scholarly journals An audit of diagnosis and treatment of tuberculosis in Ethiopia

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Valerie J. Ehlers ◽  
Getahun S. Aragaw
Keyword(s):  
Pulmonary Tuberculosis ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Tuberculosis Treatment ◽  
Diagnosis And Treatment ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
National Tuberculosis ◽  
Smear Negative

Background: Despite the existence of national tuberculosis guidelines (NTG) in Ethiopia, the incidence and prevalence of tuberculosis did not decline markedly. Audits could attempt to determine whether or not healthcare professionals actually implemented these guidelines, as non-implementation could contribute to suboptimal tuberculosis treatment outcomes.Aim: To evaluate healthcare providers’ implementation of Ethiopia’s NTG during the diagnosis and treatment of tuberculosis in order to enhance tuberculosis treatment outcomes.Methods: A descriptive, cross-sectional study design was used.Results: Healthcare providers implemented the NTG during tuberculosis diagnosis for female (60.9%; n = 67) and male (56.1%; n = 69) patients. The correct numbers of anti-tuberculosis pills, complying with the NTG recommendations, were prescribed for 91.8% (n = 101) of the women and for 90.2% (n = 111) of the men. However, both over- and under-prescriptions of anti-tuberculosis drugs occurred. There was an over-diagnosis of smear-negative pulmonary tuberculosis. Only 2.6% (n = 2) of the 76 smear-negative pulmonary tuberculosis patients had been diagnosed correctly.Conclusion: Implementation of the NTG should be enhanced, especially with regard to the diagnosis of smear-negative pulmonary tuberculosis patients and the correct prescription of anti-tuberculosis drugs. This would help to increase the number of correctly-diagnosed and -treated tuberculosis patients, improve tuberculosis treatment outcomes, decrease the spread of tuberculosis and prevent the development of multi-drug-resistant tuberculosis strains.

scholarly journals Health seeking behaviour in pulmonary tuberculosis: a cross sectional study

2018 ◽  
Vol 5 (4) ◽  
pp. 1346 ◽  
Author(s):  
Jebamalar J. ◽  
Priya Senthilkumar ◽  
Mary Ramola
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Patient Delay ◽  
Diagnosis And Treatment ◽  
Sectional Study ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Cross Sectional ◽  
Tuberculosis Patients

Background: Health seeking behaviour has been identified as a complex and dynamic process which influences disease burden of tuberculosis. The present study aimed to study health seeking behaviour among pulmonary tuberculosis patients in a metropolitan city and to assess diagnostic and treatment delays and their determinants.Methods: A cross sectional study was conducted among newly diagnosed pulmonary tuberculosis patients registered for intensive phase of Category 1 ATT during the study period in Zone VIII of Chennai Corporation. The sample size was 197. The study was conducted over a period of one year from September 2015 to August 2016. A standardized WHO interview schedule on diagnostic delay was used for the study.Results: Patients sought healthcare for more severe symptoms like hemoptysis (delay of 38 days) earlier than for cough (delay o- 8 days). Other reasons for delay in seeking care were hope of self-resolution, financial constraints, fear of what the diagnosis would be, incompatible timings etcetera. The total mean delay from onset of symptoms till start of treatment was around 47 days, out of which the patient delay was 42 days. Factors significantly associated with delay included smoking, age more than 35 years and not approaching healthcare facilities first.Conclusions: An unacceptably high patient delay is the major contributor to total delay in the diagnosis and treatment of pulmonary tuberculosis patients. There is increased odds of delay among smokers compared to those who have never smoked. So smokers may be added to the high risk group for suspicion of tuberculosis for fast tracking of diagnosis and treatment. Furthermore, methods to curb over the counter medications should be explored.

scholarly journals Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037913
Author(s):  
Mala George ◽  
Geert-Jan Dinant ◽  
Efrem Kentiba ◽  
Teklu Teshome ◽  
Abinet Teshome ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Secondary Outcome ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative ◽  
Culture Positive ◽  
Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

scholarly journals The Effect of Side Effects Tuberculosis Treatment in the Early Stage Towards Compliance with Tuberculosis Patients

2021 ◽  
Vol 5 (01) ◽  
pp. 29-32
Author(s):  
Joko Sapto Pramono ◽  
Nilam Noorma ◽  
Andi Lis Arming Gandini ◽  
Sopia Fitriani
Keyword(s):  
Side Effects ◽  
Pulmonary Tuberculosis ◽  
Health Workers ◽  
Early Stage ◽  
Treatment Compliance ◽  
Tuberculosis Treatment ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Early Stages ◽  
Significant Difference

Pulmonary tuberculosis treatment causes various side effects including nausea and vomiting, itching, vision problems, and anemia. Drug side effects in the early stages are one of the causes of non-adherence to complete treatment. The purpose of this study was to analyze the effect of the side effects Tuberculosis treatment in the early stages on treatment compliance for tuberculosis patients. This study used a cross sectional design. Samples were taken as many as 71 respondents, the instruments used were side effects of early-stage tuberculosis treatment and compliance with tuberculosis treatment in tuberculosis patients from the Morisky Medication Adherence Scale (MMAS). The results of the study found 97.7% adherent and 2.3% non-adherent, 39.5% mild side effects and 60.5% severe side effects. Chi-square test showed that no significant difference between the side effects of TB treatment in the early stages of tuberculosis treatment compliance in patients p = 0.669 at significant level of 95% (α = 0.05). There was no effect between the side effects of Tuberculosis treatment in the early stages of treatment compliance for Tuberculosis patients. It was recommended that health workers continue to monitor the side effects of tuberculosis treatment and provide motivation to carry out treatment completely. Keywords: side effects; early stage; treatment; pulmonary tuberculosis; compliance

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