The burden and determinants of post-TB lung disease

BACKGROUND: Post-TB lung disease (PTLD) is an important but under-recognised chronic respiratory disease in high TB burden settings such as Tanzania.METHODS: This was a cross-sectional survey of adults within 2 years of completion of TB treatment in Kilimanjaro, Tanzania. Data were collected using questionnaires (symptoms and exposures), spirometry and chest radiographs to assess outcome measures, which were correlated with daily life exposures, including environment and diet.RESULTS: Of the 219 participants enrolled (mean age: 45 years ± 10; 193 88% males), 98 (45%) reported chronic respiratory symptoms; 46 (22%) had received treatment for TB two or more times; and HIV prevalence was 35 (16%). Spirometric abnormalities were observed in 146 (67%). Chest X-ray abnormalities occurred in 177 (86%). A diagnosis of PTLD was made in 200 (91%), and half had clinically relevant PTLD. The prevalence of mMRC ≥Grade 3 chronic bronchitis and dyspnoea was respectively 11% and 26%. Older age, multiple episodes of TB and poverty indicators were linked with clinically relevant PTLD.CONCLUSIONS: We found a substantial burden of PTLD in adults who had recently completed TB treatment in Tanzania. There is a pressing need to identify effective approaches for both the prevention and management of this disease.

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Relationship of Anxiety and Depression with Respiratory Symptoms: Comparison between Depressed and Non-Depressed Smokers in Singapore

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16010163 ◽

2019 ◽

Vol 16 (1) ◽

pp. 163 ◽

Cited By ~ 21

Author(s):

Cyrus SH Ho ◽

Elysia LY Tan ◽

Roger CM Ho ◽

Marcus YL Chiu

Keyword(s):

Smoking Cessation ◽

Lung Disease ◽

Multiple Regression ◽

Respiratory Symptoms ◽

Psychiatric Symptoms ◽

Psychiatric Patients ◽

Anxiety Symptoms ◽

University Hospital ◽

Cross Sectional Survey ◽

Cross Sectional

The rising prevalence of smokers in the community, specifically psychiatric patients, necessitates smoking cessation as an important strategy for reducing the harmful effects of tobacco. This study aims to compare the profiles of depressed and non-depressed smokers and evaluate how psychiatric symptoms influence respiratory symptoms. A cross-sectional survey was administered to 276 non-depressed adult smokers in the community and 69 adult smokers who had been formally diagnosed with depression in the outpatient clinic of a University Hospital in Singapore. Participants were administered questionnaires on smoking attitudes and perceptions, psychiatric symptoms, and respiratory symptoms. Correlations and multiple regression analyses were conducted. The mean age of smokers in the study was 35.32 ± 13.05 years. Smokers in the community and psychiatric samples were largely similar on all of the sociodemographic factors, except that fewer depressed people were employed (χ2 = 8.35, p < 0.01). Smokers with depression also reported more attempts to quit smoking (χ2 = 7.14, p < 0.05), higher mean depressive, anxiety, and stress symptom (DASS) scores (t = −10.04, p < 0.01), and endorsed more respiratory symptoms than smokers in the community (t = −2.40, p < 0.05). The DASS scores, number of cigarettes smoked daily, years of smoking, general perception of smokers getting heart disease, and presence of lung disease were positively and significantly correlated with respiratory symptoms. On multiple regression, only anxiety symptoms (β = 0.26, p < 0.05) and the presence of lung disease (β = 0.22, p < 0.001) were significantly correlated with respiratory symptoms. Depressed smokers reported greater difficulty in quitting tobacco use, and they perceived more severe respiratory symptoms compared to non-depressed counterparts. Anxiety symptoms were positively associated with the severity of respiratory symptoms. Smoking cessation campaigns need to specifically target psychological symptoms in smokers and focus more psychoeducation on the risk of cardiovascular disease in the middle-aged population.

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Technology Assessment in Different Nations and Lessons from a Cross-Sectional Survey of Magnetic Resonance Imaging (MRI) Diffusion

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300001458 ◽

1985 ◽

Vol 1 (3) ◽

pp. 515-536 ◽

Cited By ~ 1

Author(s):

Paul F. Gross

Keyword(s):

Magnetic Resonance Imaging ◽

Cost Effectiveness ◽

Magnetic Resonance ◽

Medical Technology ◽

Resonance Imaging ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Magnetic Resonance Imaging Mri ◽

Diagnostic Modalities ◽

Made In

Magnetic resonance imaging (MRI) is a rapidly evolving medical technology which has become widely diffused before comprehensive assessment of its safety, efficacy, cost-effectiveness, and relative cost-effectiveness compared with diagnostic modalities that it seems most likely to replace could be made. In early 1982 there were fewer than ten units worldwide. In August 1984, there were about 150 units and the figure will be closer to 300 by the end of 1985.

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Alarming tuberculosis rate among people who inject drugs in Vietnam

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab548 ◽

2021 ◽

Author(s):

Nicolas Nagot ◽

Vinh Vu Hai ◽

Thuy Thi Thu Dong ◽

Oanh Khuat Thi Hai ◽

Delphine Rapoud ◽

...

Keyword(s):

Antiretroviral Therapy ◽

People Who Inject Drugs ◽

Risk Groups ◽

High Rate ◽

Hiv Positive ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Chest X Ray ◽

Hiv Negative

Abstract Background The tuberculosis (TB) epidemic is not homogeneous in the general population but presents high-risk groups. People who inject drugs (PWID) are such a group. However, TB among PWID remains largely undocumented. Our goal was to assess the prevalence of TB and the risk factors associated with TB among PWID in Vietnam. Methods We implemented a cross-sectional survey among two community-based cohorts of HIV-positive and HIV-negative PWID in Hai Phong. Participants were screened for TB using questions on TB symptoms. Those who reported any symptom were accompanied by peers to the TB clinic for chest X-Ray. If the latter was abnormal, a sputum was collected to perform an Xpert® MTB/RIF test. Results 885 PWID were screened for TB. For both cohorts, most PWID were male (>90.0%), with a median age of 42 years. Beside heroin injection, 52.5% of participants reported smoking methamphetamine, and 63.2% were on methadone. Among HIV-positive PWID (N=451), 90.4% were on antiretroviral therapy and 81.6% had a viral load <1,000 copies/mL. Using a complete-case analysis, the estimated TB prevalence was 2.3% (95%CI: 1.0-4.5) and 2.1% (95%CI: 0.8-4.2) among HIV-positives and HIV-negatives, respectively. Living in couple, arrest over the past six months, homelessness and smoking methamphetamine were independently associated with TB but not HIV infection. Conclusions In a context of very large antiretroviral therapy coverage, this extremely high rate of TB among PWID requires urgent actions.

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Delays in diagnosis and treatment of pulmonary tuberculosis in patients seeking care at a regional referral hospital, Uganda: a cross sectional study

BMC Research Notes ◽

10.1186/s13104-019-4616-2 ◽

2019 ◽

Vol 12 (1) ◽

Author(s):

Winters Muttamba ◽

Samuel Kyobe ◽

Alimah Komuhangi ◽

James Lakony ◽

Esther Buregyeya ◽

...

Keyword(s):

Health Facility ◽

Cross Sectional Study ◽

Patient Delay ◽

Referral Hospital ◽

Cross Sectional Survey ◽

Total Delay ◽

Cross Sectional ◽

Treatment Unit ◽

Regional Referral Hospital ◽

Tb Treatment

Abstract Objective A cross-sectional survey involving 134 pulmonary TB patients started on TB treatment at the TB Treatment Unit of the regional referral hospital was conducted to ascertain the prevalence of individual and health facility delays and associated factors. Prolonged health facility delay was taken as delay of more than 1 week and prolonged patient delay as delay of more than 3 weeks. A logistic regression model was done using STATA version 12 to determine the delays. Results There was a median total delay of 13 weeks and 110 (82.1%) of the respondents had delay of more than 4 weeks. Patient delay was the most frequent and greatest contributor of total delay and exceeded 3 weeks in 95 (71.6%) respondents. At multivariate analysis, factors that influenced delay included poor patient knowledge on TB (adjOR 6.904, 95% CI 1.648–28.921; p = 0.04) and being unemployed (adjOR 3.947, 95% CI 1.382–11.274; p = 0.010) while being female was found protective of delay; adjOR 0.231, 95% CI 0.08–0.67; p = 0.007). Patient delay was the most significant, frequent and greatest contributor to total delay, and factors associated with delay included being unemployed, low knowledge on TB while being female was found protective of delay.

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TB prevalence in Zimbabwe: a national cross-sectional survey, 2014

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.21.0341 ◽

2022 ◽

Vol 26 (1) ◽

pp. 57-64

Author(s):

M. Chipinduro ◽

C. Timire ◽

J. Chirenda ◽

R. Matambo ◽

E. Munemo ◽

...

Keyword(s):

Control Strategies ◽

Age Groups ◽

Smear Microscopy ◽

Cross Sectional Survey ◽

Prevalence Survey ◽

Cross Sectional ◽

Multiple Imputations ◽

Prevalence Estimates ◽

Chest X Ray ◽

Tb Diagnostics

BACKGROUND: We conducted the first national TB prevalence survey to provide accurate estimates of bacteriologically confirmed pulmonary TB disease among adults aged ≥15 years in 2014.METHODS: A TB symptoms screen and chest X-ray (CXR) were used to identify presumptive TB cases who submitted two sputum samples for smear microscopy, liquid and solid culture. Bacteriological confirmation included acid-fast bacilli smear positivity confirmed using Xpert® MTB/RIF and/or culture. Prevalence estimates were calculated using random effects logistic regression with multiple imputations and inverse probability weighting.RESULTS: Of 43,478 eligible participants, 33,736 (78%) were screened; of these 5,820 (17%) presumptive cases were identified. There were 107 (1.9%) bacteriologically confirmed TB cases, of which 23 (21%) were smear-positive. The adjusted prevalences of smear-positive and bacteriologically confirmed TB disease were respectively 82/100,000 population (95% CI 47–118/100,000) and 344/100,000 (95% CI 268–420/100,000), with an overall all-ages, all-forms TB prevalence of 275/100,000 population (95% CI 217–334/100,000). TB prevalence was higher in males, and age groups 35–44 and ≥65 years. CXR identified 93/107 (87%) cases vs. 39/107 (36%) using the symptom screen.CONCLUSION: Zimbabwe TB disease prevalence has decreased relative to prior estimates, possibly due to increased antiretroviral therapy coverage and successful national TB control strategies. Continued investments in TB diagnostics for improved case detection are required.

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The values of serum cytokines in chronic lung disease in newborn

Medicinski pregled ◽

10.2298/mpns1108362b ◽

2011 ◽

Vol 64 (7-8) ◽

pp. 362-367

Author(s):

Lidija Banjac

Keyword(s):

Growth Factor ◽

Lung Disease ◽

Chronic Lung Disease ◽

Insulin Like Growth Factor ◽

Abnormal Chest ◽

Study Results ◽

Chest X Ray ◽

Birth Body Weight ◽

Pregnancy And Birth ◽

Made In

Introduction. Chronic lung disease in the newborn is a complication of mechanical ventilation. The diagnosis of chronic lung disease is made in children of over 36 post-conceptual weeks? age who still require additional oxygen and who have abnormal chest x-ray findings. This study was aimed at triaging newborns at risk of developing chronic lung disease. The operating study hypothesis was that the values of insulin-like growth factor I below 30 ?g/L in the 33rd post-conceptual week were associated with the development of chronic lung disease. Material and Methods. The above hypothesis was verified by a cohort, prospective study, which included preterm newborns of 33 gestational weeks? age or less who were hospitalised at the Department of Neonatology of the Clinical Centre of Montenegro from Aril 2008 to July 2009. The blood sample was taken in the 33rd post-conceptual week and the insulin-like growth factor value was determined by the method of enzyme immunoassay. Results. Our study results confirmed the theory of statistically significant correlation of the length of pregnancy and birth body weight with insulin-like growth factor serum level. Discussion. We did not find any statistically significant correlation between the insulin-like growth factor serum value and chronic lung disease in the newborn. It is possible that the insulin-like growth factor has a different role at various stages of pathogenesis of diseases of prematurity. Conclusion. We believe that by correcting the term for determining the levels we can get a significant correlation between low values of insulin- like growth factor -1 and chronic lung disease.

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The burden of chronic respiratory diseases in adults in Nepal: A systematic review

Chronic Respiratory Disease ◽

10.1177/1479973121994572 ◽

2021 ◽

Vol 18 ◽

pp. 147997312199457

Author(s):

Winifred Ekezie ◽

Alex Robert Jenkins ◽

Ian Philip Hall ◽

Catrin Evans ◽

Rajendra Koju ◽

...

Keyword(s):

Lung Disease ◽

Low Income ◽

Lung Diseases ◽

Disease Burden ◽

Airflow Obstruction ◽

Chronic Respiratory Disease ◽

Low Income Countries ◽

Chronic Obstructive ◽

Cross Sectional ◽

Chronic Lung Diseases

While chronic lung disease causes substantial global morbidity and mortality, global estimates have primarily been based on broad assumptions. Specific country data from low-income countries such as Nepal are limited. This review assessed primary evidence on chronic respiratory disease burden among adults in Nepal. A systematic search was performed in June 2019 (updated May 2020) for studies through nine databases. High levels of heterogeneity deemed a narrative synthesis appropriate. Among 27 eligible studies identified, most were low-moderate quality with cross-sectional and retrospective study design. Chronic lung diseases identified were chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and restrictive lung diseases. Studies were categorised as: (i) community-based, (ii) hospital-based and (iii) comorbidity-related and disease burden. Reported disease prevalence varied widely (COPD, 1.67–14.3%; asthma, 4.2–8.9%). The prevalence of airflow obstruction was higher among rural dwellers (15.8%) and those exposed to household air pollution from domestic biomass burning as opposed to liquid petroleum gas users (Odds Ratio: 2.06). Several comorbidities, including hypertension and diabetes mellitus added to the disease burden. The review shows limited literature on lung disease burden in Nepal. Publications varied in terms of overall quality. Good quality research studies with prospective cohorts related to respiratory conditions are required.

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What affected Chinese parents’ decisions about tuberculosis (TB) treatment: Implications based on a cross-sectional survey

PLoS ONE ◽

10.1371/journal.pone.0245691 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245691

Author(s):

Tingsong Xia ◽

Juan Chen ◽

Jian Rui ◽

Jinxu Li ◽

Yuli Guo

Keyword(s):

Self Efficacy ◽

Risk Perceptions ◽

High Rate ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Perceived Susceptibility ◽

Perceived Severity ◽

Response Efficacy ◽

Tb Treatment ◽

Chinese Parents

Objective Although progress has been made in tuberculosis (TB) treatment, China still remains one of the high-burden TB countries. One important reason that has not received sufficient scholarly attention is that Chinese individuals tend to underestimate the threat of TB. This contributed to the high rate of delay in seeking TB treatment and noncompliance with doctors’ regimen. Hence, this research examined how TB knowledge affected Chinese parents’ risk perceptions and their efficacy appraisal in TB treatment, and how their risk perception and efficacy appraisal affected their intentions to seek timely TB treatment for their children and adhere to doctors’ regimen. Methods We conducted an online cross-sectional survey with 1129 parents of children attending kindergarten, primary school, and middle school in Shajing, a region with high TB incidence in China. Perceived severity of TB threat to self and to others, perceived susceptibility, response efficacy, and self-efficacy were measured, in addition to TB knowledge and intentions to seek timely TB treatment and adhere to doctors’ regimens. Results Ordinal least squares regression demonstrated that TB knowledge was positively associated with perceived severity of TB threat to self, perceived severity of TB threat to others, perceived susceptibility, response efficacy, and self-efficacy, but it did not affect their medical decisions. In addition, binary logistic regression revealed that response efficacy and self-efficacy predicted both intentions positively, and perceived severity of TB threat to self only enhanced Chinese individuals’ intention to follow doctors’ regimens. Conclusion Health education aimed at knowledge improvement may be effective in changing one’s perceptions of the given health threat but may not be effective to change their behavior. Thus, practitioners need to focus on changing Chinese parents’ perceptions of TB rather than simply improving their knowledge. Specifically, it is necessary to lower their efficacy in self-management and enhance their perceived infectiousness of TB.

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Cross-sectional study of nutritional intake among patients undergoing tuberculosis treatment along the Myanmar–Thailand border

BMJ Open ◽

10.1136/bmjopen-2021-052981 ◽

2022 ◽

Vol 12 (1) ◽

pp. e052981

Author(s):

Karim Damji ◽

Ahmar H Hashmi ◽

Lin Lin Kyi ◽

Michele Vincenti-Delmas ◽

Win Pa Pa Htun ◽

...

Keyword(s):

Weight Gain ◽

Primary Outcome ◽

Cross Sectional Study ◽

Nutritional Intake ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Tb Treatment ◽

Micronutrient Intake ◽

Caloric Requirements

ObjectiveThis study summarises nutritional intake among patients with tuberculosis (TB) along the Myanmar–Thailand border according to the local diet.SettingTB clinic along the Myanmar–Thailand border.ParticipantsCross-sectional surveys of 24-hour food recall were conducted with participants receiving anti-TB treatment. Participants were purposively selected to reflect proportion of age, sex and HIV co-infection based on historical patient records. Out of a total of 28 participants, 20 (71.4%) were men and 5 (17.9%) were co-infected with HIV.Primary and secondary outcome measuresThe primary outcome compared actual recorded intake to recommended intake. Secondary outcomes compared weight gain and body mass index (BMI) from diagnosis to time of survey.ResultsThere were no significant differences in macronutrient or micronutrient intake by sex or for patients supplementing their rations. Mean treatment length at time of survey was 20.7 weeks (95% CI: 16.5 to 24.8). A significantly higher proportion of women (8/8, 100%) met caloric requirements compared with men (9/20, 45.0%, p=0.010), but few participants met other macronutrient or micronutrient requirements, with no significant differences by sex or for patients supplementing their rations. From diagnosis to the time of the survey, participants averaged significant weight gain of 6.48 kg (95% CI: 3.87 to 9.10) and increased BMI of 2.47 kg/m2 (95% CI: 1.45 to 3.49; p=0.0001 for both). However, 50% (14/28) still had mild or more severe forms of malnutrition.ConclusionsThis cross-sectional survey of nutritional intake in patients undergoing TB treatment in a sanatorium setting demonstrates the difficulty in sufficiently meeting nutritional demands, even when providing nutritional support.

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Investigation of osteoporosis and its influencing factors in a group of Chinese patients with Interstitial Lung Disease

10.21203/rs.3.rs-737845/v1 ◽

2021 ◽

Author(s):

Hui Zhang ◽

Xiao-Wen Sheng ◽

Fan Zhang ◽

Yu-Qi Hu ◽

Li-Ru Huang ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Lung Disease ◽

Chinese Patients ◽

Mineral Density ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Affecting ◽

Multiple Factors ◽

Lung Structure ◽

High Prevalence

Abstract Background Interstitial lung disease (ILD) seriously influences patient’s quality of life (QOL) due to an abnormally repaired lung structure and damaged lung function, as well as its many complications. Osteoporosis is a systemic bone disease characterized by low bone mineral density (BMD) and may impair QOL and increase mortality in ILD patients. We conducted this study to investigate osteoporosis in Chinese ILD patients. Methods We performed a cross-sectional survey of 179 Chinese ILD patients. BMD levels were evaluated, and the clinical variables of the patients were recorded. The physical activity and QOL of patients were evaluated by a questionnaire when enrolled. Regression analysis was used to identify factors affecting BMD in ILD patients. Results In total, 68.2% of the included patients had an abnormal BMD, 24.6% had osteoporosis, and 43.6% had osteopenia. Decreased of BMD in ILD patients was associated with multiple factors, of which sex, height, weight, ILD subtypes and serum parathyroid hormone (PTH) were most significantly. The QOL of ILD patients with osteoporosis is dramatically declining. Conclusions Osteoporosis and osteopenia have high prevalence rates in ILD patients and seriously affect patients’ QOL. The development of osteoporosis and low BMD in ILD patients are influenced by multiple factors. Early identification and interventions are expected to benefit the QOL of ILD patients.

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