scholarly journals STUDI FENOMENOLOGI : DUKUNGAN TERHADAP KEPATUHAN MINUM OBAT PADA PENDERITA TUBERCULOSIS DENGAN MULTIDRUG-RESISTANT

2021 ◽  
Vol 8 (1) ◽  
pp. 12-20
Author(s):  
Murwanti Murwanti
Keyword(s):  
Health Services ◽  
Community Involvement ◽  
Sampling Technique ◽  
Phenomenological Approach ◽  
Multidrug Resistant ◽  
Spiritual Support ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Background: Tuberculosis is an infectious disease if the patient does not complete therapeutic treatment can cause multidrug-resistant tuberculosis (MDR-TB). The role of the environment is needed to support treatment.The study aims to explore more deeply the family's support for medication adherence in patients with multidrug-resistant tuberculosis (TBC-MDR). Method: This type of research is qualitative using a descriptive phenomenological approach, in-depth interviews of 5 participants based on purposive sampling technique. Results: The results of the study found the role of the family towards TB-MDR patients manifested in emotional, physical, instrumental, and spiritual support. emotional support consists of positive and negative emotional. Community involvement after counseling was supportive but there were some who could not accept even families of MDR-TB sufferers were also shunned. The role of health services is to convey information, prepare medicines, supervise, motivate treatment, remind check schedules, refer to more complete facilities when needed, visit homes and ensure patients take medication if unable to come to the public health service. Conclusion: This study found 3 main themes, namely the role of comprehensive family, community involvement and the role of health services in mentoring TB-MDR patients.

scholarly journals Health education on multidrug-resistant tuberculosis prevention among tuberculosis patients

2021 ◽  
Vol 10 (1) ◽  
pp. 27
Author(s):  
Hema Malini ◽  
Emil Huriani ◽  
Devia Putri Lenggogeni ◽  
Shinta Herlina
Keyword(s):  
Health Education ◽  
Community Health Centers ◽  
Statistical Tests ◽  
Group Discussion ◽  
Sampling Technique ◽  
Multidrug Resistant ◽  
P Value ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

The high incidence of multidrug-resistant tuberculosis (MDR-TB) in the community due to the lack of socialization or the provision of health education about MDR-TB. During this time, health education is only focused on tuberculosis (TB) generally. The purpose of this study was to determine the effect of health education on the behavior of MDR-TB prevention in patients with pulmonary tuberculosis in two Community Health Centers in Padang. This study design is quasi-experimental with pre and post-test groups only. The program intervention of health education was conducted for a month with lecture method and group discussion using flipchart and video as media. The sampling technique used purposive sampling were 29 patients with TB who are still in the phase of treatment. Data collection used a set of questionnaires. The data analysis in this study using statistical tests t-test. The results showed, there is a significance influence of health education on knowledge with p-value=0.000 (p≤0.05) and attitude with p-value=0.000 (p≤0.05). The result also showed that 65.5% of patients taking medication regularly. It was also that there is the effect of health education on the behavior of MDR-TB prevention in TB patients. It is expected that the providing of health education on the prevention of behavior on MDR-TB is emphasized on the motivation and self-efficacy of the patients and involvement of supervision on taking medication.

scholarly journals Patients’ Perception of a Community Pharmacist-Managed Multidrug-Resistant Tuberculosis Program in Peru: A Public Health Perspective

2017 ◽  
Vol 8 (3) ◽  
pp. 11 ◽  
Author(s):  
Sean O'Brien ◽  
Jacy Downey
Keyword(s):  
Public Health ◽  
Community Pharmacist ◽  
Community Pharmacists ◽  
Multidrug Resistant ◽  
Perceived Barriers ◽  
The Public ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Objectives: The primary objective is to investigate the public’s perception about the role of the community pharmacist in Peru’s directly observed treatment, short course (DOTS) program. The secondary objective is to assess perceived barriers that would prevent the public from utilizing community pharmacists in order to identify future opportunities for community pharmacists to increase adherence to multidrug-resistant tuberculosis (MDR-TB) therapy. Design: Qualitative study comprised of an 8 close-ended survey questionnaire. Setting: Healthcare clinics established by a medical mission group in Lima and surrounding communities, Peru, from July 13 to July 27, 2015. Participants: Patients 15 years of age and over who sought healthcare at the clinics. Main outcome measures: Public’s perception about the role of the community pharmacist in Peru and barriers that would prevent the public from seeking a community pharmacist. Results: Out of the 445 patients approached, 438 patients completed the survey, resulting in a 98% response rate. More than half (52%) of the respondents were likely to seek a community pharmacist to assist them in completing a MDR-TB medication regimen. Almost half (48%) of the respondents felt comfortable with assistance of a community pharmacist in completing an MDR-TB regimen. The physician was the first health care professional that was contacted for all medical situations, including drug-related questions (61%). Lack of privacy in the pharmacy (53%) and busyness of the pharmacists (52%) were the top perceived barriers for asking community pharmacists questions. Conclusion: This study highlights the need for pharmacist participation in Peru’s DOTS program. Furthermore, this investigation has identified several issues of concern related to current community pharmacy practice in Peru. Therefore, future efforts may be necessary to address these identified areas of opportunity to promote the community pharmacist’s role in health screening, drug therapy monitoring, and counseling to decrease the public health burden of MDR-TB. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents or royalties.   Type: Original Research

Safety and Efficacy of Delamanid in the Treatment of Multidrug-Resistant Tuberculosis (MDR-TB)

2013 ◽  
Vol 5 ◽  
pp. CMT.S11675 ◽  
Author(s):  
Stephen K. Field
Keyword(s):  
Multidrug Resistant ◽  
Phase Iii ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Improved Outcomes ◽  
Resistance Patterns ◽  
Mdr Tb ◽  
Phase Iii Study

Globally, the incidence of tuberculosis (TB) is declining but the proportion of drug-resistant cases has increased. Strains resistant to both isoniazid and rifampin, and possibly other antibiotics, called multidrug-resistant (MDR), are particularly difficult to treat. Poorer outcomes, including increased mortality, occur in patients infected with MDR strains and the costs associated with treatment of MDR-TB are substantially greater. The recent recognition of MDR-TB and strains with more complex resistance patterns has stimulated the development of new TB medications including fluoroquinolones, oxazolidinones, diarylquinolines, nitroimidazopyrans, ethylenediamines, and benzothiazinones. Bedaquiline, a diarylquinoline, was approved for the treatment of MDR-TB in 2012. Addition of delamanid to WHO-approved treatment improved outcomes for MDR-TB and for extensively drug-resistant TB in a large randomized, controlled phase II clinical trial and is undergoing evaluation in a large international phase III study. This review will focus on MDR-TB and the role of delamanid in its treatment.

scholarly journals Model Tatalaksana Komprehensif Tuberculosis Multidrug-Resistant (TB-MDR) Melalui Pendekatan Provider Pelayanan Kesehatan

2020 ◽  
Vol 1 (2) ◽  
pp. 51-57
Author(s):  
Okky Haidar Yahya Irawansa ◽  
Yudha Bhaskoro ◽  
Ahmad Rizki Maulana ◽  
Febri Endra Budi Setyawan
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Providers ◽  
Health Workers ◽  
Multidrug Resistant ◽  
Health Service Provider ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Long Term Treatment ◽  
Mdr Tb

Introduction: Tuberculosis is a highly contagious disease and requires long-term treatment and large amounts of medication. This can affect the high risk of Multidrug-Resistant Tuberculosis (MDR-TB). A health service approach in providing comprehensive management including promotive, preventive, curative, and rehabilitative is very necessary to overcome these cases. Aim of study: This article aims to determine interventions that can be carried out by health services in preventing the occurrence of multidrug-resistant tuberculosis (MDR-TB). Method: The method used is a literature review through national to international journals that examine the interventions that can be carried out by health services in preventing MDR-TB. The articles or data sources that have been obtained will be compared with one another so that the factors that most influence the occurrence of MDR-TB can be found. Results and Discussion: The literature search results show that health workers, especially doctors, have an important role in managing MDR-TB cases. Management of MDR-TB in a comprehensive manner is carried out through promotive, preventive, curative, and rehabilitative programs through a health service provider approach. Educational activities regarding TB, MDR-TB, or the possibility of drug resistance are important to do to prevent new cases of MDR-TB. Curative treatment is carried out to improve mental and social health. Furthermore, rehabilitative efforts are carried out as a means to improve health status recovery for MDR-TB sufferers. Conclusion: Health service providers can improve facilities, they can carry out promotive, curative rehabilitative management to reduce the incidence of MDR-TB.

scholarly journals Clofazimine as a Treatment for Multidrug-Resistant Tuberculosis: A Review

2021 ◽  
Vol 89 (2) ◽  
pp. 19
Author(s):  
Rhea Veda Nugraha ◽  
Vycke Yunivita ◽  
Prayudi Santoso ◽  
Rob E. Aarnoutse ◽  
Rovina Ruslami
Keyword(s):  
Multidrug Resistant ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Repurposed Drugs ◽  
Group 5 ◽  
Poor Outcomes ◽  
Group B

Multidrug-resistant tuberculosis (MDR-TB) is an infectious disease caused by Mycobacterium tuberculosis which is resistant to at least isoniazid and rifampicin. This disease is a worldwide threat and complicates the control of tuberculosis (TB). Long treatment duration, a combination of several drugs, and the adverse effects of these drugs are the factors that play a role in the poor outcomes of MDR-TB patients. There have been many studies with repurposed drugs to improve MDR-TB outcomes, including clofazimine. Clofazimine recently moved from group 5 to group B of drugs that are used to treat MDR-TB. This drug belongs to the riminophenazine class, which has lipophilic characteristics and was previously discovered to treat TB and approved for leprosy. This review discusses the role of clofazimine as a treatment component in patients with MDR-TB, and the drug’s properties. In addition, we discuss the efficacy, safety, and tolerability of clofazimine for treating MDR-TB. This study concludes that the clofazimine-containing regimen has better efficacy compared with the standard one and is also well-tolerated. Clofazimine has the potential to shorten the duration of MDR-TB treatment.

scholarly journals The Correlation Between Interleukin-10 1082G/A Gene Polimorphism Late Onset with Nephrotoxicity Secondary to Antituberculosis Treatment in Multidrug Resistant Tuberculosis Patients

2019 ◽  
Vol 39 (4) ◽  
pp. 215-219
Author(s):  
Harsini Harsini ◽  
Reviono Reviono ◽  
Umarudin Umarudin
Keyword(s):  
Late Onset ◽  
Interleukin 10 ◽  
Multidrug Resistant ◽  
Protective Role ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Antituberculosis Treatment ◽  
Mdr Tb

Backgrounds: Tuberculosis controlling programme has become more complex with MDR-TB problem. Interleukin 10 (IL-10) 1082G/A gene polimorphism correlates with IL-10 secretion as anti-inflammatory cytokine which plays important role in pathogenesis of MDR-TB infection. The management of MDR-TB which used aminoglycosides could cause nephrotoxic effect to the patients. The protective role of IL-10 from IL-10 1082 G/A genotype to nephrotoxicity due to kanamycin still becomes a prolem nowadays. Methods: This study was a retorspective cohort study of MDR-TB patients who underwent treatment in Dr. Moewardi Hospital in 2011-2015. Results: Subjects of the study were 89 MDR-TB patients with IL-10 1082 G/A genotype polimorphism. The proportions of IL-10 1082 G/A genotype were AA genotype of 13.48%, GG of 4.49%, and GA of 82.2%. Statistic test showed that the onset of nephrotoxicity in GG genotype was faster than GA and AA genotype Conclusions: Interleukin 10 1082 G/A gene polymorphism had no significant correlation with nephrotoxicity onset in MDR-TB patients treated with kanamycin in Dr. Moewardi hospital. (J Respir Indo. 2019; 39(4): 215-9)

scholarly journals The Knowledge of Nurses on the Management of Multidrug Resistant Tuberculosis at Primary Health Care Facilities: A Pilot Study

2018 ◽  
Vol 19 (3) ◽  
Author(s):  
Vikesh Singh ◽  
Elsie S Janse van Rensburg
Keyword(s):  
Sampling Technique ◽  
Knowledge Score ◽  
Multidrug Resistant ◽  
Health Care Facilities ◽  
Eastern Cape ◽  
Knowledge Gaps ◽  
Cross Sectional ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

The decentralisation of the multidrug-resistant tuberculosis (MDR TB) programme to primary healthcare (PH) facilities in an Eastern Cape health district was implemented to improve the effectiveness of MDR TB services. Nurses working in TB units play a key role in M DR TB management; therefore, they should be equipped with updated knowledge. This study assessed the knowledge of PH nurses working in TB units regarding MDR TB management. A quantitative, cross-sectional descriptive study was conducted: data were collected using a structured questionnaire. Non-probability sampling was applied in this study. A convenience sampling technique was used and 25 of the 42 facilities were selected. Two nurses from each facility were recruited, resulting in 50 questionnaires being distributed. A total of 32 respondents completed the questionnaires. Descriptive statistics were used to describe the data. The overall scores were high with a mean knowledge score of 61%. Thirty eight percent of the nurses had been trained in MDR TB and only 28% did not know how to use an N95 mask. However, knowledge gaps were identified in respect of the management of side effects of MDR TB medication. Although most respondents demonstrated an efficient level of knowledge of MDR TB management, knowledge gaps were identified and recommendations were offered to address these gaps.

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.

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