Optimal methods of psychological support in patientswith multidrug-­resistant pulmonary tuberculosis and their effect on adherence to treatment

2021 ◽  
pp. 67-75
Author(s):  
N.A. Lytvynenko ◽  
Yu.O. Senko ◽  
L.M. Protsyk ◽  
V.V. Davydenko ◽  
S.P. Korotchenko ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Psychological Support ◽  
Psychological State ◽  
Adherence To Treatment ◽  
Individual Counseling ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Long Time ◽  
The Impact

Tuberculosis is a severe infectious disease that negatively affects not only the physical condition of patients, but also the psychological condition of patients. The first thing — the shock of the first diagnosis of tuberculosis for the patient. The second thing — when the patient realizes that he must be treated for an unusually long time. Objective — to learn the impact of providing psychological support for the patients with tuberculosis in a phthisiatric hospital in the form of individual counseling and group classes for patients. Materials and methods. A prospective surgical study was provided to establish the level of knowledge, level of adherence to treatment of patients with tuberculosis and the degree of violation of their psycho-emotional state at the beginning of treatment, and individual counseling and group classes for patients. The study included 335 patients with multidrug-resistant pulmonary tuberculosis, who received treatment at the clinic of the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine on short-term and individualized regimens of antimycobacterial therapy in the framework of scientific developments. Patients received questionnaires before treatment and before discharge, counseling on tuberculosis and their psychological state, various group classes. Results and discussion. A comprehensive approach of treatment using different methods of psychological support allowed increasing the level of adherence to treatment by 32% in the group of patients who received a group classes, compared with those patients who didn’t; reduce the level of stigma by 40.5%, halve the severity anxiety disorders. Conclusions. Comprehensive psychological support should be a mandatory component in the treatment of patients with multidrug-resistant tuberculosis, which can significantly reduce stigma, improve the psychological state of patients and their adaptation in society.

scholarly journals Causes of multidrug-resistant tuberculosis from the perspectives of health providers: challenges and strategies for adherence to treatment during the COVID-19 pandemic in Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ludmilla Leidianne Limirio Souza ◽  
Felipe Lima dos Santos ◽  
Juliane de Almeida Crispim ◽  
Regina Célia Fiorati ◽  
Sónia Dias ◽  
...  
Keyword(s):  
Health Professionals ◽  
Social Protection ◽  
Multidrug Resistant ◽  
Social Risk ◽  
Health Providers ◽  
Adherence To Treatment ◽  
Structured Interviews ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background Multidrug-resistant tuberculosis (MDR-TB) is a serious phenomenon on a global scale that can worsen with the COVID-19 pandemic. The study aimed to understand the perceptions of health professionals about MDR-TB, their strategies to ensure adherence to treatment and their challenges in the context of the COVID-19 pandemic in a priority municipality for disease control. Methods We conducted a qualitative study and recruited 14 health providers (four doctors, three nurses, three nursing technicians, three nursing assistants and a social worker) working in a city in the state of São Paulo, Brazil. Remote semi-structured interviews were conducted with the participants. For data analysis, the thematic content analysis technique was applied according to the study’s theoretical framework. Results The study revealed the causes of MDR-TB are associated with poverty, vulnerability, and social risk. A pre-judgement from the providers was observed, namely, all patients do not adhere due their resistance and association with drug abuse or alcoholism. The study also observed difficulty among health providers in helping patients reconstruct and reframe their life projects under a care perspective, which would strengthen adherence. Other issues that weakened adherence were the cuts in social protection and the benefits really necessary to the patients and a challenge for the providers manage that. The participants revealed that their actions were impacted by the pandemic and insecurity and fear manifested by patients after acquiring COVID-19. For alleviating this, medical appointments by telephone, delivery of medicine in the homes of patients and visits by health professionals once per week were provided. Conclusion The study advances knowledge by highlighting the challenges faced by the health system with the adherence of patients with MDR-TB in a context aggravated by the pandemic. An improvement in DOT is really necessary to help the patients reframe their lives without prejudices, face their fears and insecurity, recover their self-esteem and motivate in concluding their treatment.

scholarly journals Risk Factors for Multidrug-Resistant Tuberculosis among Patients with Pulmonary Tuberculosis at the Central Chest Institute of Thailand

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0139986 ◽  
Author(s):  
Charoen Chuchottaworn ◽  
Vipa Thanachartwet ◽  
Piamlarp Sangsayunh ◽  
Thu Zar Myint Than ◽  
Duangjai Sahassananda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

scholarly journals Prevalence of Tuberculosis in Diabetic Patients

2021 ◽  
Vol 15 (5) ◽  
pp. 1058-1060
Author(s):  
Shamshad Ali ◽  
M Imran Aslam ◽  
Nayyar M Elahi ◽  
Waseem A Khan ◽  
M Saqib Musharaf ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Extra Pulmonary Tuberculosis ◽  
Medical College ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
The Mean ◽  
Extra Pulmonary

Aim: To determine the frequency of tuberculosis in the patients of diabetes. Study design: Cross-Sectional Place and duration of study: Department of Pulmonology, Avicenna Medical College, Lahore from 1st March 2020 to 31st August 2020. Methodology: Two hundred patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking proper consent. Patients admitted in outpatient department with diabetic duration greater than 5years. The different variants of pulmonary and extra pulmonary tuberculosis were measured. Results: There were 120(60%) males and 80(40%) were females with mean age was 51.8±18.22 years. The mean duration of diabetes was 11.5±9.19 years. 60% patients were addicted to gutka and smoking. Active tuberculosis was only found in 30(15%) cases. Pulmonary tuberculosis were 17(56.7%) and the rest 13(43.3%) were extra pulmonary tuberculosis. Eighteen (60%) patients had smear positive and 12(40%) had smear -ve TB. Conclusion: The frequency of tuberculosis in the diabetic patients was high as compared to other population. It can be cure by early diagnosed of disease otherwise multidrug-resistant tuberculosis can become serious health problem among public. Key words: Prevalence, Tuberculosis, Diabetic patient, Multidrug-resistant tuberculosis

scholarly journals Assessing the impacts of short-course multidrug-resistant tuberculosis treatment in the Southeast Asia Region using a mathematical modeling approach

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248846
Author(s):  
Win Min Han ◽  
Wiriya Mahikul ◽  
Thomas Pouplin ◽  
Saranath Lawpoolsri ◽  
Lisa J. White ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Treatment Initiation ◽  
Multidrug Resistant ◽  
Treatment Regimens ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Short Course ◽  
Mdr Tb ◽  
The Impact

This study aimed to predict the impacts of shorter duration treatment regimens for multidrug-resistant tuberculosis (MDR-TB) on both MDR-TB percentage among new cases and overall MDR-TB cases in the WHO Southeast Asia Region. A deterministic compartmental model was constructed to describe both the transmission of TB and the MDR-TB situation in the Southeast Asia region. The population-level impacts of short-course treatment regimens were compared with the impacts of conventional regimens. Multi-way analysis was used to evaluate the impact by varying programmatic factors (eligibility for short-course MDR-TB treatment, treatment initiation, and drug susceptibility test (DST) coverage). The model predicted that overall TB incidence will be reduced from 246 (95% credible intervals (CrI), 221–275) per 100,000 population in 2020 to 239 (95% CrI, 215–267) per 100,000 population in 2035, with a modest reduction of 2.8% (95% CrI, 2.7%–2.9%). Despite the slight reduction in overall TB infections, the model predicted that the MDR-TB percentage among newly notified TB infections will remain steady, with 2.4% (95% CrI, 2.1–2.9) in 2020 and 2.5% (95% CrI, 2.3–3.1) in 2035, using conventional MDR-TB treatment. With the introduction of short-course regimens to treat MDR-TB, the development of resistance can be slowed by 38.6% (95% confidence intervals (CI), 35.9–41.3) reduction in MDR-TB case number, and 37.6% (95% CI, 34.9–40.3) reduction in MDR-TB percentage among new TB infections over the 30-year period compared with the baseline using the standard treatment regimen. The multi-way analysis showed eligibility for short-course treatment and treatment initiation greatly influenced the impacts of short-course treatment regimens on reductions in MDR-TB cases and percentage resistance among new infections. Policies which promote the expansion of short-course regimens and early MDR-TB treatment initiation should be considered along with other interventions to tackle antimicrobial resistance in the region.

scholarly journals Early Bactericidal Activity of Paromomycin (Aminosidine) in Patients with Smear-Positive Pulmonary Tuberculosis

2000 ◽  
Vol 44 (12) ◽  
pp. 3285-3287 ◽  
Author(s):  
P. R. Donald ◽  
F. A. Sirgel ◽  
T. P. Kanyok ◽  
L. H. Danziger ◽  
A. Venter ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bactericidal Activity ◽  
Dose Group ◽  
Multidrug Resistant ◽  
Cross Resistance ◽  
Confidence Limits ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Smear Positive Pulmonary Tuberculosis ◽  
The Difference

ABSTRACT The early bactericidal activity of the aminoglycoside paromomycin (aminosidine) in doses of 7.5 and 15 mg/kg of body weight was measured in 22 patients with previously untreated smear-positive pulmonary tuberculosis. The fall in log10 CFU per milliliter of sputum per day during the first 2 days of treatment for 7 patients receiving a paromomycin dosage of 7.5 mg/kg/day was 0.066, with a standard deviation (SD) of 0.216 and confidence limits from −0.134 to 0.266, and that for 15 patients receiving 15 mg/kg/day was 0.0924, with an SD of 0.140 and confidence limits from 0.015 to 0.170. The difference between the mean and zero was not significant for the 7.5-mg/kg dose group but was significant for the 15-mg/kg dose group (t = 2.55, P = 0.023). Since paromomycin has no cross-resistance with streptomycin and has no greater toxicity than other aminoglycosides, these results suggest that it has the potential to substitute for streptomycin in antituberculosis regimens and may be a particularly valuable addition to the drug armamentarium for the management of multidrug-resistant tuberculosis.

scholarly journals Impact of multidrug-resistant tuberculosis and its medications on adverse maternal and perinatal outcomes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e034821 ◽  
Author(s):  
Kefyalew Addis Alene ◽  
Akilew Awoke Adane ◽  
Alemken Jegnie
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Perinatal Outcomes ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
The Impact

IntroductionMultidrug-resistant tuberculosis (MDR-TB) is a common public health problem affecting pregnant women. However, the impact of MDR-TB and its medication on pregnancy and perinatal outcomes has been poorly understood and inconsistently reported. Therefore, using the available literature, we aim to determine whether MDR-TB and its medications during pregnancy impact maternal and perinatal outcomes.Methods and analysisThis systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Systematic searches will be conducted in PubMed, Scopus and Web of Science on 10 February 2020 for studies that reported adverse maternal and perinatal outcomes due to MDR-TB and/or its medication. The search will be performed without language and time restrictions. Adverse birth outcomes include miscarriage or abortion, stillbirth, preterm birth, low birth weight, small and large for gestational age, and neonatal death. Two independent reviewers will screen search records, extract data and assess the quality of the studies. The Newcastle-Ottawa Quality Assessment Scale will be used to assess the methodological quality of the included studies. In addition to a narrative synthesis, a random-effects meta-analysis will be conducted when sufficient data are available. I2 statistics will be used to assess the heterogeneity between studies.Ethics and disseminationAs it will be a systematic review and meta-analysis based on previously published evidence, there will be no requirement for ethical approval. Findings will be published in a peer-reviewed journal and will be presented at various conferences.

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