TUBERCULOCIDAL AND TUBERCULOSTАTIC ACTIVITY OF 1,2,4-TRIAZOLE DERIVATIVES IN VITRO (DETERMINATION OF MIC (MINIMUM INHIBITORY CONCENTRATION)

Objective: To study the clinical course of tuberculosis (TB) with multiple drug resistance (MDR) in the treatment of short-term courses recommended by the WHO. Methods: Design of research – a retrospective study of 42 (100%) patients of both sexes aged 18-62 years who were on stationary and then in outpatient treatment with short-term courses in 2017 and received a short course of chemotherapy for MDR TB (4-6 CmMfxPtoCfzZEH / 5 MfxPtoCfzZE) recommended by WHO. Results: According to the data on treatment outcomes, 4 (9.6%) of the patient because of the serious undesirable setting have been withdrawn from therapy. Out of 33 (78.6%) people with positive sputum test, smear conversion to negative was detected in 1 month already in half of the patients; of 99.2% of patients at the end of 3 months of chemotherapy, the destruction of pulmonary parenchyma persisted in 66.7% of patients. A favorable outcome of therapy was achieved in 73.8%, an unfavorable outcome occurred in 7.1% of cases. 3 (7.1%) of the patient fell out of sight, and 2 (4.8%) patients still continue treatment. Conclusion: The question of the efficacy of treatment with a short course of chemotherapy in Kyrgyzstan remains open, more objective answers will be given after a long detailed and voluminous analysis of the research conducted. Quite optimistic preliminary results obtained by us, we can say that a shorter duration of treatment will allow access to a more likely effective treatment, so as to reduce the high moment rates of portability treatment in patients. Although it is necessary to further confirm the effectiveness of these expectations it should not listen to the obstacle to the implementation of WHO recommendations. Keywords: Drug-resistant tuberculosis, multiple drug resistance, short courses of chemotherapy.

This study is a descriptive method of research which is concerned with the relationship of the DOTS client and clinical related factor to the level of effectiveness of the DOTS program. The clinical related factor provides knowledge as to the set-up of the DOTS facility. The researchers used the correlational survey design of research since the purpose of this research study is to correlate the DOTS client and clinical related factor as to the effectiveness of the Directly Observed Treatment Short course (DOTS) for tuberculosis in terms of program administration, information dissemination, diagnostic services and medical supplies, and medical follow up. The researchers used the NTPTB register of each Rural Health Unit for the list of clients who are registered under the Directly Observed Treatment Short course strategy for the fiscal year 2010 as the respondents of this study. There were eighty-two (82) DOTS client identified and diagnosed of having tuberculosis. In the analysis and interpretation of the data, frequency count, mean and percentage are employed particularly in the interpretation of the profile of the respondents and clinical related factor. Coefficient of Correlation and T-test (test of the relationship) is used in determining the influence of the profile of the client and clinical related factor to the effectiveness of the DOTS program. The findings of the study reveal that there is a significant relationship between the profile of the clients, clinical related factors and the level of effectiveness of the Directly Observed Treatment short course program of the RHU. Keywords - Descriptive Correlation, Directly Observed Treatment Short course, Clinical Related Factors, Level of Effectiveness, Zambales, Philippines

Multidrug-resistant tuberculosis is already a global pandemic, with focal "hot spots" of ongoing transmission. Although DOTS (directly observed treatment, short course) chemotherapy is the goal of global tuberculosis control, short-course chemotherapy will not cure multidrug-resistant tuberculosis. In settings of high transmission of multidrug-resistant tuberculosis, "DOTS plus" (a complementary DOTS-based strategy with provisions for treating multidrug-resistant tuberculosis) is warranted. DOTS-plus project implementation to date reveals important clinical, epidemiological, and economic lessons. Community-based strategies designed to enhance local capacity are cost effective and make it possible to meet new medical challenges.

Tuberculosis (TB), a disease subject to mandatory reporting, is widely distributed in our country. The Direct Observed Treatment, Short-course (DOTS) is an effective protocol to increase TB treatment success. We developed a program in our hospital to increase discharged patient participation in DOTS, which helps ensure they receive 6 to 9 months of post-discharge medication therapy to maximize treatment outcomes. We identified four key problems related to low TB patient participation in DOTS. These included (1) patients did not understand the DOTS program; (2) staff did not know how to conduct the DOTS protocol; (3) staff had not received in-service DOTS education; and (4) the hospital had no DOTS patient education or teaching aids available. To improve TB patient participation in DOTS, we revised patient education material, provided continuing education to nursing staff, invited physicians and community co-workers to join in the outreach program, and made posters to remind discharged patients to sign up for the DOTS program. Patient participation in DOTS rose from 27.1% to 96.3% and nursing staff knowledge of DOTS rose from 86.3% to 100%. This program effectively increased TB patient motivation to join DOTS after hospital discharge and also improved successful recovery and treatment completion rates. Increasing post-discharge TB patient participation in the DOTS protocol is an effective strategy for achieving the national goal of reducing TB cases by 50% within ten years.

BackgroundIn India, the Revised National TB control programme (RNTCP) offers free diagnosis and treatment for tuberculosis (TB), based on the Directly Observed Treatment Short course (DOTS) strategy. We conducted a qualitative study to explore the experience and consequences of having TB on patients enrolled in DOTS and their caretakers in Tumkur district, located in a southern state of India, Karnataka.MethodsWe conducted 33 in-depth interviews on a purposive sample of TB patients from three groups: (1) patients who reached RNTCP directly on their own and took DOTS at RNTCP; (2) patients who were referred by private practitioners (PPs) to RNTCP and took DOTS at RNTCP; and (3) patients diagnosed by RNTCP and took DOTS from PPs. Data was analyzed using a thematic approach with the support of NVivo9.ResultsThe study revealed that TB and DOTS have a large impact on patient’s lives, which is often extended to the family and caretakers. The most vulnerable patients faced the most difficulty in accessing and completing DOTS. The family was the main source of support during patient’s recovery. Patients residing in rural areas and, taking DOTS from the government facilities had to overcome many barriers to adhere to the DOTS therapy, such as long travelling distance to DOTS centers, inconvenient timings and unfavorable attitude of the RNTCP staff, when compared to patients who took DOTS from PPs. Advantages of taking DOTS from PPs cited by the patients were privacy, flexibility in timings, proximity and more immediate access to care. Patients and their family had to cope with stigmatization and fear and financial hardships that surfaced from TB and DOTS. Young patients living in urban areas were more worried about stigmatisation, than elderly patients living in rural areas. Patients who were referred by PPs experienced more financial problems compared to those who reached RNTCP services directly.ConclusionOur study provided useful information about patient’s needs and expectations while taking DOTS. The development of mechanisms within RNTCP towards patient centered care is needed to enable patients and caretakers cope with disease condition and adhere to DOTS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1545-9) contains supplementary material, which is available to authorized users.

BackgroundTuberculosis (TB) is a common and often deadly infectious disease caused by various strains of mycobacterium, usually mycobacterium tuberculosis in humans. The disease has major causes of morbidity and mortality, particularly where the diagnostic and control program is not far extended.ObjectiveTo compare the treatment outcomes of tuberculosis patients in a private clinic with a governmental health center in Jimma city, Ethiopia.MethodsA 10-year cross-sectional retrospective systemic record review was conducted to compare the treatment outcomes, and to describe the socio-demographic factors associated with the outcome in a private clinic with a governmental health center in Jimma city, Jimma, Ethiopia from September 12, 2007, to September 10, 2017. Finally, SPSS/EPI INFO analyzed data.ResultsThe present study revealed that within a 10 year duration the private clinic gives anti-TB treatment coverage for 582 patients whereas the governmental health center treats 510 patients. The treatment success rate of the private clinic is 98.1% which is 1.03-fold that of the governmental health center (95.3%); while the treatment failure of the private clinic was 0.2%, but there was no treatment failure in the governmental health center.ConclusionBoth sectors achieved the expected WHO targets by newly recommended strategy for TB treatment, DOTS (Directly Observed Treatment Short Course) and treatment success is much better to standard. This shows good progress of DOTS strategy and a decrease of noncompliance in this area. Age, educational level, and the types of TB diagnosis and treatment outcome of the patients were statistically associated in both sectors. Better counseling and awareness about the disease should have to be given for every anti-TB treatment receiving patients, despite their educational level and occupational status in both sectors.

Adherence to therapy in patients with tuberculosis (TB) is a major determinant of their outcomes. Unfortunately, there are no currently known predictors of adherence, given that this phenomenon represents a complex, task-specific behavior. Notwithstanding criticisms from civil liberty advocates, directly observed therapy (DOT), facilitated by education, holistic care, enablers and incentives, is still the best strategy to ensure patient adherence to treatment. To enhance delivery of DOT, short-course chemotherapy (SCC) must be strongly advocated. Monitoring of patient progress, dependable drug supply, and adequate programme funding are other important elements of the entire strategy. Indeed, since the global resurgence of TB and associated rampant drug resistance in the 1990s, directly observed therapy, short-course (DOTS) has now become the WHO strategy for effective TB control. Data obtained so far in different continents worldwide have underscored the unrivalled efficacy of DOTS in ensuring treatment success and preventing development of acquired drug resistance. The recent WHO/International Union against Tuberculosis and Lung Disease (IUATLD) global project on anti-TB drug resistance surveillance has also revealed that countries in which >33–90% of the population has access to the WHO DOTS strategy have, as a group, lower levels of drug resistance: primary multidrug-resistant (MDR) (1.4%; median) and acquired MDR index (0.6; median). The use of SCC was also inversely associated with the prevalence of combined resistance to any drug. Countries with MDR rates >2% reported using SCC in a median of 70% of their patients, compared with 100% in countries with MDR rates <2% (WHO/TB/97.229). Despite greater initial cost, DOTS is a more cost-effective strategy than self-administered therapy because it decreases the re-treatment costs associated with therapy failure and acquired drug resistance. Finally, in addition to harnessing the complementary roles of a national tuberculosis programme and community participation, DOTS might be further enhanced by the use of newly developed drugs with a long duration of action or more potent bactericidal and sterilizing activities.

To determine the treatment success rate among TB patients and associated factors in Anambra and Oyo, the two states with the largest burden of tuberculosis in Nigeria. A health facility record review for 2016 was conducted in the two states (Anambra and Oyo). A checklist was used to extract relevant information from the records kept in each of the selected DOTS facilities to determine TB treatment success rates. Treatment success rate was defined as the proportion of new smear-positive TB cases registered under DOTS in a given year that successfully completed treatment, whether with bacteriologic evidence of success ('cured') or without ('treatment completed'). Treatment success rate was classified into good (≥85%) and poor (<85%) success rates using the 85% national target for TB treatment outcome. Data were analysed using descriptive statistics and chi-square at P<0.05. There were 1281TB treatment enrollees in 2016 in Anambra and 3809 in Oyo (total=4835). An overall treatment success rate of 75.8% was achieved (Anambra-57.5%; Oyo-82.0%). The percentage cure rates were 61.5% for Anambra and 85.2% for Oyo. Overall, only 28.6% of the facilities in both states (Anambra-0.0%; Oyo-60.0%) had a good treatment success rate. More facilities in Anambra (100.0%) than Oyo (40.0%) had a poor treatment success rate (p<0.001), as did more private/FBO (100.0%) than public health facilities (60.0%) (p=0.009). All tertiary facilities had a poor treatment success rate followed by 87.5% of secondary health facilities and 56.5% of primary healthcare facilities (P=0.035). Treatment success and cure rates in Anambra state were below the 85.0% of the recommended target set by the WHO. Geographical location, and level/tier and type of facility were factors associated with this. Interventions are recommended to address these problems.

Noncompliance is one of the major issues with the treatment of tuberculosis (TB), which can lead to treatment failure. A short-course of chemotherapy as recommended by World Health Organization under the umbrella term of Directly Observed Treatment Short Course (DOTS) therapy seems to be effective. The main aim in present study was done to evaluate the efficacy of short term intermittent chemotherapy in DOTS regimen in patients with extra spinal osteoarticular TB. The present prospective study was conducted in the Department of Ortho &amp; Spine Surgery, National Institute of Traumatology &amp; Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh over a period of one year between January 2018 to February 2019. 21 patients included in our Study. All the patients were given the DOTS regime as recommended by WHO and followed up at intervals of one month during the treatment for assessing the clinical improvement and compliance of the patient. The results in present study, there were 85.71% males and 14.29% were females. 42.86% were students followed by the labourer (28.57%). Hip (47.62%) was the most commonly involved joint followed by short bones of hand and foot (19.5%). All (100%) patients had an elevated ESR at the time of presentation. Eighty percent patients had shown increase in weight at the end of 6 month of treatment. All patients of extra spinal osteoarticular TB showed improvement. Treatment was found sufficient for 80% of the patients. In 20% cases treatment duration was extended. In discussion the Short term intermittent chemotherapy in DOTS regimen was optimum for the treatment of extra spinal osteoarticular TB and was associated with good compliance.

Epidemiology of Mycobacterium bovis and Mycobacterium tuberculosis in animals: Transmission dynamics and control challenges of zoonotic TB in Ethiopia

Directly observed treatment short course (DOTS) and self-administered therapy (SAT) are the treatment options available for tuberculosis (TB). Studies conducted worldwide have shown difference in treatment outcome with these two treatment modalities. The study was undertaken to compare treatment outcome of DOTS and SAT in patients of pulmonary TB taking SAT from a tertiary care hospital and DOTS from the DOTS centre of a government hospital. It was a retrospective comparative study. The case record files of patients with pulmonary TB diagnosed from March 2011 to February 2012 were analysed as per the proforma. The sample size of patients was 150 (75 each from DOTS and SAT). The treatment outcome in DOTS group was cured 70.7%, treatment completed 1.3%, failure 5.3%, deaths 10.7%, defaulters 8% and transferred out 4% whereas in SAT group, cure was seen in 68% and 4% completed the treatment, 1.3% had treatment failure, and 26.7% were lost to follow up which included deaths, defaulters and those patients who switched over to other hospitals. The treatment success rate was similar (72%) in both groups. There was no statistically significant difference observed in the average weight gain at the end of treatment between the two groups. A total of 11 adverse drug reactions (4 DOTS, 7 SAT) were recorded in the study. The study shows no statistically significant difference between success rate in patients taking DOTS and SAT.

Introduction: Tuberculosis is one of the most prominent mycobacterium diseases known to humankind. Increasing cases world-wide led to the World Health Organization (WHO) declaring a global Emergency in April 1993. Despite the availability of „tools‟ for controlling TB, programs have been unable to sustain high cure rate. As a consequence of this, and the increasing problems of drug resistance, the International community, through the WHO, has developed and launched the Directly Observed Treatment Short Course (DOTS) strategy. Directly Observed Treatment, Short course chemotherapy is a strategy to ensure cure by providing the most effective medicine and confirming that it is taken. It is the only strategy which has been documented to be effective Worldwide on a program basis. Design: A quantitative approach using pre-experimental pre-test post-test design with one group. Participants: 50 Staff Nurses were selected using Non-Probability purposive sampling technique in Mehsana District. Interventions: Structured teaching was given to the Staff Nurses. Tool: Self Structured Questionnaire was used to assess the level of Knowledge regarding tuberculosis and dots therapy among staff nurses. Results: The research study shows that in pre test (20%) of sample had a poor knowledge (score 1-10) regarding knowledge about tuberculosis and dots therapy, while average knowledge (score 11-20) was observed in 46% of the sample and (34%) of sample having good (20-41) knowledge score. And in the post test (0%) of sample had a poor knowledge (score 1-10) regarding knowledge about tuberculosis and dots therapy, while average knowledge (score 11-20) was observed in (18%) of the sample and (82%) of sample having good (20-41) knowledge score. And the comparison between pre test and post test observation score regarding knowledge of tuberculosis and dots therapy. The mean pre test observation score was 16.4 and the mean post test score was the 23, and the Standard Deviation was 5.64 in pre test and 7.67 in post test score, also the calculated “t”value was 4.20 was greater than the table value at 0.05 level of significance. The structured teaching was effective in increasing the Knowledge regarding tuberculosis and dots therapy among staff nurses. Chi-square test to associate the level of knowledge and selected demographic variable. Conclusion: The findings of the study indicate that structured teaching programme is effective in increase knowledge regarding tuberculosis and dots therapy among staff nurses.

Tuberculosis is a common respiratory disease imposing significant health burden. Directly observed treatment short course strategy ensures patient compliance in tuberculosis treatment. The aim of this study was to assess pattern of tuberculosis, trend and outcome of patients registered at Directly observed treatment short course centre of Tribhuvan University Teaching Hospital. A retrospective observational study was conducted at Tribhuvan University Teaching Hospital. Tuberculosis patients of all age groups registered from July 2017 to June 2020 at Tribhuvan University Teaching Hospital Directly observed treatment short course centre were included. Data entry and analysis was done in SPSS version 20.0. Descriptive statistics was performed and results were interpreted in mean, frequency and percentage. A total of 2790 tuberculosis patients were included for final analysis. There were 1736 (62.2%) males. Mean age of patients was 37.94±20.28 years. Pulmonary tuberculosis was the most common type of tuberculosis seen in 948 (34%) patients. Fifty percent of total tuberculosis cases were confined to thorax. Tubercular pleural effusion and pleurisy (14.6%), central nervous system (13.2%), bone and joint (12.2%) were common forms of extrapulmonary tuberculosis. The mean incident tuberculosis cases registered annually was 697.5±95.63. Nearly half (49.1%) of the patients completed tuberculosis treatment regimen while 43.3% were referred to other Directly observed treatment short course centre as per their convenience. This study reflects the trend and pattern of tuberculosis epidemiology at tertiary care hospital of Nepal. There is a huge burden of both pulmonary and extrapulmonary tuberculosis at Tribhuvan University Teaching Hospital with slight annual variation in incident tuberculosis cases. Despite implementation of Directly observed treatment short course, the problem of non-compliance persists among the tuberculosis patients.

After the initial gains in Tuberculosis case detection and cure rates, progress became stunted by persisting constraints and challenges in the implementation of the Directly Observed Treatment Short course strategy. This prompted the Stop Tuberculosis partners in 2006 to adopt innovative approaches including the Public-Private Mix, to improve access to and quality of care. This paper assesses the level of Public-Private Mix in Tuberculosis control in Jos, Plateau State. This was a facility-based, cross sectional study where data from all consenting private health care facilities owned by medically trained personnel and private medical practitioners in Jos North and Jos South Local Government Areas was collected using structured questionnaires. Eight (47.1%) of all 17 facilities assessed gave anti Tuberculosis drugs on clinical suspicion of Tuberculosis, 5(29.4%) required Acid Fast Bacillus result and 3(17.6%) referred elsewhere for the Tuberculosis management. Only 6 facilities (35.3%) were microscopy, treatment centres, or both. Ten (58.8%) of the facilities had the Directly Observed Treatment Short course guidelines, but these could be sighted in only 5 (29.4%), while six (35.3%) had Tuberculosis record and referral forms. In 13 (76.5%) of the facilities, no local government Tuberculosis and Leprosy supervisors had ever visited them. Only 30 (57.7%) medical practitioners had access to the Directly Observed Treatment Short course. Thirty two (61.5%) respondents treated Tuberculosis according to the Directly Observed Treatment Short course strategy, but 19 (36.5%) still used the conventional method. Only 22(42.3%) practitioners had ever received any training on the Directly Observed Treatment Short course strategy. The level of Public-Private Mix in Tuberculosis control in Jos is low.

Combined VBM Chemotherapy and Involved Field (IF) Radiotherapy in Early Stage Hodgkin's Lymphoma (HL): A Single Centre Experience.