scholarly journals Receiving healthcare for drug-resistant TB: a cross-sectional survey from Pakistan

2021 ◽  
Vol 11 (3) ◽  
pp. 114-119
Author(s):  
S. Abbas ◽  
J. Denholm ◽  
M. Kermode ◽  
Y. Xiaoguang ◽  
S. Kane
Keyword(s):  
Health System ◽  
Financial Support ◽  
Public Facility ◽  
Drug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Experience ◽  
Resistant Tuberculosis ◽  
Healthcare Experience ◽  
Khyber Pakhtunkhwa Province

OBJECTIVE: To describe and quantify patients’ self-reported experiences of receiving healthcare from Pakistan’s Programmatic Management of Drug-Resistant Tuberculosis (PMDT) model of care, and to understand these experiences within the broader context of Pakistan’s health system.METHOD: This was a cross-sectional survey of patients attending three PMDT clinics in Khyber-Pakhtunkhwa Province in Pakistan.RESULTS: The median consultation time at the PMDT clinics was 10 minutes. In their most recent visit to the PMDT clinic, 34.9% of patients spent >40% of their monthly income to access treatment. To specify, 71% of patients reported spending out-of-pocket for ancillary medicines and 44.7% for laboratory tests. In 10.5% of cases, medicines for drug-resistant TB (DR-TB) were dispensed without the patient attending the clinic. Only 43.7% of treatment supporters regularly accompanied patients to the clinic, and 6% supervised the patient’s intake of medicines. Disbursement of financial support was irregular in 98.6% of cases. Only 6.2% of patients received their daily injections from a public facility, the rest went elsewhere.CONCLUSION: Several shortcomings in PMDT services, including hurried consultations, irregularities in financial support, and gaps in Pakistan’s broader health system undermined healthcare experience of patients with DR-TB. To improve health outcomes and patients’ care experience these service gaps need to be addressed.

scholarly journals Prevalence of drug-resistant tuberculosis and imputed burden in South Africa: a national and sub-national cross-sectional survey

2018 ◽  
Vol 18 (7) ◽  
pp. 779-787 ◽  
Author(s):  
Nazir Ahmed Ismail ◽  
Lindiwe Mvusi ◽  
Ananta Nanoo ◽  
Andries Dreyer ◽  
Shaheed V Omar ◽  
...  
Keyword(s):  
South Africa ◽  
Drug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

scholarly journals Prevalence of drug-resistant tuberculosis in Zimbabwe: A health facility-based cross-sectional survey

2019 ◽  
Vol 87 ◽  
pp. 119-125 ◽  
Author(s):  
Collins Timire ◽  
John Z. Metcalfe ◽  
Joconiah Chirenda ◽  
Jerod N. Scholten ◽  
Barbara Manyame-Murwira ◽  
...  
Keyword(s):  
Health Facility ◽  
Drug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

Evaluating the readiness of mobile technology in Saudi Arabia: An Integrative Perspective with respect to e-health (Preprint)

2020 ◽  
Author(s):  
Fahad Alanezi
Keyword(s):  
Saudi Arabia ◽  
Health System ◽  
Mobile Phones ◽  
Personal Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Apps ◽  
History Of ◽  
Vision 2030 ◽  
Awareness Programs

UNSTRUCTURED E-health system is emerging and providing health services and solutions through different electronic gadgets. Saudi Arabia has launched a program called Saudi Arabia vision 2030, in which providing state-of-the-art health facilities to their citizen is of topmost priority. After all the efforts, the residents of Saudi Arabia are still reluctant for the adaptation of e-health system. The current study was conducted to evaluate the obstacle in adoption of the e-health system through the mobile phones. The current study was cross-sectional survey and was conducted by developing a self-administered structured questionnaire asking the utilization of mobile phone in state of health emergency prior to ask any medical history. Majority of the participants was married and doing jobs in different firms and have their personal mobile phones (p = 0.100, > 0.05) which indicates easily access to the e-health apps. The majority of the participants suffers from either obesity or high blood pressure (p = 0.018, < 0.05) regardless of either history of mental disorder or other family history of mental diseases. The pattern of diseases with mental disorders correlate well with adoption of e-health in government policies. The obstacles in adopting e-health includes fear of the loss of personal data and information (p = 0.0401, < 0.05). Moreover, they did not trust on online medications as the doctor cannot prescribe medicines without seeing physical health of the patient. The current study concluded that by making improvement in policies and proper commercializing the e-health apps together with awareness programs can boast the adoption of e-health in Saudi Arabia.

scholarly journals Vaccination knowledge, attitudes and practices in patients with HIV: a cross-sectional survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Rousset ◽  
G Voglino ◽  
E Boietti ◽  
A Corradi ◽  
M R Gualano ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Health System ◽  
Vaccination Coverage ◽  
Public Health System ◽  
Cross Sectional Survey ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Contagion Risk ◽  
High Level

Abstract Background Infectious diseases are more common and severe in patients with HIV, which show different response to vaccines and a diminished protection. It is therefore very important to assess knowledge and attitudes towards vaccination in people with HIV, since precise vaccination coverage and vaccine hesitancy are not well established in this subgroup of patients. Methods A sample of 119 patients with HIV completed a cross-sectional survey. Patients were recruited during their routine medical examination at the infectious diseases clinic in Turin. The survey explored these main areas: demographics and history of HIV infection, vaccination history, attitudes towards vaccination, confidence in the public health system, contagion risk and disease seriousness perception. In this preliminary phase descriptive analysis were conducted. Results Preliminary data show that mean age of the participants was 49.51 years, 80% were males. The median of HIV infection duration was 10 years, while the median of the lymphocyte count was 762.50 cells/mm3. The disease with the highest vaccination coverage was tetanus (88.7%), considered a serious or very serious disease by 85.6% of the participants, despite low or very low contagion risk perception (84.1%). The disease with the lowest vaccination coverage was Herpes Zoster (7.3%), despite high or very high seriousness perception (70%). Furthermore, 99.1% of the participants showed high or very high confidence toward public health system professionals, and the majority of them (59.5%) stated that vaccines are more useful for the community than for the single person. Conclusions Vaccination coverage is still not fully satisfactory regarding diseases considered infrequent or mild. Considering the high level of confidence toward the public health system that has emerged, it is necessary to implement informative and operative strategies about vaccination for European HIV patients, which are particularly at risk regarding infectious diseases. Key messages Vaccination coverage and risk perception in HIV patients is not satisfactory for many diseases and an effort to implement informative strategies in Europe is needed. The role of vaccination in preventing infectious diseases in HIV patients should be recognized and strengthened by relying on the high level of confidence toward European public health systems.

Evaluation of health system in Iraq from people's point of view: a comparative study of two different eras

2021 ◽  
Vol 4 (2) ◽  
pp. 380-387
Author(s):  
Saad Ahmed Ali Jadoo ◽  
Adil H. Alhusseiny ◽  
Shukr Mahmood Yaseen ◽  
Mustafa Ali Mustafa Al-Samarrai ◽  
Anmar Shukur Mahmood
Keyword(s):  
Health System ◽  
Health Sector ◽  
Health Resources ◽  
Sampling Technique ◽  
Point Of View ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Current Health ◽  
Multi Stage ◽  
Geographical Regions

Background: Since the 2003 United States–British Coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion. Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study. Results: A total of 365 heads of households (response rate: 71.7%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Young age group (p = 0.003), men (p = < 0.001), unmarried (p = 0.001), high educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001),  and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system. Conclusions: Most Iraqis surveyed expressed disappointment from the health system after the 2003 US-led invasion. The current health system is faltering at all levels and does not meet the citizens' basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system.

scholarly journals Factors influencing diagnosis and treatment initiation for multidrug-resistant/rifampicin-resistant tuberculosis in six sub-Saharan African countries: a mixed-methods systematic review

2020 ◽  
Vol 5 (7) ◽  
pp. e002280 ◽  
Author(s):  
Charity Oga-Omenka ◽  
Azhee Tseja-Akinrin ◽  
Paulami Sen ◽  
Muriel Mac-Seing ◽  
Aderonke Agbaje ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health System ◽  
Barriers And Facilitators ◽  
Diagnosis And Treatment ◽  
Drug Resistant ◽  
African Countries ◽  
Drug Resistant Tuberculosis ◽  
Patient Level ◽  
Resistant Tuberculosis ◽  
Sub Saharan

BackgroundDrug-resistant tuberculosis burdens fragile health systems in sub-Saharan Africa (SSA), complicated by high prevalence of HIV. Several African countries reported large gaps between estimated incidence and diagnosed or treated cases. Our review aimed to identify barriers and facilitators influencing diagnosis and treatment for drug-resistant tuberculosis (DR-TB) in SSA, which is necessary to develop effective strategies to find the missing incident cases and improve quality of care.MethodsUsing an integrative design, we reviewed and narratively synthesised qualitative, quantitative and mixed-methods studies from nine electronic databases: Medline, Global Health, CINAHL, EMBASE, Scopus, Web of Science, International Journal of Tuberculosis and Lung Disease, PubMed and Google Scholar (January 2006 to June 2019).ResultsOf 3181 original studies identified, 55 full texts were screened, and 29 retained. The studies included were from 6 countries, mostly South Africa. Barriers and facilitators to DR-TB care were identified at the health system and patient levels. Predominant health system barriers were laboratory operational issues, provider knowledge and attitudes and information management. Facilitators included GeneXpert MTB/RIF (Xpert) diagnosis and decentralisation of services. At the patient level, predominant barriers were patients being lost to follow-up or dying due to lengthy diagnostic and treatment delays, negative public sector care perceptions, family, work or school commitments and using private sector care. Some patient-level facilitators were HIV positivity and having more symptoms.ConclusionCase detection and treatment for DR -TB in SSA currently relies on individual patients presenting voluntarily to the hospital for care. Specific interventions targeting identified barriers may improve rates and timeliness of detection and treatment.

The pattern of comorbidity and its prevalence among drug-resistant tuberculosis patients at treatment initiation in Lagos, Nigeria

2020 ◽  
Vol 114 (6) ◽  
pp. 415-423
Author(s):  
Olusola A Adejumo ◽  
Bolanle Olusola-Faleye ◽  
Victor A Adepoju ◽  
Mustapha Gidado ◽  
Moses O Onoh ◽  
...  
Keyword(s):  
Treatment Initiation ◽  
Reproductive Age ◽  
Health Concern ◽  
Comorbid Condition ◽  
Thyroid Function Tests ◽  
Drug Resistant ◽  
Reproductive Health Services ◽  
Cross Sectional ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

Abstract Background Multimorbidity is increasingly being recognized as a serious public health concern in the control of both drug-susceptible and drug-resistant tuberculosis (DR-TB). This study assessed the pattern of comorbidities and their prevalence in DR-TB patients at treatment initiation in Lagos, Nigeria. Methods A cross-sectional study was conducted. The baseline laboratory records (human immunodeficiency virus [HIV] status, fasting blood sugar, audiometry, thyroid function tests, serum electrolyte, haemoglobin level and pregnancy test) of DR-TB patients initiated on treatment in Lagos, Nigeria between 1 August 2014 and 31 March 2017 were reviewed. Results A total of 565 DR-TB patients’ laboratory records were reviewed, of which 397 (70.3%) had comorbidities. The proportion with one, two, three and four comorbidities was 60.2%, 29.7%, 8.1% and 2.0%, respectively. Anaemia was the most common (48.1%) comorbid condition, while anaemia and hypokalaemia (7.3%), anaemia and hypothyroidism (6.5%) and anaemia and HIV (5%) were most common among patients with more than one comorbid condition. DR-TB patients with comorbidity were significantly older (34.8±12.3 y) than those without comorbidity (32.0±12.8 y) (p=0.038). Of the 176 females in the reproductive age group, 8 (4.5%) were pregnant at baseline. Conclusions The prevalence of comorbidity among DR-TB patients was high. There is a need for the national TB program to expand its DR-TB council of experts and also integrate reproductive health services into DR-TB management in Nigeria.

scholarly journals Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Winters Muttamba ◽  
Racheal Tumwebaze ◽  
Levicatus Mugenyi ◽  
Charles Batte ◽  
Rogers Sekibira ◽  
...  
Keyword(s):  
Health Care ◽  
Social Protection ◽  
Medical Expenditure ◽  
Drug Resistant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cost Drivers ◽  
Assistance Programs ◽  
Free Health Care ◽  
Mdr Tb

Abstract Background Tuberculosis (TB) patients in Uganda incur large costs related to the illness, and while seeking and receiving health care. Such costs create access and adherence barriers which affect health outcomes and increase transmission of disease. The study ascertained the proportion of Ugandan TB affected households incurring catastrophic costs and the main cost drivers. Methods A cross-sectional survey with retrospective data collection and projections was conducted in 2017. A total of 1178 drug resistant (DR) TB (44) and drug sensitive (DS) TB patients (1134), 2 weeks into intensive or continuation phase of treatment were consecutively enrolled across 67 randomly selected TB treatment facilities. Results Of the 1178 respondents, 62.7% were male, 44.7% were aged 15–34 years and 55.5% were HIV positive. For each TB episode, patients on average incurred costs of USD 396 for a DS-TB episode and USD 3722 for a Multi drug resistant tuberculosis (MDR TB) episode. Up to 48.5% of households borrowed, used savings or sold assets to defray these costs. More than half (53.1%) of TB affected households experienced TB-related costs above 20% of their annual household expenditure, with the main cost drivers being non-medical expenditure such as travel, nutritional supplements and food. Conclusion Despite free health care in public health facilities, over half of Ugandan TB affected households experience catastrophic costs. Roll out of social protection interventions like TB assistance programs, insurance schemes, and enforcement of legislation related to social protection through multi-sectoral action plans with central NTP involvement would palliate these costs.

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