Phase-wise comparison of depression and stigma among tuberculosis patients undergoing treatment in Dhaka, Bangladesh
Phase-wise comparison of depression and stigma among tuberculosis patients undergoing treatment in Dhaka, Bangladesh
- Research Article
10
- 10.1016/j.puhe.2015.04.010
- May 18, 2015
- Public Health
Duration of treatment in pulmonary tuberculosis: are international guidelines on the management of tuberculosis missing something?
- Research Article
- 10.30978/tb-2023-2-7
- Jun 22, 2023
- Tuberculosis, Lung Diseases, HIV Infection
Current methods of investigation in TB patients, namely sputum microscopy, culture, and molecular genetic methods, although well-studied, have a number of disadvantages, such as low sensitivity, long time required to obtain results, or high cost. Because of this, the search for alternative diagnostic tools and methods for predicting the course and effectiveness of treatment in patients with tuberculosis becomes relevant. In this study, ferritin, interleukin-6 (IL-6), and human-beta-defensin-1 (HBD-1) were selected for comparison of prognostic performance. Objective — to investigate the dynamics of ferritin, IL-6, and human-beta-defensin-1 levels against the background of the intensive phase of pulmonary tuberculosis therapy and to identify the most effective marker for predicting the effectiveness of treatment. Materials and methods. 100 patients with pulmonary tuberculosis and 20 healthy individuals were included in the study. Examination of patients was carried out according to the current standards of providing medical care to tuberculosis patients. In addition, the patients' fasting blood ferritin, IL-6 and HBD-1 levels were determined at the beginning of treatment and after 60 days. Healthy individuals from the control group had a single determination of ferritin, IL-6 and HBD-1 blood levels on an empty stomach. Results and discussion. At the beginning of treatment, the ferritin level was significantly lower (95.95 ± ± 8.68) ng/ml in patients who later effectively completed the intensive phase of anti-tuberculosis treatment than in patients with ineffective intensive phase of treatment (152.27 ± 8.85) ng/ml. The same trend persisted after 60 days: in the effective intensive phase — (123.87 ± 13.39) ng/ml, in the ineffective one — (239.76 ± 12.91) ng/ml, p < 0.05. In effective intensive phase of antituberculosis treatment, the level of IL-6 was significantly lower. Thus, at the beginning of treatment, it was (82.59 ± 6.89) pg/ml in patients with an effective intensive phase of treatment and (146.42 ± 8.04) pg/ml in patients with ineffective intensive treatment phase. After 60 days, it was (48.88 ± 4.19) pg/ml in patients with an effective intensive phase of treatment and (142.89 ± 9.11) pg/ml in patients with ineffective intensive treatment phase, p < 0.05. The level of HBD-1 was higher when the intensive phase of antituberculosis therapy was ineffective, as when measured at the beginning of treatment (effective intensive phase — (18.71 ± 3.31) pg/ml, ineffective intensive phase — (32.79 ± 8.31) pg/ml), as well as when measured after 60 days (effective intensive phase — (19.93 ± 3.58) pg/ml, ineffective intensive phase — (42.92 ± 12.99) pg/ml, p < 0.05). Conclusions. Levels of ferritin, IL-6 and HBD-1 are significantly increased in tuberculosis patients compared to healthy individuals, which allows them to be considered as markers of tuberculosis inflammation. Higher concentrations of these markers, both at the beginning of treatment and after 60 doses, are predictors of failure of antituberculosis therapy. The strongest relationship between the studied markers and parameters of the severity of the tuberculosis process is observed in the study of HBD-1, which allows us to consider it as the most effective marker of the severity of the course among presented ones.
- Research Article
1
- 10.4103/ijh.ijh_58_20
- Jan 1, 2021
- Iraqi Journal of Hematology
BACKGROUND: Hematological changes involving all blood cells are some of the most common complications in both tuberculosis (TB) and malaria infection. The changes induced by malaria infection are diverse, and the first line anti-TB treatment regimen which involves two phases may alter these changes in TB participants co-infected with malaria (TB/MP).OBJECTIVE: In this study, we aimed to ascertain the impact of malaria co-infection on leukocyte indices of TB-infected participants at pre-treatment, intensive and continuation phase therapy.MATERIALS AND METHODS: In this cross-sectional study, 180 participants were recruited comprising; 60 (35 TB and 25 TB malaria) participants before treatment, sixty (36 TB and 24 TB-Malaria) participants after intensive phase treatment and sixty (27 TB and 33 TB-Malaria) participants after continuation phase therapy. Whole blood was used for the measurement of total (total white blood cell [TWBC]) and differential white cell count, Platelet count, and packed cell volume (PCV).RESULTS: Before initiation of treatment, TWBC, neutrophil, lymphocyte, platelet count, and neutrophil-lymphocyte ratio were significantly reduced (P = 0.041, 0.022, 0.046, and 0.026, respectively), whereas eosinophil count was significantly increased in TB/Malaria participants compared to TB participants (P = 0.043). There was no significant change in these parameters after intensive phase treatment (P > 0.05). However, after continuation phase treatment, PCV was significantly reduced, while eosinophil was significantly increased in TB/Malaria participants compared with TB participants (P = 0.046 and 0.045, respectively).CONCLUSION: Malaria co-infection induces the significant reduction in leukocyte indices of TB patients at pretreatment but not at the intensive and continuation phase anti-TB therapy except eosinophils count which was increased before treatment and continuation phase treatment.
- Research Article
68
- 10.1001/jama.286.5.599
- Aug 1, 2001
- JAMA
Tuberculosis (TB) is an increasing global problem, despite effective drug therapies. Access to TB therapy during conflict situations has not been studied. To determine the effect of irregular TB treatment due to an armed conflict in Guinea-Bissau, West Africa. Ongoing retrospective cohort study conducted in the capital city of Bissau among 101 patients with TB who received irregular or no treatment during the civil war (war cohort; June 7-December 6, 1998) and 108 patients with TB who received treatment 12 months earlier (peace cohort; June 7-December 6, 1997) and comparison of an additional 42 patients who had completed treatment before June 6, 1998, and 69 patients who had completed treatment before June 6, 1997. Mortality rates, compared by irregular (war cohort) vs regular (peace cohort) access to treatment, by intensive vs continuation phase of treatment, and by those who had previously completed treatment for TB. Irregular treatment was associated with an increased mortality rate among patients with TB. The mortality rate ratio (MR) was 3.12 (95% confidence interval [CI], 1.20-8.12) in the war cohort, adjusting for age, sex, human immunodeficiency virus (HIV) infection, residence, and length of treatment. Each additional week of treatment before the war started increased probability of survival by 5% (95% CI, 0%-10%). In the intensive phase of treatment, the adjusted MR was 3.30 (95% CI, 1.04-10.50) and in the continuation phase it was 2.26 (95% CI, 0.33-15.34). Increased mortality among the war cohort was most marked in HIV-positive patients, who had an adjusted MR of 8.19 (95% CI, 1.62-41.25). Mortality was not increased in HIV-positive or HIV-negative patients who had completed TB treatment when the war started. Interruption of treatment had a profound impact on mortality among patients with TB during the war in Guinea-Bissau. Regular treatment for TB was associated with significantly improved survival for HIV-infected individuals. In emergencies, it is crucial to ensure availability of TB drugs.
- Research Article
2
- 10.7759/cureus.30827
- Oct 29, 2022
- Cureus
Background Psychiatric disorders, particularly depression is prevalent among patients with tuberculosis (TB) and affect their treatment compliance. Patients with tuberculosis can develop depression due to multiple factors like longer treatment duration, social stigma, lack of family support, etc.In this study, depression and its associated factors were examined among patients with tuberculosis enrolled in a directly observed treatment short-course (DOTS) center in North Delhi. Methods In this DOTS center-based, cross-sectional study, 320 patients with pulmonary and extra-pulmonary TB above 18 years old were included. Basic socio-demographic information was gathered using a Hindi questionnaire, and depression was identified using the patient health questionnaire-9. People who received a score of 10 or higher were deemed to have depression. The Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY, USA) was used for data analysis. Analysis between depression and no-depression groups was done by the chi-square test and a p-value< 0.05 was considered statistically significant. Results The study involved 320 patients in all, 193 (60.3%) of whom were men. The median age was 38 years, and the interquartile range (IQR) was 24 to 52 years. Depression was found to be present in half of the patients. Patients with a higher proportion of depression were male, belonged to the middle or below socio-economic status, were currently unemployed and literate, had monthly family income less than 8000 rupees, weight below 45 kg, used alcohol and tobacco, and were undergoing intensive phase (IP) of TB treatment (p-value< 0.05). Depression was not found to be associated with age, site of TB, previous history of anti-tubercular treatment (ATT) intake, marital status, and family size. Conclusion Depression among patients with TB is common and affects half of the patients afflicted with it. When evaluating patients with TB, physicians and DOTS providers should have a high index of suspicion for depression.
- Research Article
5
- 10.1093/pubmed/fdac141
- Nov 30, 2022
- Journal of Public Health
Tuberculosis (TB) is well-known for causing wasting. Patients on treatment gain weight and weight loss is associated with unfavorable treatment outcomes. There is limited description of weight loss and its predictors during intensive treatment phase. The objective of this study was to assess the predictors of weight loss during intensive phase and to see if there is any association exists with sputum conversion at the end of intensive phase of treatment. Data collected as a part of the prospective TB cohort (Regional Prospective Observational Research for TB India Phase 1) conducted in Pondicherry, Cuddalore and Viluppuram districts of Tamil Nadu were used for this study. Sputum smear and body weight comparison were made in the baseline and at the end of second month of treatment. In all, 726 participants had weight measurements at the two time points and 18.7% had weight loss; mean weight lost being 2.3kg (SD 3.05). Mean weight loss was more among males (2.4kg, SD 3.2), diabetics (2.8kg, SD 3.9) and alcoholics (2.1kg, SD 2.4). Alcohol consumption was the only predictor of weight loss after adjusting for age, diabetes, marital status and BMI (aRR 1.52, P 0.02). Weight loss was not associated with sputum conversion at the end of second month. Alcohol use emerged as the major predictor for weight loss during intensive phase.
- Research Article
- 10.3389/fmed.2025.1472295
- Mar 26, 2025
- Frontiers in medicine
A prediction model is hereby developed to identify poor treatment outcomes during the intensive phase in patients with initial treatment of pulmonary tuberculosis (TB). The data of inpatients with pulmonary TB were collected from a tertiary hospital located in Southeastern China from July 2019 to December 2023. The included patients were divided into the modeling group and the validation group. The outcome indicator was based on a comparison of pulmonary CT findings before and after the two-month intensive phase of anti-TB treatment. In the modeling group, the independent risk factors of pulmonary TB patients were obtained through logistic regression analysis and then a prediction model was established. The discriminative ability (the area under the curve of the receiver operating characteristic, AUC), its calibration (GiViTI calibration chart), and its clinical applicability (decision curve analysis, DCA) were respectively evaluated. In addition, the prediction effectiveness was compared with that of the machine learning model. A total of 1,625 patients were included in this study, and 343 patients had poor treatment outcomes in the intensive phase of anti-TB treatment. Logistic regression analysis identified several independent risk factors for poor treatment outcomes, including diabetes, cavities in the lungs, tracheobronchial TB, increased C-reactive protein, and decreased hemoglobin. The AUC values were 0.815 for the modeling group and 0.851 for the validation group. In the machine learning models, the AUC values of the random forest model and the integrated model were 0.821 and 0.835, respectively. The prediction model established in this study presents good performance in predicting poor treatment outcomes during the intensive phase in patients with pulmonary TB.
- Research Article
- 10.1002/jia2.26483
- Jul 1, 2025
- Journal of the International AIDS Society
Differentiated service delivery (DSD) models aim to tailor health services delivery to clients' preferences and clinical characteristics while reducing the burden on health systems. In Uganda, DSD models developed for HIV care were adapted to the tuberculosis (TB) services context to mitigate disruptions from the COVID-19 pandemic and inform national efforts to improve TB care. Beginning in April 2021, four facility-based and five community-based DSD models were implemented in 28 TB clinics in Kampala and Soroti Regions. All clients in the intensive (months 1-2) and continuation (months 3-6) phases of treatment were eligible. Client preference and clinician concurrence determined model choice. All models allowed TB medication dispensing intervals ranging from biweekly to multi-month dispensing (MMD; ≥2 months). Data abstracted in December 2022 from TB registers and DSD enrolment tracking tools at 21 of 28 implementing facilities were used to evaluate the intervention. The TB treatment success rate (i.e. proportion cured or who completed treatment, vs. those who died, failed, were lost-to-follow-up or had no recorded outcome) in the DSD cohort was compared to facilities' 2018-2019 results using Fischer's exact test. Most facilities offered one (Kampala) or two (Soroti) facility-based models and one community-based model. Among 1864 TB clients enrolled between April 2021 and March 2022, 1822 (97.7%) used ≥1 DSD models; 210/1822 (11.5%) ever switched models. Overall, 70.5% (1284/1822) of clients enrolled in ≥1 facility-based model and 40.5% (737/1822) in ≥1 community-based model. The use of community-based models increased during the continuation phase. Facility-Based Individual Management and Home Delivery were the most-used models. In the intensive phase, the longest medication dispensation interval was biweekly for 50.0% of patients, monthly for 41.3% and MMD for 8.8%. During the continuation phase, the longest interval was biweekly for 0.6%, monthly for 71.7% and MMD for 27.6%. Overall, 1582/1864 (84.9%) clients were successfully treated, compared to 858/1177 (72.9%) in 2018-2019 (p<0.001). Seven (0.4%) patients failed treatment, 32 (1.7%) were lost to follow-up, 101 (5.4%) died and 142 (7.6%) were not evaluated. TB DSD models were successfully implemented. TB treatment outcomes under DSD compared favourably to historical outcomes. Investigating factors affecting MMD use and model choice could further inform programme design.
- Research Article
1
- 10.4103/2277-8632.117183
- Jan 1, 2013
- Journal of Dr. NTR University of Health Sciences
Background: Default remains an important challenge and a threat for tuberculosis (TB) control. Aims and Objectives: Objectives of the study were to analyze timing of treatment interruption and pattern of default among TB patients on directly observed treatment, short-course under Revised National Tuberculosis Control Programme. Materials and Methods: The present cross sectional study was conducted among the cohort of patients registered during January 2011 to September 2011 at the Tuberculosis Unit, Ambala city. Number of interruptions/doses missed, number, and timing of default were taken from TB register and treatment cards. Results: Out of 80 defaulters, majority (50,62.5%) defaulted in the continuation phase of treatment. Out of these 50 patients, 31 were new and remaining 19 were from previously treated categories. In category I, maximum default was seen in the third month of treatment ( 2.84%). The cumulative default rate at the end of second month was 2.57%. The default rate at the end of the eighth month, when all patients were censored, was 8.18%. In category II, maximum default (3.61%) occurred in the fourth month. The cumulative default rate by the end of third month was 13.92%; and by the end of eighth month, 21.76%. The default rate by the end of the tenth month, by which time all patients were censored, was 21.76%. Conclusions: Patient defaulting from treatment remains a matter of concern. Factors behind higher default rate in continuation phase need to be explored. Default in intensive phase of treatment and without smear conversion at the end of intensive phase should be retrieved on a priority basis.
- Research Article
14
- 10.1111/tmi.13371
- Feb 3, 2020
- Tropical Medicine & International Health
Shortening tuberculosis (TB) treatment duration is a research priority. We tested the efficacy and safety of 3- and 4-month regimens containing moxifloxacin in a randomised clinical trial in pulmonary TB (PTB) patients in South India. New, sputum-positive, adult, HIV-negative, non-diabetic PTB patients were randomised to 3- or 4-month moxifloxacin regimens [moxifloxacin (M), isoniazid (H), rifampicin (R), pyrazinamide (Z) and ethambutol (E)] or to a control regimen (2H3 R3 Z3 E3 /4R3 H3 ) [C]. The 4 test regimens were 3R7 H7 Z7 E7 M7 [M3], 2R7 H7 Z7 E7 M7 /2R7 H7 M7 [M4], 2R7 H7 Z7 E7 M7 /2R3 H3 M3 [M4-I] or 2R7 H7 Z7 E7 M7 /2R3 H3 E3 M3 [M4-IE]. Treatment was directly observed. Clinical and bacteriological assessments were done monthly during treatment and for 24months post-treatment. The primary end point was TB recurrence post-treatment. Of 1371 patients, randomised, modified intention-to-treat (ITT) analysis was done in 1329 and per-protocol (PP) analysis in 1223 patients. Regimen M3 was terminated due to high TB recurrence rates. 'Favourable' response at end of treatment was 96-100% in the moxifloxacin regimensand 93% in the control regimen. Among these, the TB recurrence occurred in 4.1% in the M4 regimen and in 4.5% in the control regimen and demonstrated equivalence within a 5% margin (95% CI -3.68, 4.55). Similar findings were observed in modified ITT analysis. The TB recurrence rates in the M4-I and M4-IE regimens did not show equivalence with the control regimen. Sixteen (1.4%) of 1087 patients in the moxifloxacin regimens required treatment modification. The 4-month daily moxifloxacin regimen [M4] was found to be equivalent and as safe as the 6-month thrice-weekly control regimen.
- Research Article
7
- 10.1097/md.0000000000026841
- Aug 6, 2021
- Medicine
Smear-positive pulmonary tuberculosis (SPPTB) is the major contributor to the spread of tuberculosis (TB) infection, and it creates high morbidity and mortality worldwide. The objective of this study was to determine the predictors of delayed sputum smear conversion at the end of the intensive phase of TB treatment in Kota Kinabalu, Malaysia.This retrospective study was conducted utilising data of SPPTB patients treated in 5 TB treatment centres located in Kota Kinabalu, Malaysia from 2013 to 2018. Pulmonary TB (PTB) patients included in the study were those who had at least completed the intensive phase of anti-TB treatment with sputum smear results at the end of the 2nd month of treatment. The factors associated with delayed sputum smear conversion were analyzed using multiple logistic regression analysis. Predictors of sputum smear conversion at the end of intensive phase were evaluated.A total of 2641 patients from the 2013 to 2018 periods were included in this study. One hundred eighty nine (7.2%) patients were identified as having delayed sputum smear conversion at the end of the intensive phase treatment. Factors of moderate (advanced odd ratio [aOR]: 1.7) and advanced (aOR: 2.7) chest X-ray findings at diagnosis, age range of >60 (aOR: 2.1), year of enrolment 2016 (aOR: 2.8), 2017 (aOR: 3.9), and 2018 (aOR: 2.8), smokers (aOR: 1.5), no directly observed treatment short-course (DOTS) supervisor (aOR: 6.9), non-Malaysian citizens (aOR: 1.5), and suburban home locations (aOR: 1.6) were associated with delayed sputum smear conversion at the end of the intensive phase of the treatment.To improve sputum smear conversion success rate, the early detection of PTB cases has to be fine-tuned so as to reduce late or severe case presentation during diagnosis. Efforts must also be in place to encourage PTB patients to quit smoking. The percentage of patients assigned with DOTS supervisors should be increased while at the same time ensuring that vulnerable groups such as those residing in suburban localities, the elderly and migrant TB patients are provided with proper follow-up treatment and management.
- Research Article
3
- 10.4103/ijmy.ijmy_174_20
- Jan 1, 2020
- International Journal of Mycobacteriology
Tuberculosis and malaria (TB/MP) co-infection generates severe pathology that affects the levels of cytokines and hemostatic parameters than either disease. Anti-TB treatment regimen involves phases of different drug cocktails that may additionally modulate the levels of inflammatory cytokines and hemostatic parameters. This study investigated the variations in the levels of hemostatic and inflammatory markers when compared between TB patients with and without malaria at pretreatment, intensive, and continuation phase treatment. In this cross-sectional study, 180 patients were recruited comprising; 35 TB-only and 25 TB/malaria patients at pretreatment, 36 TB-only and 24 TB/malaria patients at intensive phase treatment, and 27 TB-only and 33 TB/malaria patients at continuation phase therapy. P-selectin (P-SEL), platelet-activating factor (PAF), platelet factor-4, GP IIb/IIIa complex, tumor necrosis factor-alpha (TNF-α), interleukin (IL)-10, IL-6, IL-2, transforming growth factor (TGF)-β, and thrombopoietin (TPO) were assayed using enzyme-linked immunosorbent assays. Mann-Whitney test and Spearman's rank correlation were applied for statistical test. At pretreatment, the median levels of IL-6 and IL-10 were significantly lowered, while P-selectin (P-SEL), GP IIb/IIIa, and PAF were significantly increased in TB/malaria patients compared to TB patients without malaria. At intensive treatment, TNF-α, IL-6, and IL-2 were significantly higher, while IL-10 and PAF were significantly reduced in TB/malaria patients compared with TB patients without malaria. At continuation phase treatment, TNF-α, IL-6, TGF-β, PF4, GP IIb/IIIa, and TPO were significantly reduced, while P-SEL was significantly increased in TB/malaria patients compared with TB patients without malaria. Differences in the levels of inflammatory cytokines and hemostatic markers between TB patients co-infected with malaria and nonmalaria-infected TB patients vary with anti-TB treatment.
- Research Article
45
- 10.2196/16634
- Jul 31, 2020
- JMIR mHealth and uHealth
Background99DOTS is a cell phone–based strategy for monitoring tuberculosis (TB) medication adherence that has been rolled out to more than 150,000 patients in India’s public health sector. A considerable proportion of patients stop using 99DOTS during therapy.ObjectiveThis study aims to understand reasons for variability in the acceptance and use of 99DOTS by TB patients and health care providers (HCPs).MethodsWe conducted qualitative interviews with individuals taking TB therapy in the government program in Chennai and Vellore (HIV-coinfected patients) and Mumbai (HIV-uninfected patients) across intensive and continuation treatment phases. We conducted interviews with HCPs who provide TB care, all of whom were involved in implementing 99DOTS. Interviews were transcribed, coded using a deductive approach, and analyzed with Dedoose 8.0.35 software (SocioCultural Research Consultants, LLC). The findings of the study were interpreted using the unified theory of acceptance and use of technology, which highlights 4 constructs associated with technology acceptance: performance expectancy, effort expectancy, social influences, and facilitating conditions.ResultsWe conducted 62 interviews with patients with TB, of whom 30 (48%) were HIV coinfected, and 31 interviews with HCPs. Acceptance of 99DOTS by patients was variable. Greater patient acceptance was related to perceptions of improved patient-HCP relationships from increased phone communication, TB pill-taking habit formation due to SMS text messaging reminders, and reduced need to visit health facilities (performance expectancy); improved family involvement in TB care (social influences); and from 99DOTS leading HCPs to engage positively in patients’ care through increased outreach (facilitating conditions). Lower patient acceptance was related to perceptions of reduced face-to-face contact with HCPs (performance expectancy); problems with cell phone access, literacy, cellular signal, or technology fatigue (effort expectancy); high TB- and HIV-related stigma within the family (social influences); and poor counseling in 99DOTS by HCPs or perceptions that HCPs were not acting upon adherence data (facilitating conditions). Acceptance of 99DOTS by HCPs was generally high and related to perceptions that the 99DOTS adherence dashboard and patient-related SMS text messaging alerts improve quality of care, the efficiency of care, and the patient-HCP relationship (performance expectancy); that the dashboard is easy to use (effort expectancy); and that 99DOTS leads to better coordination among HCPs (social influences). However, HCPs described suboptimal facilitating conditions, including inadequate training of HCPs in 99DOTS, unequal changes in workload, and shortages of 99DOTS medication envelopes.ConclusionsIn India’s government TB program, 99DOTS had high acceptance by HCPs but variable acceptance by patients. Although some factors contributing to suboptimal patient acceptance are modifiable, other factors such as TB- and HIV-related stigma and poor cell phone accessibility, cellular signal, and literacy are more difficult to address. Screening for these barriers may facilitate targeting of 99DOTS to patients more likely to use this technology.
- Research Article
16
- 10.1186/s13104-016-2277-y
- Oct 18, 2016
- BMC Research Notes
BackgroundMost tuberculosis (TB) case management guidelines emphasize microbiological cure as treatment goal without highlighting quality of life outcomes. This study assessed health-related quality of life (HRQoL) and related factors in the pre-treatment, intensive and continuation phases of anti-TB therapy among sputum smear positive pulmonary TB patients in Mbale region, Eastern Uganda.MethodsIn this cross-sectional study, questionnaires and 36-Item Short-Form Health Survey Version 2.0 (UK English SF36v2) forms were administered to 210 participants of whom 64.8 % were males. The mean age was 35.48 ± 12.21 years. For each of the three treatment phases, different patients were studied. Responses were translated into the standard 00–100 scale. Means and standard deviations were used to express HRQoL as physical composite scores (PCS) and mental composite scores (MCS). Analysis of variance was used to compare scores across phases. Multiple linear regression methods were used to model relationships between predictor variables and HRQoL for each treatment phase.ResultsHRQoL scores were different across treatment phases. General health (38.8 ± 17.5) and mental health (52.7 ± 18.6) had the lowest and highest sub-scale scores respectively. Mean PCS scores in pretreatment, intensive and continuation phases were 29.9 ± 19.4, 41.9 ± 14.2 and 62.2 ± 18.8 respectively. Mean MCS scores in the pretreatment, intensive and continuation phases were 38.8 ± 18.3, 49.4 ± 13.1 and 60.6 ± 18.8 respectively. Prior to treatment initiation, having an informal occupation (β = −28.66 (<0.001) was associated with poor HRQoL. Being unmarried (β = 11.94, p = 0.028) and belonging to the highest tertile of socioeconomic status (SES) (β = 14.56, p = 0.007) were associated with good HRQoL in the intensive phase. In the continuation phase, SES (β = 10.83, p = 0.021 for MCS and β = 13.14, p = 0.004 for PCS) predicted good HRQoL. Older age (β = −0.43 p = 0.013 for PCS and β = −0.36 p = 0.040 for MCS) was associated with poor HRQoL.ConclusionsTB treatment improved patients’ perceived health and having means of income was particularly associated with high HRQoL. Strategies to strengthen treatment support that include income generation and specific close monitoring of older patients may help improve overall TB treatment experience, by sustaining acceptable levels of physical, social and emotional functioning.
- Research Article
- 10.30978/tb2025-3-18
- Jul 29, 2025
- Tuberculosis, Lung Diseases, HIV Infection
Development of new, more effective methods of tuberculosis treatment is one of the priority areas of modern phthisiology. In recent years, antibacterial drugs of the fluoroquinolone series have begun to be widely used in the treatment of not only resistant, but also drug-susceptible tuberculosis. Objective — to evaluate the effectiveness of a 4-month chemotherapy regimen for newly diagnosed sensitive pulmonary tuberculosis, which includes moxifloxacin and rifapentine. Materials and methods. To achieve the goal, 65 patients with newly diagnosed drug-susceptible pulmonary tuberculosis were selected. 33 patients (main group) were treated with a 4-month regimen that included moxifloxacin and rifapentine in the intensive and continuation phases of treatment: 2HPZMfx 2HPMfx. 32 patients in the control group were treated with a standard 6-month regimen: 2HREZ 4HR. The average age of patients in the main group was 45.3 ± 1.3, in the control group — (44.8 ± 1.2; p > 0.05) years, in both groups people from 35 to 55 years prevailed. There were 24 men in the main group (72.73 %), 9 women (27.27 %), respectively in the control group — 23 (71.88 %) and 9 (28.12 %). Patients in both groups were identical in age, sex, clinical forms of pulmonary tuberculosis, the presence of bacterial excretion and comorbid conditions. Results and discussion. Analysis of the data obtained showed that the cessation of bacterial excretion occurred in all (33; 100 %) patients in the main group and in 30 (93.75 %) patients in the control group. Radiological changes in the lung tissue after the completion of the treatment course completely disappeared in 29 (87.88 %) patients of the main group and 27 (84.38 %) of the control group, and in another 2 (6.06 %) and 3 (9.37 %) patients, respectively, pathological changes in the lungs decreased. In 17 (51.5 %) of the main group and 14 (43.75 %) of the control group, after the completion of the treatment, body weight increased by an average of 2—3 kg. All patients (33, 100 %) of the main group after the completion of the full course of treatment recovered clinically and their signs of the disease disappeared. In the control group, this figure was 93.75 % (30 patients). In 2 patients, the treatment failed and, accordingly, their clinical condition did not improve. Five patients (15.5 %) of the main group, who did not have concomitant pathology (HIV/AIDS, hepatitis), had adverse reactions to antituberculosis drugs, which manifested themselves in varying degrees of severity. In the control group, no adverse reactions were observed. Conclusions. The results obtained showed high effectiveness of a 4-month treatment regimen for newly diagnosed drug-susceptible pulmonary tuberculosis using moxifloxacin and rifapentine in the intensive and continuation phases of treatment. A shorter treatment period has a positive effect on the patient’s psychological state, facilitates drug intake control, but more often leads to adverse reactions and is 45.44 % (3473.6 UAH) more expensive.
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