Cost-effectiveness of chemotherapy for sputum smear-positive pulmonary tuberculosis in Malawi, Mozambique and Tanzania

1994 ◽  
Vol 9 (2) ◽  
pp. 151-181 ◽  
Author(s):  
Eric De Jonghe ◽  
Christopher J. L. Murray ◽  
H. J. Chum ◽  
D. S. Nyangulu ◽  
A. Salomao ◽  
...  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Khalid Bouti ◽  
Mohammed Aharmim ◽  
Karima Marc ◽  
Mouna Soualhi ◽  
Rachida Zahraoui ◽  
...  

Background. Sputum smear-positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following the commencement of treatment. Objective. To determine the time to sputum smear conversion and study the factors influencing it. Design. A prospective study was undertaken at our hospital in Rabat over a six-month period on a cohort of 119 sputum smear positive patients. Patients were followed up fortnightly. At each followup, specimens were collected and processed for microscopy using standard protocol. Results. 96.6% of our patients completed the study (4 deaths). Sputum conversion rate was 42% after two weeks, 73% after one month, and 95% after two months. Univariate and stepwise regression analysis showed that patients who had high smear grading, miliary, and bilateral radiologic lesions were more likely to undergo delayed sputum conversion (P<0.05). Other factors were thought to influence sputum conversion but were not statistically proven in our study. Conclusion. Since viable bacilli continue to be expelled for up to two months, infection control measures should be maintained for such a time. Patients with high smear grading, miliary, and bilateral radiologic lesions need to be monitored more closely.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Daniel Melese Desalegn ◽  
Kumera Terfa Kitila ◽  
Boja Dufera Taddese ◽  
Tinsae Kidanemariam Hailu ◽  
Tariku Takle Dinku ◽  
...  

Background. Prolonged laboratory diagnostic process of tuberculosis can lead to failure to complete the diagnosis and increase dropout rate of smear positive pulmonary tuberculosis (PTB) cases. This implies such dropout patients without completing diagnosis are critical as infected individuals remain untreated in the community, providing more opportunities for transmission of the disease and adversely affecting the epidemic. The aim of this research is to determine the level of smear positive PTB diagnosis dropout rate of spot-morning-spot sputum microscopy diagnosis method in public health facilities, in Addis Ababa, Ethiopia. Methods. Retrospective review of patient documents in 13 public health facilities’ TB laboratory in Addis Ababa was conducted from October 2011 to March 2016. Data was computerized using Epi-info software and analysed using SPSS version 20.0 software. Descriptive numerical summaries were used to present the findings. Association between the dropout rate and demographic variables was assessed by Chi-square (X2). Bivariate model using Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated. P-Value less than 0.05 was taken as statistically significant. Results. Of 41,884 presumptive TB patients registered during the 53 months for laboratory investigation, 5.9% were positive for the first spot sputum smear microscopy. Among these positive cases, 142 (5.8%) and 298 (12.1%) did not come back to the laboratory to submitted early morning and second spot sputum specimens, respectively. The diagnostic dropout for morning sputum specimen in hospitals was 5.6% (58/1039) and in health centres was 5.9% (84/1424). However, higher proportion of dropout for second spot sputum specimen in hospitals was 16.4% (170/1039), compared to the health centres, 8.9% (128/1424). Diagnostic dropout of sputum smear microscopy had no significant association with sociodemographic variable (P value >0.05), while it had significant association with facility type (P value <0.05). Conclusion. In this study smear positive pulmonary tuberculosis diagnostic dropout rate was high compared to WHO reported for the new strategy shift implying the importance of shifting to same-day approach. Hence, shifting from conventional to same day is crucial to minimize the TB diagnostic dropout rate in the study area and other similar settings. Further research is needed/recommended in the local setting to compare the yield and dropout rates between same-day and conventional sputum smear microscopy approach.


2013 ◽  
Vol 57 (5) ◽  
pp. 2199-2203 ◽  
Author(s):  
Andreas H. Diacon ◽  
Rodney Dawson ◽  
Florian Von Groote-Bidlingmaier ◽  
Gregory Symons ◽  
Amour Venter ◽  
...  

ABSTRACTBedaquiline is a new antituberculosis agent targeting ATP synthase. This randomized, double-blinded study enrolling 68 sputum smear-positive pulmonary tuberculosis patients evaluated the 14-day early bactericidal activity of daily doses of 100 mg, 200 mg, 300 mg, and 400 mg bedaquiline, preceded by loading doses of 200 mg, 400 mg, 500 mg, and 700 mg, respectively, on the first treatment day and 100 mg, 300 mg, 400 mg, and 500 mg on the second treatment day. All groups showed activity with a mean (standard deviation) daily fall in log10CFU over 14 days of 0.040 (0.068), 0.056 (0.051), 0.077 (0.064), and 0.104 (0.077) in the 100-mg, 200-mg, 300-mg, and 400-mg groups, respectively. The linear trend for dose was significant (P= 0.001), and activity in the 400-mg dose group was greater than that in the 100-mg group (P= 0.014). All of the bedaquiline groups showed significant bactericidal activity that was continued to the end of the 14-day evaluation period. The finding of a linear trend for dose suggests that the highest dose compatible with safety considerations should be taken forward to longer-term clinical studies.


2017 ◽  
Vol 8 (1) ◽  
pp. 585
Author(s):  
Radita Ikapratiwi ◽  
Indah Rahmawati ◽  
Joko Mulyanto

Tuberculosis (TB) is considered as the leading killer among infectious diseases because of bacteria resulted in a high number ofmorbidity and mortality world wide. One risk factor for tuberculosisis diabetes mellitus (DM). The prevalence of TB and DM jump together globally, especially in developing countries, including Indonesia. Early and accurate diagnosis of TB cases in the enforcement is sputum smear examination. Monitoring of TB seen through sputum conversion. The purpose of this studyis to determine the duration of sputum conversion difference new case smear positive pulmonary TB patients with and without DM in hospital Prof. Dr.Margono Soekarjo (RSMS) Purwokerto. Thestudy design is observational analytic with cohort retrospective study. Sample of this study was patients who checked their health in Lung Clinis of RSMS Purwokerto obtained total sample of 44 people, consisting of 22 patients clinically diagnosed new cases smear-positive pulmonary TB with DM and 22 patients without DM in 2009 until 2012.Results of this study were analyzed using Fisher Exact Test. pvalues obtainedof 0.000 (p <0.05) (95% CI = 0,288-0,718) with relative risk 0,455. The conclusion is there were significant differences in sputum conversion time between the group of patients suffering from pulmonary uberculosis with and without DM. The conversion of sputum in patients with pulmonary tuberculosis who suffered DM is longer than patients without DM. Relative risk value which is equal to 0.455 which means that patients with DM have pulmonary tuberculosis risk by 0.455 times more likely to experience delays in sputum conversion than TB patients without DM


2019 ◽  
Vol 3 (1) ◽  
pp. 17-20
Author(s):  
Ram Bahadur Nepali ◽  
Damaru Prasad Paneru

Tubercular infection is still a pervasive public health problem in Nepal despite the massive efforts of National Health Service stakeholders. High bacterial infectivity, transmissibility, increasing drug resistance and non compliance to the therapy have been adding up challenges to prevention and control of tuberculosis. This study was conducted to observe the treatment compliance pattern among new pulmonary sputum smear positive cases of tuberculosis. A cross sectional study was carried out in the year 2009. The 114 new smear positive pulmonary tuberculosis patients registered in the six selected DOTS centres of the Banke Disrtict were randomly selected. Participants were selected from each DOTS centre by probability proportionate sampling methods. Data were analyzed by SPSS (11.0 Version) and P< 0.05 was considered as significant. Overall compliance to DOTS was 86.80 percent; of these, 57.00 percent showed excellent and regular compliance followed by nearly 30 percent good compliance. And 13.20 percent participants were non complaint to DOTS therapy. Positive Family behaviors were positively associated with compliance while alcohol consumption was found to be negatively associated with compliance however; age, sex and income were found to be non significant factors for compliance. Feeling of getting cure even before the course of DOTS therapy (feeling better after 2-3 months regular treatment) and drinking habits were found to be the major causes of non compliance. Supportive family behaviors and avoidance of alcohol consumption may promote the compliance. Excellent treatment compliance in the face of many odds is highly encouraging and the pattern can be useful in treatment despite little non compliances; furthermore compliance can be enhanced by acting on these causes of non compliances. Key words: Pulmonary, Tuberculosis, DOTS, Banke, Nepal


2016 ◽  
Vol 4 (3) ◽  
pp. 184
Author(s):  
Tauseef Ahmad ◽  
Haroon Haroon ◽  
Faisal Nouroz ◽  
Amar Nath ◽  
Sabihuddin Sabihuddin ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document