scholarly journals A Step towards Control of Multidrug Resistant Tuberculosis: Hospital Based Study from Nashik India

2016 ◽  
Vol 12 (2) ◽  
pp. 34-38
Author(s):  
SV Gosavi ◽  
M Patil ◽  
B Almale ◽  
S Dugad

Introduction: The Global TB report (2012), estimates 73,000 MDR TB patients living in India, among them only 1,660 cases were notified and 68.4% cases were put on treatment. Hence, this study was conducted with objective to assess the treatment outcome of multi drug resistant Tuberculosis patients enrolled in DOTS plus (Cat-VI) site.Methodology: It is a retrospective case series of MDR-TB cases conducted at Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik (Maharashtra). Information was collected on age, gender, HIV status, previous treatment of TB, weight of patient, refused to take treatment for Cat IV. Outcome was recorded in terms of cure rate, rate of failure, defaulter, treatment completed, switch to Cat V and death.Results: Among the study subject, majority of study subjects were male (65%) and highest proportion (49%) of MDR-TB was in 25-44 years of age. Out of 353 patient 241 (68.4%) were still on Cat IV in which 35% patient’s on intensive phase and 65% put on continuation phase while 12.8%, 13.5%, 4%, 1.1%, 3.6% & 0.5% patient were found to be defaulted, died, refused to take treatment, treatment completed, transfer out & switch to Cat V, respectively.Conclusion: In the present study, the majority of study subjects (99.4%) were previously treated for TB, we identified number of operational challenges in the treatment of MDR-TB like rate of defaulter, refuse to take treatment & deaths among MDR-TB patient was high. There is need to study correlates of these factors in details also need of operational research to improve MDR-TB treatment in India is considered as priority.SAARC J TUBER LUNG DIS HIV/AIDS, 2015 XII (2), page: 34-38

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Mbouna Ndiaye ◽  
Pauline Kiswendsida Yanogo ◽  
Bernard Sawadogo ◽  
Fadima Diallo ◽  
Simon Antara ◽  
...  

According to the World Health Organization, multidrug-resistant tuberculosis (MDR-TB) represents a major obstacle towards successful TB treatment and control. In Dakar, MDR-TB management began in 2010 with the strengthening of diagnostic resources. The objective of this study was to identify the factors associated with multidrug-resistant tuberculosis in Dakar between 2010 and 2016. We conducted a case-control study from January 10 to February 28, 2017 in tuberculosis centers in Dakar. of 169 cases and 507 controls. We used logistic regression with Epi-info version 7.2.1. to estimate the odds ratios of association. Factors significantly associated with MDR-TB were: residing in a periurban area (ORa=1.8; 95% CI (1.5-4.9); p=0.024), presence of MDR-TB in the entourage of patient (ORa=7.0; 95% CI (6.1-9.5); p=0.002), previous treatment failure (ORa=29.5; 95% CI (27.3-30.1); p=0.000), treatment not directly observed by a health care provider (ORa=4.3; 95% CI (4.1-7,2); p=0.000) and irregularity of treatment (ORa=1.7; 95% CI (0.5-5.4); p=0.037). Focusing interventions on population at-risk will prevent MDR-TB.


Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 


2020 ◽  
Author(s):  
Lankamo Ena Digesa ◽  
Aklil Hailu Beyene ◽  
Erdaw Tachbele Betre

Abstract Background: The emergence of multi-drug resistant tuberculosis (MDR-TB) is a challenge for global prevention and control of the disease. MDR-TB case management is difficult because it exposes to further economic and social costs that the patients face while seeking help and treatment. Ethiopia is one of the 30 MDR-TB burden countries. There is little research evidence of MDR-TB from the peripheral parts of the country.Objective: The study was designed to identify determinants of MDR-TB among patients attending anti tuberculosis treatment from peripheral districts, Southern Nations, Nationalities and People Region, Ethiopia, 2019. Methods: Hospital based case control study was conducted from March to April, 2019 in Southern Ethiopia. Cases were confirmed MDR-TB patients, while controls were those who declared cured or completed first line ant-tuberculosis treatment. The study participants were recruited by stratified random sampling. The data were entered into Epi data 4.4.3, cleaned and analyzed by SPSS 24. Bivariate and multivariable analyses was used to identify determinants of MDR-TB. Determinants with P-value <0.05 were declared as having significant association with MDR-TB and adjusted odd ratio with 95% CI was used to measure degree of association. Result: A total of 180 study participants were recruited (90 cases and 90 controls) and participated in this study. The median age for cases and controls was 29 and 30.5 years respectively. More than two third (78.89%) of case participants were from rural and 49(54.44%) of the controls were from rural. Uneducated [AOR:5.18, 95%CI (1.69-15.80)], rural resident [AOR:2.60,95%CI(1.14-6.88)], body mass index(BMI)<18.5kg/m2[AOR:3.11,95%CI(1.41-6.88], pulmonary tuberculosis[AOR:3.98,95%CI(1.11-14.22)], contact history with tuberculosis patient [AOR:3.99,95%CI (1.75-9.07)] and history of previous treatment[AOR:9.5,95%CI(4.08-22)] were found independent determinants of MDR-TB.Conclusions and Recommendation: Uneducated, rural residence, body mass index <18.5kg/m2, pulmonary tuberculosis, contact history with tuberculosis patient and history of previous treatment were associated with MDR-TB. A community level education to enhance public awareness about MDR-TB, nutritional counseling and support, strengthening contact tracing and directly observed treatment strategies with treatment adherence interventions were recommended.


Author(s):  
Widya Kurnianingsih ◽  
◽  
Didik Gunawan Tamtomo ◽  
Bhisma Murti ◽  
◽  
...  

Background: Multidrug Resistant Tuberculosis (MDR-TB) is a highest problem in the prevention and eradication of TB worldwide. MDR-TB exists in 27 countries where there are at least 6,800 MDR-TB cases annually and 12% of new TB cases registered are MDR TB. This study aimed to examine the effect of incomplete medication intake on the incidence of MDR TB. Subjects and Method: Meta-analysis and systematic review was conducted by collecting articles from Google Scholar, Pubmed, and Springer Link databases, from year 2010 to 2019. Keywords used “Risk Factor MDR TB” OR “Previous Treatment” AND “Multidrug resistant tuberculosis”. The inclusion criteria were full text, using English language, using case control study design, and reporting adjusted odds ratio. The study population was patients with Tuberculosis. The intervention was incomplete medication intake with comparison complete medication intake. The study outcome was multidrug resistant Tuberculosis. Collected articles were selected by PRISMA flow chart. Quantitative data were analyzed by fixed effect model using Revman 5.3. Results: 6 studies from Taiwan, Bangladesh, Malaysia, and Ethiophia were selected for data analysis. This study reported that incomplete medication intake increased the risk of multidrug resistant tuberculosis (aOR= 14.33; 95% CI= 12.47 to 16.47; p<0.001). Conclusion: Incomplete medication intake increases the risk of multidrug resistant Tuberculosis. Keywords: incomplete medication intake, multidrug resistant tuberculosis Correspondence: Widya Kurnianingsih. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 081556837033


2020 ◽  
Vol 12 (2) ◽  
pp. 23-29
Author(s):  
Satrio Adi Wicaksono ◽  
Yusmein Uyun ◽  
Ratih Kumala Fajar Apsari

Latar belakang: Multi Drug Resistant Tuberculosis (MDR-TB) adalah adanya resistensi terhadap obat TB minimal 2 (dua) obat anti TB yang paling poten yaitu INH dan rifampisin secara bersama-sama atau disertai resistensi terhadap obat anti TB lini pertama lainnya seperti etambutol, streptomisin dan pirazinamid. Pemilihan anestesi spinal pada pasien ini merupakan bahan diskusi yang menarik.Kasus: Seorang wanita G2P1A0 dirujuk ke RSUP Dr Kariadi dengan diagnosa TB MDR. Pasien memiliki riwayat flek paru sejak usia 15 tahun. Pasien memiliki keluhan batuk lama saat kehamilan yang pertama dan sempat mengalami putus obat. Pada pemeriksaan fisik didapatkan keadaan umum pasien tampak sesak dengan kesadaran composmentis, BB 43kg, TB 160cm. Tekanan darah 130/80 mmHg, frekuensi nadi 112x/menit, laju napas 28 x/menit, dengan temperatur 37oC. Pada pemeriksaan mata didapatkan konjungtiva palpebra anemis. Pemeriksaan jantung normal dan paru terdengar suara ronki basah kasar di kedua lapang paru. Pada pemeriksaan laboratorium didapatkan anemia dan trombositopenia. Pasien menjalani operasi seksio sesaria dengan anestesi spinal dengan bupivakain 0,5% 10 mg dengan tekanan darah awal 130/80 mmHg. Selama operasi dan pascaoperasi seksio sesaria, hemodinamik pasien stabil, tidak ditemukan hipotensi yang berat maupun kenaikan tekanan darah. Pasien kemudian dirawat di ruangan dengan perawatan pascaoperasi.Pembahasan: Pada penderita TB MDR, hampir seluruh lapang paru diisi oleh infiltrat. Anestesi regional sering disukai pada pasien dengan penyakit paru-paru kronis seperti tuberkulosis daripada anestesi umum untuk menghindari risiko hipersensitivitas pada otot polos bronkhial dan penyempitan saluran udara akibat proses inflamasi, yang dapat berdampak pada morbiditas dan mortalitas selama persalinan operatif. Ketersediaan tes fungsi paru akan sangat membantu ahli anestesi.Kesimpulan: Keadaan paru yang kurang baik dapat menjadi kontra indikasi untuk dilakukan anestesi umum.


Author(s):  
Anita Velingker ◽  
Durga Lawande

Background: Multidrug resistant tuberculosis (MDR TB) requires treatment with expensive, toxic, anti-tubercular drugs over a longer duration. Adverse drug reaction (ADR) to second line anti tubercular drugs affect compliance and hence treatment outcome. The primary objective of this study was to analyse ADRs and if these resulted in change or permanent suspension of drug. We also analysed treatment outcome, treatment adherence and co morbidities associated with MDR patients.Methods: A retrospective study was carried out at DOTS plus site in department of Pulmonary Medicine, Goa Medical College on registered MDR cases from November 2011 to October 2016. Socio demographic profile, diagnosis, treatment and ADRs were evaluated, ADRs were evaluated for frequency, causative drugs, management aspect and impact on treatment outcome.Results: Out of 201 MDR cases, 99 cases had 167 ADRs. Majority of patients having ADRs were in age group of 30-50 years with mean±standard deviation 36.82±14.47, 59 (59.59%) males and 40 (40.40%) females, 92 (92.92%) retreatment cases and 7 (7.07%) newly diagnosed. Majority of ADRs were vomiting 31(18.56%), joint pain 31 (18.56%), gastritis 21 (12.57%), hearing impairment 16 (9.58%), numbness in leg 14 (8.38%), depression 12 (7.18%). Treatment outcome of cases with ADR was cured 45 (45.45%), treatment completed16 (16.16%), progressed to XDR 6 (6.06%), transferred out 5 (5.05%), defaulter 14 (14.14%), death 13 (13.13%).Conclusions: It is very important to recognise at the earliest and treat the ADRs with least modification of the treatment regimen to have a good treatment outcome.


2021 ◽  
pp. 104973232110497
Author(s):  
Samorn Numpong ◽  
Mondha Kengganpanich ◽  
Jaranit Kaewkungwal ◽  
Wirichada Pan-ngum ◽  
Udomsak Silachamroon ◽  
...  

In this article, we aimed to understand the life experiences of Thai persons diagnosed with multi-drug-resistant tuberculosis (MDR-TB). A qualitative study using a face-to-face in-depth interview was conducted at a hospital in Thailand which has the highest prevalence of MDR-TB in the country between January and February 2019. Twenty persons living with MDR-TB in Thailand were purposively selected to represent a variety of experiences based on different gender, ages, and treatment phases. Qualitative data were transcribed and thematic analysis was applied to identify common themes and sub-themes. The results indicated that all participants faced emotional difficulties, such as fear of death, fear of stigmatization, confusion, and sadness when first knowing of their diagnosis. Family and social support were the main ways that the patients coped with difficult situations. Suicidal ideas were more prevalent among patients with poor family support. Screening for mental health problems should be routinely performed in MDR-TB patients. Proper health education should be provided to patients and families to reduce emotional difficulties and stigmatization.


2015 ◽  
Vol 9 (10) ◽  
pp. 1076-1085 ◽  
Author(s):  
Omar Sald Elmi ◽  
Habsah Hasan ◽  
Sarimah Abdullah ◽  
Mat Zuki Mat Jeab ◽  
Zilfalil Bin Alwi ◽  
...  

Introduction: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major clinical public health threat and challenges the national TB control program in Malaysia. Data that elaborates on the risk factors associated with the development of MDR-TB is highly limited in this country. This study was aimed to determine the risk factors associated with the development of MDR-TB patients in peninsular Malaysia. Methodology: This was a case control study; the data were collected from medical records of all the registered MDR-TB patients at five referral TB hospitals in peninsular Malaysia from January 2010 to April 2014. The 105 cases were all confirmed by a positive sputum culture of Mycobacterium tuberculosis for MDR-TB and extensively drug-resistant (XDR)-TB. As a comparison, a total of 209 non-MDR-TB cases were randomly selected as controls. Results: A total of 105 MDR-TB and 209 non MDR-TB patients were studied. The risk factors associated with MDR-TB within the multivariate analysis were previous tuberculosis treatment, HIV infection, being an immigrant, and high load of positive for acid-fast bacillus (AFB) smear. Conclusions: The findings of this study revealed that patients who had received previous treatment for tuberculosis, were infected with HIV, were immigrants, and had a high burden of positive testing for AFB smear were more likely to have MDR-TB. An enhanced understanding of the risk factors associated with MDR-TB strains is imperative in the development of a national policy for public health interventions.


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