scholarly journals Should we consider a ‘fourth 90’ for tuberculosis?

2019 ◽  
Vol 23 (12) ◽  
pp. 1253-1256 ◽  
Author(s):  
A. D. Harries ◽  
R. A. Dlodlo ◽  
G. Brigden ◽  
K. Mortimer ◽  
P. Jensen ◽  
...  

The international community has committed to end the tuberculosis (TB) epidemic by 2030. To facilitate the meeting of the global incidence and mortality indicators set by the World Health Organization's End TB Strategy, the Stop TB Partnership launched the three 90-(90)-90 diagnostic and treatment targets in 2014. In this paper, we argue that a ‘fourth 90’—Ensuring that 90% of all people successfully completing treatment for TB can have a good health-related quality of life'—should be considered. Many individuals who successfully complete anti-TB treatment are burdened with lifelong comorbidities—human immunodeficiency virus (HIV) and diabetes mellitus, obstructive and restrictive lung disease, involving lung destruction, cavitation, fibrosis and bronchiectasis, that either pre-existed or developed as a result of TB (e.g., chronic pulmonary aspergillosis), permanent disabilities such as hearing loss resulting from second-line anti-TB drugs, and mental health disorders. These need to be identified during TB treatment and appropriate care and support provided after anti-TB treatment is successfully completed. A ‘fourth 90’ has also been proposed for the UNAIDS 90-90-90 targets similar in scope to what is being suggested here for TB. Adoption by both HIV and TB control programmes would highlight the current focus on integrated person- and family-centred services.

AIDS Care ◽  
2021 ◽  
pp. 1-8
Author(s):  
Orlanda Q. Goh ◽  
Eugène Kroon ◽  
Carlo Sacdalan ◽  
Phillip Chan ◽  
Trevor A. Crowell ◽  
...  

2020 ◽  
Vol 30 (1) ◽  
pp. 38030 ◽  
Author(s):  
Deivendran Kalirathinam ◽  
Raj Guruchandran ◽  
Prabhakar Subramani

The 2019 novel coronavirus officially named as coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization, has spread to more than 180 countries. The ongoing global pandemic of severe acute respiratory syndrome coronavirus, which causes COVID-19, spread to the United Kingdom (UK) in January 2020. Transmission within the UK was confirmed in February, leading to an epidemic with a rapid increase in cases in March. As on April 25- 2020, there have been 148,377 confirmed cases of COVID-19 in the UK and 20,319 people with confirmed infection have died. Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy and community rehabilitation of COVID-19 patients has recently been identified as an essential therapeutic tool and has become a crucial evidence-based component in the management of these patients. This comprehensive narrative review aims to describe recent progress in the application of physiotherapy management in COVID 19 patients. Assessment and evidence- based treatment of these patients should include prevention, reduction of adverse consequences in immobilization, and long-term impairment sequelae. A variety of techniques and modalities of early physiotherapy in intensive care unit are suggested by clinical research. They should be applied according to the stage of the disease, comorbidities, and patient’s level of cooperation.


2020 ◽  
Vol 27 (09) ◽  
pp. 1976-1982
Author(s):  
Subhan Ullah ◽  
Zubash Aslam ◽  
Ghulam Abbas Shiekh

Objectives: To determine the risk factors of depressive disorders and health related quality of life among adult patients of depression presenting at psychiatric OPD clinic of Aziz Fatima Hospital Faisalabad. Study Design: Cross-sectional study. Setting: Psychiatric OPD clinic of Aziz Fatima Hospital Faisalabad Pakistan. Period: 1st August 2019 to 31st December 2019. Material & Method: 150 patients for the screening of depression Patient Health Questionnaire (PHQ) was used. For measuring health related quality of life World Health Organization Quality of Life (WHOQOL-Brief) was used. Results: It was found that out of 150 patients with depressive disorder 104(69.3%) were female and 46(30.7%) were male patients. Findings of the study assessed that depressive disorder not only impacts on the patients' mood but it also impairs the individuals overall perception of their general health, physical health, psychological wellbeing, social relationship and also distorted perception of their surrounding psychosocial environment. Conclusion: Depressive disorder is common in patients visiting psychiatric OPD clinic and findings of study suggested that age, education level, socio-economic status, death of parent at early age, unemployment, workplace issues, parental separation, loss of partner and family history of depression are important demographic variables which plays the role of significant risk factor for depression and impairs the quality of life among depressive patients.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256652
Author(s):  
Dini Widiarni Widodo ◽  
Robert Mars ◽  
Ronny Suwento ◽  
Widayat Alviandi ◽  
Imelda Ika Dian Oriza ◽  
...  

Objective This study aimed to investigate the functional outcomes, satisfaction, and quality of life of patients with microtia following reconstructive surgery. Methods This cross-sectional study was conducted using retrospective data of patients with microtia following reconstructive surgery using the Nagata technique. Data were obtained from the medical records of patients who underwent reconstructive surgery at the Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, Dr. Cipto Mangunkusumo Hospital between 2014 and 2018. All eligible patients were referred to participate in this study between November 2018 and March 2019. The hearing function was assessed by a professional audiologist after surgery. Patient satisfaction was evaluated by interview using a previously developed questionnaire, while quality of life was assessed using the EuroQol-5D-Young questionnaire. Results Thirty-one eligible subjects were included in the study. Pain and discomfort were the most commonly reported factors related to the quality of life following surgery. Approximately 67.7% of the patients were satisfied; 19.4% were very satisfied, and 12.9% reported acceptance of their surgical outcomes. The most common complication was infection (n = 8). Most patients did not experience any problems in their lives after microtia surgery. Conclusions The highest rate of satisfactory outcomes was observed for the lobule subunit, which was assumed to be associated with the use of the Z-plasty technique. The most common complication was infection, as environmental hygiene was the most important factor. Thus, further concern for maintaining good hygiene is necessary to improve the quality of reconstructive surgery. The level of satisfaction with microtia reconstructive surgery was adequate. Most patients had a good health-related quality of life without experiencing any problems.


2021 ◽  
Author(s):  
Yuko Morita ◽  
Taeko Sasai-Sakuma

Abstract Background: This study investigated the optimal nocturnal sleep duration required by collegiate athletes to maintain physical and mental health, compared with non-athlete students. Methods: In this cross-sectional study, a questionnaire survey was conducted to assess demographic variables, lifestyle and sleep habits, and health-related quality of life in 298 collegiate students (non-athletes, n = 158; athletes, n = 140). Physical component summary and mental component summary were assessed by using a Short-Form 8 Health survey, and participants with good physical as well as mental component summary scores were considered to have a good health-related quality of life. To confirm an association between nocturnal sleep length and good health-related quality of life, logistic regression analyses were conducted in non-athlete students and collegiate athletes separately. Subsequently, receiver operating characteristics curve analyses were performed for detection of the cut-off points for nocturnal sleep duration sufficient to maintain good health-related quality of life in both collegiate athletes and non-athlete students. Results: The average nocturnal sleep duration was 7 hours 4 minutes among collegiate athletes, and 75.7% of them had a worse physical component summary. The cut-off point for nocturnal sleep duration in collegiate athletes was 7.98 hours (area under the curve: 0.69, P = 0.013, sensitivity: 85.5%, specificity: 56.2%), which was longer than the cut-off of 6.58 hours for non-athlete students. Conclusion: Collegiate athletes required longer nocturnal sleep than non-athlete students. Nevertheless, their habitual nocturnal sleep duration was shorter compared to their optimal duration; around 80% of them faced chronic insufficient sleep. Improving sleep habits and sleep education is important in maintaining their good health-related quality of life.


2018 ◽  
Vol 75 (3) ◽  
pp. 246-252
Author(s):  
Gora Miljanovic ◽  
Milan Marjanovic ◽  
Sonja Radakovic ◽  
Miljojko Janosevic ◽  
Tatjana Mraovic ◽  
...  

Background/Aim. Chronic renal disease is one of the growing problems all over the world. Health-related quality of life (HRQoL) is an important indicator for those with a chronic disease, such as chronic renal disease, because it may serve as predictor of mortality and hospitalization. The aim of this study was to assess HRQoL in patients on chronic maintenance hemodialysis (HD), and compare it with patients suffering from hypertension (HTA), and normal controls of the same age and gender (C). Methods. The study enrolled 224 males and females older than 18 years: 67 in the HD group, 78 in the HTA group, and 79 in the C group. HRQoL was assessed in all groups using 15-D questionnaire. Results. Significantly higher level of education was recorded in the HD group compared to other two groups. In the HD group there were significantly less employed persons (9%) and significantly more retired (67.2%). All groups were similar regarding an average monthly income and marital status. We found significantly lower total HRQoL score in patients in the HD group, compared to normal controls (0.78 ? 0.16 vs. 0.89 ? 0.10 in the HTA and 0.95 ? 0.06 in the C group) as well as specific scores in almost all investigated domains, except in speech, eating and mental functions. Patients in the HD and HTA groups had similar self-reported quality of life in additional 3 domains: hearing, elimination and distress, while the HD group reported significantly lower scores in remaining 9 domains: mobility, vision, breathing, sleeping, usual activities, discomfort and symptoms, depression, vitality and sexual activity. Patients in the HTA group had significantly lower scores than normal controls in 8 domains (hearing, sleeping, elimination, usual activities, discomfort and symptoms, depression, distress and vitality) as well as in total quality of life, while in remaining 4 domains there was no significant difference (mobility, vision, breathing, sexual activity). Conclusion. Both investigated chronic diseases lead to impairment of HRQoL, which is substantially stronger in hemodialysis than in hypertension. Considering the relationship between depression and HRQoL measures, it may be useful to treat depression of HD patients in order to improve their quality of life.


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