scholarly journals INFLUENCE OF PATIENT-RELATED FACTORS ASSOCIATED ON TB OUTCOMES AMONG TB PATIENTS IN MOMBASA COUNTY

2021 ◽  
Vol 6 (3) ◽  
pp. 49-65
Author(s):  
Godana Barako ◽  
Simon Karanja ◽  
Rahma Udu
Keyword(s):  
Treatment Outcome ◽  
Quantitative Data ◽  
Psychosocial Support ◽  
Work Place ◽  
Unique Contribution ◽  
Related Factors ◽  
Random Sample Size ◽  
Factors Associated ◽  
Tb Treatment ◽  
Treatment Implementation

Purpose: The purpose of the study was to determine patient-related factors associated with TB outcomes among TB patients in Mombasa County. Methodology: Study was conducted in Mombasa County which is one of the 47 counties in Kenya with an urban population of 1,063,854. The study used a cross-sectional research design. The study population was the total number of notified patients with tuberculosis in one quarter in the study area (Mombasa’s health care units) and this was found to be 1207 in the year 2017. It was from this population that a systematic random sample size of 292 patients were interviewed. Quantitative data were analyzed using SPSS version 20 Descriptive statistics frequency (%), mean, and standard deviation were used to express quantitative data. In bivariate analyses, odds ratios (OR) and 95% confidence intervals (CI) for the association between TB treatment outcome and health related factors, institutional factors and patient related factors was done using logistic regression. Results: The results revealed that patients who are educated about health are more likely to cure of TB than patients who are not (OR 1.716, 95% CI, 0.35 to 1.48). More so, patients who receive psychosocial support are more likely to get cured than those who don’t receive psychosocial support (OR 4.08, 95% CI, 2.00 to 8.32). The results of the study give evidence to, therefore, conclude patient related factors are critical to TB treatment outcome.   Unique contribution to theory, policy and practice: Strengthening TB adherence counselling for patients treated for the first time to improve treatment completion. Counselling service should also be enhanced for patients taking alcohol and those smoking cigarettes as both are associated with less likelihood of completing TB treatment. Implementation of TB work place program through sensitization of company managers on the importance of TB treatment support to reduce chances of loss to follow as sighted by focused group discussions. Patients centred TB services should be provided by all facilities by focusing on the needs of the patients by agreeing on the best time to pick drugs to reduce the risk of loss to follow ups.

scholarly journals Predictors of Adverse TB Treatment Outcome among TB/HIV Patients Compared with Non-HIV Patients in the Greater Accra Regional Hospital from 2008 to 2016

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Kenneth Mawuta Hayibor ◽  
Delia Akosua Bandoh ◽  
Adwoa Asante-Poku ◽  
Ernest Kenu
Keyword(s):  
Treatment Outcome ◽  
Treatment Success ◽  
Regional Hospital ◽  
Hiv Status ◽  
Hiv Patients ◽  
Related Factors ◽  
Factors Associated ◽  
Tb Treatment ◽  
Outcome Monitoring ◽  
The Impact

Introduction. The convergence of TB and HIV dual epidemics is a major public health challenge in Ghana as well as many developing countries. Treatment outcome monitoring is a vital part of the surveillance needed to successfully eliminate TB. The impact of HIV status and demographic and treatment-related factors on adverse TB treatment outcome has not been studied in the Greater Accra Regional Hospital. This study determined factors associated with TB treatment outcome in patients with TB-HIV coinfection and TB-only infection in the hospital. Method. A cross-sectional study was carried out in the Greater Accra Regional Hospital. We reviewed TB treatment cards of patients who received treatment for tuberculosis in the hospital from 2008 to 2016. Data on treatment outcome and sociodemographic and clinical characteristics were extracted on TB-only-infected and TB/HIV-coinfected patients. The chi-squared test and binary and multiple logistic regression models were used to assess factors associated with adverse treatment outcome. Results. Out of the 758 patient records analyzed, 174 (22.9%) were TB-HIV-coinfected patients. Overall treatment success for all TB patients was 88.1% (668/758). About 11.9% (90/758) of the patients had an adverse treatment outcome, including treatment failure 0.9% (7/758), defaulting 0.9% (7/758), and death 10.0% (76/758). TB-HIV-coinfected patients’ treatment success was 78.1% (136/174). TB-only patients’ treatment success was 91.4% (532/582). Independent predictors of adverse treatment outcome were found to be as follows: being HIV positive (aOR: 3.85, 95% CI: 2.19-6.75; p<0.01); aged 65 and above (aOR: 1.76, 95% CI: 1.44-1.54; p=0.01); and previously failed TB treatment (aOR: 5.02, 95% CI: 2.09-28.87; p<0.01). Conclusion. Treatment outcome for TB-HIV-coinfected patients is below the WHO target. HIV status, age, and category of patient of the TB patients were associated with adverse treatment outcome. Strengthening the TB/HIV collaborative efforts by stakeholders is required for good treatment outcomes.

scholarly journals Predictors for Pulmonary Tuberculosis Treatment Outcome in Denmark 2009–2014

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Inge K. Holden ◽  
Troels Lillebaek ◽  
Niels Seersholm ◽  
Peter H. Andersen ◽  
Christian Wejse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Treatment Success ◽  
Control Program ◽  
Success Rates ◽  
Unfavourable Outcome ◽  
Pulmonary Tb ◽  
Factors Associated ◽  
Tb Treatment ◽  
Low Incidence

Abstract Monitoring of tuberculosis (TB) treatment outcome is essential to ensure an effective TB control program. In this nationwide retrospective cohort study from Denmark we present TB treatment outcome rates and risk factors associated with an unfavourable outcome. All patients notified with pulmonary TB from 2009 through 2014 were included. Logistic regression analyses were used to identify risk factors for unfavourable outcome. In total, 1681 pulmonary TB cases were included. TB treatment success rates increased during the study period. In 2014, the treatment success rate reached 85% for new culture positive cases whereas 7% cases interrupted treatment. The mortality decreased during the study period from 12.3% to 4.1%. Several risk factors associated with unfavourable outcome were identified in a multivariable model: male (OR: 2.56), Greenlandic origin (OR: 1.80), abuse of alcohol (OR: 2.90), history of mental disorder (OR: 2.46), and anaemia at time of treatment initiation (OR: 1.92). In a TB low incidence setting such as the Danish, it is important to maintain focus on preventing an unfavourable TB outcome. Patient management and treatment can be optimized by taking into consideration risk factors such as those identified in the present study.

scholarly journals Tuberculosis treatment outcomes of notified cases: trends and determinants of potential unfavourable outcome, France, 2008 to 2014

2020 ◽  
Vol 25 (4) ◽  
Author(s):  
Jean-Paul Guthmann ◽  
Lucie Léon ◽  
Delphine Antoine ◽  
Daniel Lévy-Bruhl
Keyword(s):  
Treatment Outcome ◽  
Error Variance ◽  
Multidrug Resistant ◽  
Surveillance Data ◽  
Unfavourable Outcome ◽  
Factors Associated ◽  
Tb Treatment ◽  
Outcome Monitoring ◽  
Over Time

Background Surveillance of tuberculosis (TB) treatment outcome, for which reporting has been mandatory in France since 2007, is a key component of TB control. Aim We aimed to present surveillance data for non-multidrug-resistant (MDR) cases reported between 2008 and 2014, and identify factors associated with potentially unfavourable treatment outcome. Methods Patients were classified according to their treatment outcome 12 months after beginning treatment. Poisson regression with a robust error variance was used to investigate factors associated with potentially unfavourable treatment outcome. Missing data were handled using multiple imputation. Results A total of 22,526 cases were analysed for treatment outcome. Information available on treatment outcome increased between 2008 (60%) and 2014 (71%) (p < 0.001). During this period, 74.1% of cases completed treatment, increasing from 73.0% in 2008 to 76.9% in 2014 (p < 0.001). This proportion was 74.0% in culture-positive pulmonary cases. Overall, 19.8% of cases had a potentially unfavourable outcome, including lost-to-follow-up, transferred out, still on treatment, death related to TB and interrupted treatment. Potentially unfavourable outcome was significantly associated with TB severity, residing in congregate settings, homelessness, being a smear-positive pulmonary case, being born abroad and residing in France for < 2 years, history of previous anti-TB treatment and age > 85 years. Conclusion Monitoring of treatment outcome is improving over time. The increase in treatment completion over time suggests improved case management. However, treatment outcome monitoring needs to be strengthened in cases belonging to population groups where the percentage of unfavourable outcome is the highest and in cases where surveillance data shows poorer documented follow-up.

Management of Recurrent or Progressing Skull Base Chondrosarcomas: Predictors of Long-Term Outcomes

2020 ◽  
Author(s):  
Jonathan D. Breshears ◽  
Franco DeMonte ◽  
Ahmed Habib ◽  
Paul W. Gidley ◽  
Shaan M. Raza
Keyword(s):  
Natural History ◽  
Skull Base ◽  
Radiation Treatment ◽  
Systemic Disease ◽  
Primary Treatment ◽  
Salvage Treatment ◽  
Low Grade ◽  
Related Factors ◽  
Factors Associated ◽  
Initial Recurrence

Abstract Background Skull base chondrosarcomas (CSA) are difficult tumors to cure and there is little data regarding salvage therapy. Objective This study aims to identify presentation and treatment-related factors which impact the progression free survival (PFS) and disease specific survival (DSS) for recurrent CSA, and to identify salvage treatment factors associated with successful restoration to the natural history following primary treatment. Methods This single-institution retrospective review included patients with recurrent/progressive CSA over a 25-year period. Survival analysis for factors impacting PFS and DSS was performed. Salvage treatment factors associated with achieving PFS ≥newly diagnosed median PFS were identified using univariate statistics. Analysis was performed on first recurrences and all recurrences combined. Results A total of 47 recurrence/progression events were analyzed from 17 patients (median two events/patient, range = 1–8). The overall PFS and DSS for the initial recurrence was 32 (range = 3–267) and 79 (range = 3–285) months, respectively. Conventional grade III or mesenchymal histology significantly predicted shorter PFS and DSS (p < 0.0001). After stratification by histology, previous radiation predicted shorter PFS for low-grade tumors (p = 0.009). Gross total resection (GTR) after a first time recurrence was significantly associated with successful salvage treatment (p < 0.05); however, this was rare. Conclusion In this series, high grade histology and prior radiation treatment negatively impacted salvage treatment outcomes, while GTR was associated with restoration to natural history following primary treatment. Careful consideration of histology, systemic disease status, previous treatments, and the anatomic extent of the skull base disease can optimize the outcomes of salvage intervention.

Comprehensive genomics depict accessory genes encoding pathogenicity and biofilm determinants in Enterococcus faecalis

2021 ◽  
Vol 16 (3) ◽  
pp. 175-184
Author(s):  
Karthika Suryaletha ◽  
Sivakumar K Chandrika ◽  
Sabu Thomas
Keyword(s):  
Enterococcus Faecalis ◽  
Signaling System ◽  
Phosphotransferase System ◽  
Related Factors ◽  
Polysaccharide Lyase ◽  
Factors Associated ◽  
Analysis Methodology ◽  
Accessory Genes ◽  
Genes Encoding ◽  
Phage Proteins

Aim: Enterococcus faecalis is a leading nosocomial pathogen in biofilm-associated polymicrobial infections. The study aims to understand pathogenicity and biofilm determinants of the pathogen by genome analysis. Methodology: Genome sequencing of a strong biofilm forming clinical isolate Enterococcus faecalis SK460 devoid of Fsr quorum-signaling system, was performed and comparative genomics was carried out among a set of pathogenic biofilm formers and nonpathogenic weak biofilm formers. Results: Analysis revealed a pool of virulence and adhesion related factors associated with pathogenicity. Absence of CRISPR-Cas system facilitated acquisition of pheromone responsive plasmid, pathogenicity island and phages. Comprehensive analysis identified a subset of accessory genes encoding polysaccharide lyase, sugar phosphotransferase system, phage proteins and transcriptional regulators exclusively in pathogenic biofilm formers. Conclusion: The study identified a set of genes specific to pathogenic biofilm formers and these can act as targets which in turn help to develop future treatment endeavors against enterococcal infections.

Prevalence and family factors associated with loneliness during COVID-19: A cross-sectional study from South India

2020 ◽  
Vol 3 (02) ◽  
pp. 61-67
Author(s):  
G. Sanjana ◽  
Vijaya Raghavan
Keyword(s):  
Online Survey ◽  
South India ◽  
Survey Design ◽  
Southern India ◽  
Related Factors ◽  
Cross Sectional ◽  
Health Crisis ◽  
Factors Associated ◽  
Family Discord ◽  
The Impact

Background: Loneliness can affect anyone at any point in their life. It can be detrimental to the wellbeing and quality of life of individuals and communities. In the ongoing COVID-19 pandemic, loneliness is considered as a public health crisis. Hence, the objectives of the study were to estimate the prevalence of loneliness and family related factors associated with loneliness among general population in south India. Materials and Methods: The study employed a crosssectional online survey design. The data was collected in the first phase of the lockdown in 2020 from adults in Southern India. Socio-demographic profile and family related variables were collected using a semistructured proforma. Loneliness was assessed by UCLA loneliness scale. Results: Of 573 total respondents to the survey, aged between 18-65 years, 43% were male and 57% were female. The overall prevalence of loneliness was 63% (358/573). No significant gender differences were observed in the prevalence of loneliness. Family discord was associated with higher rates of loneliness (p less than 0.01). Other factors associated were younger age and being single. Conclusion: Rates of loneliness during the COVID-19 lockdown were high in Southern India. Findings suggest that interventions should prioritize younger people. Increasing social support and improving interpersonal skills, which in turn would help reduce family discord and may reduce the impact of COVID-19 on loneliness.

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