Study about Tuberculosis in Thailand: An approach to Treatment, GIS and Sichon Model

Author(s):  
Arak Wongworachat ◽  
Kunagorn Nituton ◽  
Choosak Nithikathkul

In this study, we seek to identify geographical areas where ongoing tuberculosis epidemiological characteristics is occurring by linking Geographic Information Systems (GIS) technology in Thailand. In addition, we seek to assess how the directly observed treatment short-course (DOTS) program improved new tuberculosis diagnosis and treatment successes in Sichon District, Nakhon Si Thammarat province, Thailand from 2014 to 2016. The assessment program included seven indicators, and the results revealed that 73 new cases of tuberculosis were admitted for treatment on average every year, with rates of risk group screening findings of 4.28, 5.23, and 6.04 %, respectively. Patients who come to the hospital for diagnosis make up most of the demographic. However, only a minor proportion of patients are identified through community-based primary screening. In the years 2013-2016, the mortality rate of TB cases is expected to rise by 10.25 %, 4.25 %, and 5.56 %, respectively. The elderly and HIV-positive patients comprise most of the TB mortality population. When completing the DOTS program at a hospital, however, the rate of success has fallen short of the targets. Furthermore, the screening technique excludes the target group. As a result, people suffering tuberculosis are reported to be slower and more susceptible to symptoms. As a result, researchers advise that the DOTS program be supported by enhancing treatment follow-up to improve the effectiveness of TB treatment and collaboration with health care worker (HCW).

2014 ◽  
Vol 289 (44) ◽  
pp. 30190-30195 ◽  
Author(s):  
Sultan Tousif ◽  
Dhiraj Kumar Singh ◽  
Shaheer Ahmad ◽  
Prashini Moodley ◽  
Maitree Bhattacharyya ◽  
...  

Tuberculosis (TB) remains the second highest killer from a single infectious disease worldwide. Current therapy of TB is lengthy and consists of multiple expensive antibiotics, in a strategy referred to as Directly Observed Treatment, Short Course (DOTS). Although this therapy is effective, it has serious disadvantages. These therapeutic agents are toxic and are associated with the development of a variety of drug-resistant TB strains. Furthermore, patients treated with DOTS exhibit enhanced post-treatment susceptibility to TB reactivation and reinfection, suggesting therapy-related immune impairment. Here we show that Isoniazid (INH) treatment dramatically reduces Mycobacterium tuberculosis antigen-specific immune responses, induces apoptosis in activated CD4+ T cells, and renders treated animals vulnerable to TB reactivation and reinfection. Consequently, our findings suggest that TB treatment is associated with immune impairment.


Reports ◽  
2018 ◽  
Vol 1 (3) ◽  
pp. 25
Author(s):  
Sarvath Ali ◽  
Marepalli Rao ◽  
Ahmed Sahly ◽  
Abdulazeez Alfageeh ◽  
Abdulrahman Bakari

Tuberculosis (TB) is a global public health concern, specifically in countries which have high prevalence of HIV/AIDS, malnutrition, unhygienic conditions, etc. Some evidence has been presented that diabetes mellitus (DM) is a risk factor for TB. On the other hand, among those who have DM, TB infection enhances glucose intolerance and worsens glycemic control. The combination of TB and DM, due to immuno-compromised status of DM, can delay the healing process of TB. The focus of this paper is the World Health Organization directly observed treatment, short course (DOTS) program implemented in Gazan province, Saudi Arabia, to treat TB. The data included some patients with both TB and DM. The data has been analyzed to assess how effective the DOTS program was in managing TB. It was found that DM was not a significant factor in the outcome of TB treatment. We used the same data and observed that the non-significance of DM is due to heterogeneity of patient population, Saudis and Non-Saudis. The prevalence of DM was very high among Saudis. This is understandable in view of different lifestyles. Non-Saudis are predominantly Yemenis. For Saudis, DM was indeed found to play a role in the treatment outcome of TB, after an application of a classification tree methodology on the data. This is the main focus of the paper.


2016 ◽  
Vol 44 ◽  
pp. 229-251 ◽  
Author(s):  
Rachel Fanelwa Ajayi ◽  
Ezo Nxusani ◽  
Samantha F. Douman ◽  
Anovuyo Jonnas ◽  
Nomaphelo Ntshongontshi ◽  
...  

The Directly Observed Treatment, Short-course (DOTS) constitutes the main strategy for the control of tuberculosis (TB). However, isoniazid (INZ) one of the drugs used in the regimen is potentially hepatotoxic and may lead to drug-associated hepatitis. During TB treatment, regular follow up is essential to ensure adherence to therapy and facilitate clinical monitoring of INZ to prevent hepatic dysfunction for those patients at risk of drug-induced hepatotoxicity. Proposed herein is a sensitive and simple electrochemical method for the determination of INZ where the proposed PANSA/PVP-AgNPs/CYP2E1 modified Au electrode provides strong electrocatalytic activity toward INZ. High Resolution Transmission Microscopy (HR-TEM) and Electrochemical Impedance Spectroscopy (EIS) studies of PANSA/PVP-AgNPs/CYP2E1 revealed that the nanocomposite PANSA/PVP-AgNPs is highly electroactive and biocompatible with a morphology ideal for the immobilization of CYP2E1. With the advantages of a wide linearity (2 µM – 22 µM) which covers the peak INZ serum level value of 3 µg/mL (22 µM), a good sensitivity of 1.25 µA/ µM and a low detection limit of 0.65 µM, this proposed nanobiosensor holds great potential for the determination of INZ in human samples. The practicality of the nanobiosensor has been successfully demonstrated through the determination of INZ in commercially available pharmaceutical tablets using steady state amperometry, CV and DPV. Michaelis-Menten parameters such as KM, KMapp and IMAX were calculated to be 1.9 x 10-6 A, 1.34 µM and 5.8 µM respectively thus confirming the suitability of the proposed nanobiosenors for use in human samples.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048369
Author(s):  
Berhane Megerssa Ereso ◽  
Mette Sagbakken ◽  
Christoph Gradmann ◽  
Solomon Abebe Yimer

ObjectiveTo compare tuberculosis (TB) treatment outcomes and associated factors among patients attending community-based versus facility-based directly observed treatment, short course (DOTS).DesignA prospective cohort study.SettingThe study was conducted in Southwest Ethiopia. There were seven hospitals (five primary, one general and one specialised), 120 health centres and 494 health posts.ParticipantsA total of 1161 individuals consented to participate in the study (387 patients under community-based DOTS (CB-DOTS) and 774 patients under facility-based DOTS (FB-DOTS)). Individuals who could not respond to the questions, mentally or critically ill patients, and those less than 15 years old, were excluded from the study.Primary outcome measureTB treatment outcomes were compared among patients under CB-DOTS versus FB-DOTS. Risk ratio (RR), risk difference (RD) and confidence interval (CI) were calculated among the study groups. In addition, χ2 or Fisher’s exact tests were used to compare group differences, with a p value of <0.05 considered statistically significant.ResultsPatients who opted for CB-DOTS were more likely to be cured by 12% than those who opted for FB-DOTS (RR=1.12, 95% CI=0.96 to 1.30). Patients under CB-DOTS had a lesser risk of death (RR=0.93, 95% CI=0.49 to 1.77) and a lower risk of treatment failure (RR=0.86, 95% CI=0.22 to 3.30) than those under FB-DOTS. Furthermore, patients who opted for CB-DOTS were less likely to have a positive sputum smear result at the end of the treatment period (p=0.042) compared with their counterparts.ConclusionThe study showed that CB-DOTS is more effective than FB-DOTS in terms of improving cure rate and sputum conversion rate, as well as lowering treatment failure rate. Our findings show the need for scaling up and a further decentralisation of CB-DOTS approach to improve access to TB treatment service for the rural community.


2019 ◽  
Vol 13 (02) ◽  
pp. 123-129
Author(s):  
Yi-Wen Huang ◽  
Chang-Yao Tsao ◽  
Wei-Wen Chen ◽  
Pai-Sheng Yen ◽  
Jen-Jyh Lee ◽  
...  

Introduction: Directly Observed Treatment Short course (DOTS) is one of the most cost-effective approaches for TB treatment. However, TB incidence rates remain high in the mountain areas of Taiwan. A lay health advisor (LHA) strategy is integrated into DOTS as an Enhanced-DOTS (E-DOTS) to provide trustworthy, culturally-specific services in mountain areas that consider the characteristics of local ethnic groups. Methodology: We recruited two Taiwanese indigenes as LHAs (one for each county) to screen close contacts in five townships of Hualien and Nantou counties from January 1, 2011 to December 31, 2013. Incidence and active finding rates of TB during the E-DOTS periods (2011-2013 for Hualien and 2012-2013 for Nantou) were compared with data when traditional DOTS was implemented (2006-2010 for Hualien and 2006-2011 for Nantou) to evaluate the effectiveness of E-DOTS using the before-and-after study design. Results: Incidence rate in Hualien decreased from 393.3 in 2011 to 235.7 in 2013 per 100,000 population and from 338 in 2012 to 235.5 in 2013 in Nantou mountain area. Furthermore, the active case finding rate increased from 15.42% in 2012 to 27.38% in 2013 as compared to an average of 6.5% for CDC, Taiwan, for the specified years. TB treatment success rates were significantly improved from an average of less than 80% to an average of higher than 90% after E-DOTS was implemented. Conclusions: Our findings highlighted that the use of LHAs in E-DOTS is an effective and applicable strategy for controlling tuberculosis in the mountain areas of Taiwan.


Author(s):  
Aisyah Lahdji

ABSTRACTPulmonary tuberculosis is a disease that until now has a high morbidity rate, including in Indonesia. Indonesia ranks second with the highest TB burden in the world. From 2013 to 2016, the percentage of the success rate of treatment in Semarang City was 83%, where the lift was still below the target of 90% and in the health profile of the Bangetayu Primary Health Care Semarang, the cure rate was 55% and complete treatment was 34%. One of the controls in TB disease is treatment with the Directly Observed Treatment Short-Course (DOTS) system by monitoring medication. The existence of these efforts still cannot increase the success rate of TB treatment. The purpose of this study was to analyze the scope of achievement of the success of pulmonary TB treatment in Bangetayu Primary Health Care in terms of service quality aspects. This study included descriptive observational research with a qualitative approach. Data collection in this study used interviews and observations by determining the source with the snowball sampling method, namely the head of the health care, the person in charge of the P2P program, the holder of the pulmonary TB program and laboratory officer. This research was conducted at Bangetayu Primary Health Care in November 2018 to December 2018. Assessment of service quality is seen from the aspects of input, process and 5 dimensions of service quality. The results of the study found that the quality of management services from input, process and 5 dimensions of service quality at the Bangetayu Primary Health Care were good. The conclusion of this study is that the Bangetayu Primary Health Care has implemented TB service management well, even though the achievements of TB treatment have not met the target, so that the failure to achieve success in TB treatment in Bangetayu Primary Health Care, Semarang is not caused by health service factors.Keywords                   : Pulmonary tuberculosis, Bangetayu Primary Health Care, service qualityCorrespondence to      : [email protected]   ABSTRAKTuberculosis Paru (TB Paru) adalah  penyakit yang sampai saat ini memiliki angka kesakitan yang tinggi termasuk di Indonesia. Indonesia menduduki peringkat kedua dengan nilai beban TB tertinggi di dunia. Dari tahun 2013 hingga tahun 2016, presentase angka keberhasilan pengobatan di Kota Semarang sebesar 83%, dimana angkat tersebut masih berada dibawah target sebesar 90% . Pada profil kesehatan Puskesmas Bangetayu Semarang, didapatkan angka kesembuhan sebesar 55% dan pengobatan lengkap sebesar 34%. Salah satu pengendalian pada penyakit TB adalah pengobatan dengan system Directly Observed Treatment Short-Course (DOTS) dengan pemantauan minum obat. Adanya upaya tersebut masih belum bisa meningkatkan angka keberhasilan pengobatan TB secara optimal. Tujuan penelitian ini adalah untuk menganalisis  capaian keberhasilan pengobatan TB paru di Puskesmas Bangetayu yang ditinjau dari aspek mutu pelayanan. Penelitian ini termasuk penelitian deskriptif observatif dengan pendekatan kualitatif. Pengumpulan data pada penelitian ini menggunakan wawancara dan observasi dengan penentuan narasumber dengan metode snowball sampling, yaitu kepala puskesmas, penanggungjawab program P2P dan pemegang program TB paru, petugas Laboratorium. Penelitian ini dilakukan di Puskesmas Bangetayu Semarang pada bulan November 2018 hingga Desember 2018. Penilaian mutu pelayanan dilihat dari aspek input, proses dan 5 dimensi mutu pelayanan. Hasil penelitian didapatkan bahwa mutu pelayanan manajemen dari input, proses dan 5 dimensi mutu pelayanan di Puskesmas Bangetayu Semarang sudah baik. Kesimpulan pada penelitian ini adalah Puskesmas Bangetayu sudah  menerapkan manajemen pelayanan TB dengan baik, meskipun capaian keberhasilan pengobatan TB belum memenuhi target, sehingga ketidakberhasilan capaian keberhasilan pengobatan TB di Puskesmas Bangetayu, Semarang tidak disebabkan oleh faktor pelayanan kesehatan.Kata Kunci     : TB Paru, puskesmas bangetayu, mutu pelayananKorespondensi : [email protected]


2021 ◽  
Vol 9 ◽  
pp. 205031212198949
Author(s):  
Cylia Nkechi Iweama ◽  
Olaoluwa Samson Agbaje ◽  
Prince Christian Ifeanachor Umoke ◽  
Chima Charles Igbokwe ◽  
Eyuche Lawretta Ozoemena ◽  
...  

Introduction: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients’ treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. Methods: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients’ demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence ( P < 0.05) Results: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00–0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92–232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38–271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00–0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12–0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6–304.3) were associated with tuberculosis medication nonadherence. Conclusion: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.


Sign in / Sign up

Export Citation Format

Share Document