scholarly journals The Spanish multidrug resistant tuberculosis network

2000 ◽  
Vol 5 (4) ◽  
pp. 43-45 ◽  
Author(s):  
S Samper ◽  
M. J. Iglesias ◽  
O Tello ◽  
Keyword(s):  
Multidrug Resistance ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Set Up ◽  
Genomic Typing

The network to monitor the spread of multidrug resistance tuberculosis (MDR-TB) in Spain based on genomic typing and set up in January 1998 benefits from the participation of about 90% of the laboratories of the national health system. Of the 94 MDR-TB pa

scholarly journals Multidrug-resistant tuberculosis from the health providers’ perspective: strategies for compliance and equity in seeking the care in COVID-19 era (Brazil, 2020)

2021 ◽  
Author(s):  
Ludmilla Leidianne Limirio Souza ◽  
Felipe Lima dos Santos ◽  
Juliane de Almeida Crispim ◽  
Regina Célia Fiorati ◽  
Sónia Dias ◽  
...  
Keyword(s):  
Health System ◽  
Health Professionals ◽  
Social Protection ◽  
Multidrug Resistant ◽  
Global Scale ◽  
Health Providers ◽  
Structured Interviews ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Abstract BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) itself is a serious phenomenon on a global scale that can worsen with the COVID-19 pandemic. The study aimed to understand the perception of health professionals about multidrug-resistant tuberculosis, their strategies to ensure adherence to treatment and the challenges in the context of the COVID-19 pandemic, in a priority municipality for disease control in the state of São Paulo, Brazil. METHODS: We conducted a qualitative study and recruited fourteen health professionals, four doctors, three nurses, three nursing technicians, three nursing assistants and a social worker, working in the Ribeirão Preto health system. Remote semi-structured interviews were conducted with these professionals. For data analysis, Thematic Content Analysis was applied according to the theoretical framework defined for the study. RESULTS: The findings showed the relationship between poverty, inequality and MDR-TB. Concerning the COVID-19 pandemic, reports from professionals show an interference in the monitoring of patients. As for social protection and the benefits that covered the patients, they were cut. Professionals also reported concerns about obtaining COVID-19 and adopting strategies to ensure adherence, as well as reinforcements of the DOTS strategy. CONCLUSION: The study advances in knowledge by highlighting the challenges faced by the health system for the adherence of MDR-TB patients in a context aggravated by Pandemic. The strategies defined by these health professionals have somehow guaranteed the achievement of equity and avoided the catastrophic encounter between TB-MDR and COVID-19.

scholarly journals Gridlock from diagnosis to treatment of multidrug resistant tuberculosis (MDR-TB) in Tanzania: patients’ perspectives from a focus group discussion

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stellah G. Mpagama ◽  
Mangi J. Ezekiel ◽  
Peter M. Mbelele ◽  
Anna M. Chongolo ◽  
Gibson S. Kibiki ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health System ◽  
Health Care Providers ◽  
Multidrug Resistant ◽  
International Standards ◽  
Care Providers ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background Molecular diagnostics have revolutionized the diagnosis of multidrug resistant tuberculosis (MDR-TB). Yet in Tanzania we found delay in diagnosis with more than 70% of MDR-TB patients having a history of several previous treatment courses for TB signaling prior opportunities for diagnosis. We aimed to explore patients’ viewpoints and experiences with personal and socio-behavioral obstacles from MDR-TB diagnosis to treatment in an attempt to understand these prior findings. Methods The study was conducted in December 2016 with MDR-TB patients admitted at Kibong’oto Infectious Diseases Hospital. A qualitative approach deploying focus group discussions (FGDs) was used to gather information. Groups were sex aggregated to allow free interaction and to gauge gender specific issues in the social and behavioral contexts. The FGDs explored pathways and factors in the service delivery that may have contributed in the delay in accessing MDR-TB diagnostics and/or treatment. Collected data were coded, categorized and thematically interpreted. Results Forty MDR-TB patients participated in six FGDs. Challenges and barriers contributing to the delay in accessing MDR-TB diagnosis to treatment were as follows: 1) Participants had a different understanding of MDR-TB that led to seeking services outside the conventional health system; 2) Socio-economic adversity made health-seeking behavior difficult and often unproductive; 3) In the health system, challenges included inadequacy of MDR-TB diagnostic centers, lack of knowledge on behalf of health care providers to consider MDR-TB and order appropriate diagnostics; 4) The specimen referral system for early diagnosis of MDR-TB was inefficient. Non-adherence of TB patients to first-line anti-TB drugs prior to MDR-TB diagnosis, given the multitude of barriers discussed, was coupled with both intentional and unintentional non-adherence of health care providers to international standards of TB care. Conclusion Patient-centered strategies bridging communities and the health system are urgently required for optimum MDR-TB control in Tanzania.

scholarly journals Factors Associated with Multidrup-Resistant Tuberculosis

1970 ◽  
Vol 3 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Md Nurul Amin ◽  
Md Anisur Rahman ◽  
Meerjady Sabrina Flora ◽  
Md Abul Kalam Azad
Keyword(s):  
Multidrug Resistance ◽  
Multidrug Resistant ◽  
Tuberculosis Patients ◽  
Face To Face ◽  
Control Programs ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Directly Observed Treatment ◽  
Sputum Conversion

This case control study was conducted in selected centers of Dhaka City from March to July 2008 to determine the association of multidrug-resistant tuberculosis with the attributes related to treatment and socio-economic condition of tuberculosis patients. Sixty seven culture-proven multidrug-resistant tuberculosis cases and similar number of age and sex matched controls were selected purposively. Data were collected by face to face interview and documents' review, using a pre tested structured questionnaire and a checklist. Multidrug-resistance was found to be associated with occupation (p=0.001) and residential status (p=0.001) of the tuberculosis patients. Tuberculosis patients who did not remain under directly observed treatment were 3 times more likely to develop multidrugresistant tuberculosis (OR 3.21, 95%CI=1.59-6.52). Multidrug-resistance was associated with inadequacy of treatment (OR 2.56, 95%CI=2.03-3.23). Failure of sputum conversion at the end of 2 months of treatment was detected to be the best predictor of multidrug-resistant tuberculosis (OR 11.82, 95% CI=4.61-30.33), followed by treatment with non Directly Observed Treatment Short course regimen and high labor intensive occupations like agriculture, production and transport. The risk factors of multidrug-resistant tuberculosis warrant much improvement in the effective implementation of control programs. Ibrahim Med. Coll. J. 2009; 3(1): 29-33 Key wards: Tuberculosis, MDR TB.   doi: 10.3329/imcj.v3i1.2917   

scholarly journals KALIUM DI MULTIDRUG RESISTANCE TUBERKULOSIS DENGAN PENGOBATAN KANAMISIN (Potassium in Multidrug Resistance Tuberculosis with Kanamycin)

2018 ◽  
Vol 21 (1) ◽  
pp. 16 ◽  
Author(s):  
J.B. Suparyatmo ◽  
B. Rina AS ◽  
Harsini Harsini ◽  
Sukma Sukma
Keyword(s):  
Multidrug Resistance ◽  
Potassium Level ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Before And After ◽  
Mdr Tb ◽  
The Difference ◽  
Antibiotic Agents

Multidrug-Resistant Tuberculosis (MDR-TB) with bacillary resistance to at least isoniazid and rifampicin in vitro is a worldwidephenomenon. For MDR-TB second-line antibiotic agents that are more potent and more toxic must be used. . One of them is kanamycingiven intravenously every day for six (6) months therapy. Kanamycin is nephrotoxic and can lead to hypokalemia. This study is carriedout to know the comparison between the potasium level before and after kanamycin therapy (2, 4 and 6 months after therapy). Thisstudy is a cohort retrospective design, comprising 34 patients who had a potassium baseline before therapy in Moewardi Hospital,Surakarta from January 2011–August 2012. The characteristic data included: age, sex, weight and comorbidity. The potassium levelafter 2, 4 and 6 months post therapy was compared with the potassium data baseline using One Way ANOVA test with p< 0.05, CI95%. The difference between the potassium level after 6 months therapy and potassium baseline was significant, p < 0.05. However,the difference of the kalium level after 2 and 4 months after therapy was not significant, p > 0.05. Hypokalemia occurred in 6 patientsafter 2 months therapy, 8 patients after 4 months therapy and 3 patients after 6 months therapy. There was a significant differencebetween the potassium level after 6 months therapy and potassium baseline. Further study should be continued to know the existenceof hypokalemia among MDR-TB patients

scholarly journals Gridlock from Diagnosis to Treatment of Multidrug Resistant Tuberculosis (MDR-TB) in Tanzania: Patients’ Perspectives from the Focus Group Discussion

2018 ◽  
Author(s):  
Stellah G Mpagama ◽  
Ezekiel Mangi ◽  
Peter M Mbelele ◽  
Anna M Chongolo ◽  
Gibson S Kibiki ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health System ◽  
Health Care Providers ◽  
Group Discussion ◽  
Multidrug Resistant ◽  
Care Providers ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

AbstractIntroductionMolecular diagnostics have revolutionized the diagnosis of multidrug resistant tuberculosis (MDR-TB). Yet in Tanzania we found delay in diagnosis with more than 70% of MDR-TB patients having history of several previous treatment courses for TB signaling complications of prior missed diagnosis. We aimed to explore patients’ viewpoints and experiences with personal and socio-behavioral obstacles from MDR-TB diagnosis to treatment in an attempt to understand these prior findings.MethodsThe study was conducted in December 2016 with MDR-TB patients admitted at Kibong’oto Infectious Diseases Hospital. We used semi-structured interviews and focus group discussion to examine patients’ views and experiences during MDR-TB diagnosis. Groups were sex aggregated to allow free interaction and to gauge gender specific issues in the social and behavioral contexts. The discussion – explored patients’ delivery factors that were impacting delay from MDR-TB diagnosis to treatment. Iterative data collection and analysis was applied with data, codes and categories being compared and refined.ResultsForty-five MDR-TB patients participated in 6 focus group discussions. Challenges and barriers contributing to the delay from MDR-TB diagnosis to treatment were as follows: 1) The general population had differing understanding of MDR-TB that led to seeking services from traditional healers; 2) Also socio-economic adversity made health-seeking behavior difficult and often unproductive; 3) In the health system, challenges included inadequacy of MDR-TB diagnostic centers, lack of knowledge on behalf of health care providers to consider MDR-TB and order appropriate diagnostics; 4) Insufficiency in the specimen referral system for early diagnosis of MDR-TB. Non-adherence of TB patients to first-line anti-TB drugs prior to MDR-TB diagnosis given the multitude of barriers discussed was coupled with both intentional and unintentional non-adherence of health care providers to international standards of TB care.ConclusionPatient-centered strategies bridging communities and the health system are urgently required for optimum MDR-TB control in Tanzania.

scholarly journals The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on multidrug-resistant tuberculosis in India and China

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chathika K Weerasuriya ◽  
Rebecca C Harris ◽  
C Finn McQuaid ◽  
Fiammetta Bozzani ◽  
Yunzhou Ruan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Second Line ◽  
Second Line Therapy ◽  
China And India ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Line Therapy ◽  
Mdr Tb

Abstract Background Despite recent advances through the development pipeline, how novel tuberculosis (TB) vaccines might affect rifampicin-resistant and multidrug-resistant tuberculosis (RR/MDR-TB) is unknown. We investigated the epidemiologic impact, cost-effectiveness, and budget impact of hypothetical novel prophylactic prevention of disease TB vaccines on RR/MDR-TB in China and India. Methods We constructed a deterministic, compartmental, age-, drug-resistance- and treatment history-stratified dynamic transmission model of tuberculosis. We introduced novel vaccines from 2027, with post- (PSI) or both pre- and post-infection (P&PI) efficacy, conferring 10 years of protection, with 50% efficacy. We measured vaccine cost-effectiveness over 2027–2050 as USD/DALY averted-against 1-times GDP/capita, and two healthcare opportunity cost-based (HCOC), thresholds. We carried out scenario analyses. Results By 2050, the P&PI vaccine reduced RR/MDR-TB incidence rate by 71% (UI: 69–72) and 72% (UI: 70–74), and the PSI vaccine by 31% (UI: 30–32) and 44% (UI: 42–47) in China and India, respectively. In India, we found both USD 10 P&PI and PSI vaccines cost-effective at the 1-times GDP and upper HCOC thresholds and P&PI vaccines cost-effective at the lower HCOC threshold. In China, both vaccines were cost-effective at the 1-times GDP threshold. P&PI vaccine remained cost-effective at the lower HCOC threshold with 49% probability and PSI vaccines at the upper HCOC threshold with 21% probability. The P&PI vaccine was predicted to avert 0.9 million (UI: 0.8–1.1) and 1.1 million (UI: 0.9–1.4) second-line therapy regimens in China and India between 2027 and 2050, respectively. Conclusions Novel TB vaccination is likely to substantially reduce the future burden of RR/MDR-TB, while averting the need for second-line therapy. Vaccination may be cost-effective depending on vaccine characteristics and setting.

PP581 Catastrophic Costs Of Multidrug-Resistant Tuberculosis: Estimation Based On The Cost Of Treatment In China

2020 ◽  
Vol 36 (S1) ◽  
pp. 43-43
Author(s):  
Lijun Shen ◽  
Shangshang Gu ◽  
Fan Zhang ◽  
Zhao Liu ◽  
Yuehua Liu
Keyword(s):  
Market Price ◽  
Multidrug Resistant ◽  
Policy Support ◽  
World Health ◽  
Chinese Patients ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Drug Affordability ◽  
The Cost

IntroductionChina bears a considerably high burden of multidrug-resistant tuberculosis (MDR-TB). Second-line anti-TB drugs are urgently needed yet domestic MDR-TB drugs are expensive and lack policy support. Patients’ living conditions are closely related to the drug affordability. The national TB prevention programs should play a critical role. The purpose of this study is to measure the cost of treating MDR-TB patients under different treatment schemes and price sources. The results of this study are expected to inform the relevant drug protection policies and provide inputs for further cost-effectiveness analyses.MethodsBased on the treatment plan of China's Multidrug-Resistant Pulmonary Tuberculosis Clinical Path (2012 edition) and the World Health Organization (WHO) Drug-Resistant Tuberculosis Treatment Guide (2018 edition), the treatment costs of MDR-TB were measured under different scenarios. Catastrophic health expenditure was then calculated if the treatment cost exceeds 40 percent of the household's non-subsistence income. National, rural and disposable income per capita in 2018, were used to represent Chinese patients’ affordability.ResultsUnder varied treatment schemes and market price sources in China, the total costs for MDR-TB patients range from 19,401 to 126,703 CNY [2,853 to 18,633 USD] per person. Under current prices, all treatment schemes recommended by the WHO will incur catastrophic costs for Chinese MDR-TB patients. Significant differences were found between rural and urban areas as 52.8 percent of the treatment listed in the 2012 China Guideline would lead to catastrophic cost for rural patients but not urban ones.ConclusionsOur study concludes that the domestic drugs are more expensive than the international purchase price and the treatment of MDR-TB imposes substantial economic burden on patients, especially in the rural areas. The results of the study also indicate that it is urgent for the state to emphasize government responsibility and initiate centralized procurement for price negotiations to reduce the market price of MDR-TB drugs. The urban-rural gap should also be addressed in the design of future policies to ensure the drug affordability for all patients in need.

scholarly journals Outcomes of Community-Based Systematic Screening of Household Contacts of Patients with Multidrug-Resistant Tuberculosis in Myanmar

2019 ◽  
Vol 5 (1) ◽  
pp. 2
Author(s):  
Nang Thu Thu Kyaw ◽  
Aung Sithu ◽  
Srinath Satyanarayana ◽  
Ajay M. V. Kumar ◽  
Saw Thein ◽  
...  
Keyword(s):  
Chest Radiography ◽  
Multidrug Resistant ◽  
Sputum Smear ◽  
Community Based ◽  
Household Contacts ◽  
Resistant Tuberculosis ◽  
Symptom Screening ◽  
Multidrug Resistant Tuberculosis ◽  
Screening Algorithm ◽  
Mdr Tb

Screening of household contacts of patients with multidrug-resistant tuberculosis (MDR-TB) is a crucial active TB case-finding intervention. Before 2016, this intervention had not been implemented in Myanmar, a country with a high MDR-TB burden. In 2016, a community-based screening of household contacts of MDR-TB patients using a systematic TB-screening algorithm (symptom screening and chest radiography followed by sputum smear microscopy and Xpert-MTB/RIF assays) was implemented in 33 townships in Myanmar. We assessed the implementation of this intervention, how well the screening algorithm was followed, and the yield of active TB. Data collected between April 2016 and March 2017 were analyzed using logistic and log-binomial regression. Of 620 household contacts of 210 MDR-TB patients enrolled for screening, 620 (100%) underwent TB symptom screening and 505 (81%) underwent chest radiography. Of 240 (39%) symptomatic household contacts, 71 (30%) were not further screened according to the algorithm. Children aged <15 years were less likely to follow the algorithm. Twenty-four contacts were diagnosed with active TB, including two rifampicin- resistant cases (yield of active TB = 3.9%, 95% CI: 2.3%–6.5%). The highest yield was found among children aged <5 years (10.0%, 95% CI: 3.6%–24.7%). Household contact screening should be strengthened, continued, and scaled up for all MDR-TB patients in Myanmar.

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