, resp.). Approximately 74% of diabetic patients were Mycobacterium sputum positive compared to only 51% of nondiabetic patients. Diabetic patients were also more likely to develop pulmonary TB (87%) compared to nondiabetic TB patients (59%). Diabetic TB patients had a higher mortality rate (7.5%) compared to the TB only and DM only groups (1 and 2%, resp.). The duration of TB symptoms was longer in nondiabetic TB patients compared to diabetic TB patients (4.5 versus 2.6 months, resp.). Diabetes antedated TB by a mean time of 4 years.Conclusions. We found a higher number of sputum-smear-positive cases and pulmonary TB cases as well as a greater number of males and higher mortality rate in diabetic patients compared to nondiabetic patients.

scholarly journals Worker safety in Designated Microscopy Centers (DMC) and Tuberculosis unit (TU) under Revised National Tuberculosis Control programme (RNTCP) in state of Bihar – Contribution & Role of DTST

2013 ◽  
Vol 3 (1) ◽  
pp. 18-21
Author(s):  
Lalitha Krishnappa
Keyword(s):  
Capacity Building ◽  
Rural Areas ◽  
Control Programme ◽  
Worker Safety ◽  
Current Status ◽  
National Guidelines ◽  
Cross Sectional ◽  
Tb Control ◽  
The Impact

Damien Foundation India Trust (DFIT), one of the members of International Federation of Anti-Leprosy associations (ILEP) are involved in providing technical and financial support in leprosy and TB control through its projects spread across the country. While support to leprosy control started way back in 1982 through its own project, support to TB control started only in 2003. This study was part of evaluation taken to assess the role of DTST in achieving the planned objectives and to assess the impact of DFIT’s involvement in TB control. To assess the current status of worker safety in DMC/TUs of RNTCP centers in state of Bihar and the role and contribution of DTST in ensuring the same. This cross sectional evaluation study was undertaken in randomly selected 8 DMCs/ TUs in rural areas of two districts of Bihar state in 2007. Evaluation was done using pre-tested observational checklist and personal discussions with key personnel. Evaluation included assessment of role & contribution of DTST with respect to infrastructure & resource availability; Training and capacity building; Practice regarding safe disposal of infected materials & worker safety. Most of the civil works was complete in functional DMC/ TUs visited. Sharp pits for sharp disposal were available in only 50% of DMCs/TUs. Staffing position complete to nearly 80%. DTST role in capacity building training, infrastructure availably and monitoring of the programme has been remarkable. However there is a need to emphasis on importance of the worker safety and universal precautions during training. Effective implementation of clearly laid down National guidelines & policy keeping in lieu of the worker safety is the need of the hour when the programme gets streamlined in the general health system.   

scholarly journals THE CORRELATION THE ROLE OF SUPERVISOR TAKING MEDICINE WITH THE SUCCESS OF TREATMENT OF LUNG TB IN PUBLIC HEALTH CENTER GERAK MAKMUR SAMPOLAWA, SOUTH BUTON

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Taswin Taswin ◽  
Izan - Izan ◽  
Wahyuddin - Wahyuddin ◽  
Dahmar Dahmar ◽  
Dahmar Dahmar
Keyword(s):  
Health Center ◽  
Community Health Center ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
Repeat Treatment ◽  
Tb Treatment ◽  
A Value ◽  
The Relationship

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterum Tuberculosis which can spread through droplets that have been infected with TB bacilli. In 2018, there was increasing case of lung TB about  33 people (4 people is broken up treatmment and failed, 29 is healed). The purpose of this study was to determine the relationship between the assistance of taking medication with the success of the treatment of pulmonary TB patients and the relationship of mentoring for repeat treatment at the puskesmas with the success of the treatment of pulmonary TB patients at Gerak Makmur Puskesmas, Sampolawa Subdistrict, South Buton District. This type of research is quantitative research using cross sectional design. The number of samples in this study were 33 people. Sampling in this study uses total sampling, which is the sample taken entirely from the population who finished treatment at the prosperous Gerak Community Health Center. Data analysis performed was univariate and bivariate analysis with chi square test. The results showed that there was a relationship between the role of the supervisor of taking drugs with the success of pulmonary TB treatment in the working area of Gerak Makmur Selatan Buton South Puskesmas with a value (p = 0,000<0,05) and there is a relationship between medical assistance and the success of pulmonary TB treatment in the working area of Gerak Makmur Selatan Buton Puskesmas with a value (p = 0.008<0,05). shows that there is a relationship between the role of the supervisor of taking drugs with the success of pulmonary TB treatment and there is a relationship between the assistance of taking drugs with the success of pulmonary TB treatment, and there is a relationship between mentoring repeat treatment with the success of pulmonary TB treatment at Gerak Makmur Selatan Buton Selatan health center.Keywoard: pulmonary TB successful treatment, supervision of taking medication

scholarly journals EVALUATING THE ROLE OF KNOWLEDGE IN KAP MODEL ON SELF-PREVENTIVE HEALTHCARE: EVIDENCE FROM TUBERCULOSIS PATIENTS IN MALAYSIA

2020 ◽  
Vol 2 (7) ◽  
pp. 01-10
Author(s):  
Khairiah Salwa Mokhtar ◽  
Nurulhasanah Abdul Rahman
Keyword(s):  
Cross Sectional Study ◽  
Transmission Risk ◽  
Preventive Healthcare ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Tuberculosis Patients ◽  
Tb Control ◽  
Suburban Areas ◽  
Successful Program

Malaysia aims to end the Tuberculosis (TB) epidemic by the year 2035. However, to ensure a successful program for TB control, it is still a challenge to instil good self-preventive healthcare among patients. Therefore, the study seeks to address the knowledge gap among TB patients and their level of prevention practices which have not been studied extensively in Malaysia. Using questionnaires, this cross-sectional study was conducted among 1606 registered TB patients in selected states of Malaysia from May 2014 to March 2015. General knowledge of TB among TB patients was high - patients from Penang, who resided in suburban areas and self-employed revealed to have high TB knowledge than the others. Thus, by identifying how TB patients view their transmission risk and prevention, practices may contribute to an improved future screening option and enhanced education efforts for medical practitioners to develop more customized programs for TB patients.

scholarly journals PERALIHAN (KONVERSI) SPUTUM BTA ANTARA PEMBERIAN DOSIS BAKU (STANDAR) DAN TINGGI RIFAMPICIN PADA PENGOBATAN (TERAPI) ANTI TUBERKULOSIS KELOMPOK (KATEGORI) I

2018 ◽  
Vol 14 (1) ◽  
pp. 1
Author(s):  
Yani Triyani ◽  
Ida Parwati ◽  
I. Sjahid ◽  
J. E. Gunawan
Keyword(s):  
Pulmonary Tuberculosis ◽  
Dose Group ◽  
Standard Dose ◽  
High Dose Group ◽  
High Dose ◽  
Intensive Phase ◽  
Pulmonary Tb ◽  
Antituberculous Treatment ◽  
Sputum Microscopy ◽  
Sputum Conversion

Acid fast bacilli (AFB) sputum microscopy is used as a diagnostic tool of pulmonary tuberculosis (TB) in TB eradication program with directly observed treatment short course (DOTS) strategy. The AFB sputum microscopy should be performed before treatment,two months after intensive phase and four months after advance phase treatment. This study is a part of a research to compare thestandard (450 mg) and high (600 mg) rifampicin dose in patients with pulmonary tuberculosis in Indonesia. The aim of this studywas to detect the sputum conversion time of AFB in pulmonary TB patients who obtained category I antituberculous treatment with standard dose compared to one who received high dose of rifampicin at the beginning and at the end of the intensive phase. This AFB sputum microscopy have been performed from September 2003 until August 2005 from 85 pulmonary TB patients every two weeksusing Ziehl Neelsen and read by means of International Union Against Tuberculosis and Lung Diseases (IUATLD) scale, in PoliklinikParu Balai Pengobatan Penyakit Paru-paru and Department of Internal Medicine RS. Dr. Hasan Sadikin. Patients with pulmonary TBwho obtained category I antituberculous treatment of the intensive phase were divided randomly double blind into two groups, usingstatistical analysis by Page test for order alternative and Mann Whitney test. After randomization, there were 52 patients who receivedstandard dose and 33 patients who had high dose of rifampicin. Sputum conversions of AFB on week 2, 4, 6, and 8 were 36.1%, 63.9%,75%, and 91.7% for standard dose group. Sputum conversions of AFB on week 2, 4, 6, and 8 were 46.2%, 80.8%, 80.8%, and 84.6%for high dose group. Sputum conversion of AFB for high dose group were faster than standard dose group (p=0.030). Dropout (DO)patients were 5.9% (5/85) and no sputum conversion of AFB on week 8 was 8.3% and 15.4% for standard dose group and high dosegroup of rifampicin, respectively. Sputum conversions of AFB for high dose group were found significant more quickly than standarddose group of rifampicin statistically.

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