National Tuberculosis Control Programme Research Articles

APERFEIÇOAMENTO SOBRE O RASTREIO DA TUBERCULOSE PARA OS AGENTES COMUNITÁRIOS DE SAÚDE DA ESTRATÉGIA DE SAÚDE DA FAMÍLIA DO NASCENTE I E II EM ARARIPINA-PE.

Tuberculosis (TB), a disease formerly described as typhus, was known in the 19th century as the white plague, decimating hundreds of thousands of people around the world. TB can be caused by any of the seven species that make up the Mycobacterium tuberculosis complex: M. tuberculosis, M. bovis, M. africanum, M. canetti, M. microti, M. pinnipedi and M. caprae. M. tuberculosis is transmitted by air, from a person with pulmonary or laryngeal TB, who eliminates bacilli in the environment (source case), to another person, by inhaling aerosols from coughing, talking or sneezing. Primary pulmonary TB usually occurs after the individual's first contact with the bacillus and is therefore more common in children. Its main characteristic is a dry or productive cough. Evening fever, without chills, does not usually exceed 38.5ºC. Night sweats and anorexia are common. Tuberculosis is a serious disease, but it is curable in the vast majority of cases, as long as the treatment is followed correctly. In Brazil, treatment is standardized and free of charge, provided by the National Tuberculosis Control Program (PNCT) in Health Units. In Brazil, tuberculosis treatment is standardized and consists of two phases: intensive and maintenance. The basic regimen recommended by the Ministry of Health (BRASIL, 2019) for adults and adolescents aged 10 and over includes rifampicin, isoniazid, pyrazinamide and ethambutol (RHZE). Directly Observed Treatment (DOT) is a fundamental strategy for ensuring patient adherence to tuberculosis treatment and reducing abandonment rates. Adopted by the Ministry of Health (MoH) based on WHO recommendations, DOT consists of direct observation of drug intake by health professionals. Community health workers (CHWs) are essential for tuberculosis control, from diagnosis to the outcome of cases. Their duties include Spreading the word to their community about tuberculosis as an important current public health problem. Educate the population about airborne transmission of tuberculosis and the preventive measures that can be adopted. To be aware of the main symptoms of tuberculosis (cough, fever, weight loss and night sweats) at all meetings with the community, as well as publicizing them, and referring suspected cases to the health unit.

Implementation of spirometry screening for post-tuberculosis lung disease (PTLD) among adolescents and adults enrolled within the National Tuberculosis Control Program of Carmelo Hospital in Chókwè District, Mozambique: A hybrid type III effectiveness-implementation study protocol

BackgroundDespite receiving adequate treatment, many tuberculosis (TB) survivors are left with post-tuberculosis complications, possibly due to lung tissue damage incurred during the active period of the disease. Current TB programs worldwide deliver quality care throughout the course of active TB treatment, yet often fail to provide organized follow-up once treatment ends. Post-tuberculosis lung disease (PTLD) is a prominent, yet underrecognized cause of chronic lung disease, managed similarly to chronic respiratory diseases with pharmacotherapy and/or personalized pulmonary rehabilitation interventions. Basic pulmonary rehabilitation packages for people finishing TB treatment are still lacking in low- and middle-income countries (LMICs). We offer a study protocol to evaluate the implementation of spirometry and symptom screening for PTLD among people who have completed TB treatment in a rural district in Mozambique.MethodsThe overall objective of this study is to evaluate the introduction of a new screening program that utilizes symptom screening and spirometry for diagnosing PTLD among adolescents and adults that have completed TB treatment. This research protocol consists of three complementary components: 1) assessing the prevalence of PTLD among patients enrolled in the National TB Control Program (NTCP) at Carmelo Hospital (CHC) in Chókwè District, Mozambique; 2) evaluating anticipated implementation outcomes through the identification of the site-, provider-, and individual-level determinants that either facilitate or hinder the successful adoption, implementation, and maintenance of the spirometry screening program, and 3) evaluating the real-time implementation outcomes/processes in order to provide practical evidence-based key indicators of successful implementation of the spirometry screening program.DiscussionProviding well-organized, evidence-based care for individuals with a history of TB who are experiencing symptoms of PTLD can relieve chronic respiratory issues, enhance quality of life, and potentially lower the risk of further pulmonary infections, including recurrent TB. However, there is a significant gap in the literature regarding the implementation of best practices of HIV and TB health services delivery. Addressing this gap could assist Mozambique in improving diagnosis, treatment, and continuity of care for people formerly living with TB. The insights from this study will help decision-makers improve spirometry screening coverage, enhance intervention effectiveness, and translate our findings to evidence-based programming.Trial registrationISRCTN92021748 retrospectively registered.

The rising tide of tuberculosis in Pakistan: Factors, impact, and multi-faceted approaches for prevention and control.

Tuberculosis (TB) remains a major public health concern in Pakistan, which is ranked fifth among high-burden TB nations worldwide. The growing frequency of drug-resistant TB strains, particularly multidrug-resistant TB (MDR-TB), creates new obstacles. Socioeconomic factors, a lack of awareness, and inadequate healthcare infrastructure all contribute to the spread of the disease. This study investigates the mechanisms contributing to the growth in tuberculosis cases in Pakistan, the implications for public health, and multifaceted approaches to prevention and control. A comprehensive literature study was undertaken, including an analysis of peer-reviewed articles, World Health Organization (WHO) data, and government sources, to identify factors driving tuberculosis prevalence, control issues, and disease-fighting tactics.Result: Several factors like Poverty, overcrowding, malnutrition, stigma, and restricted access to healthcare services are all factors contributing to an increase in tuberculosis incidence in Pakistan. The prevalence of MDR-TB, along with a lack of an integrated healthcare response, complicates efforts to contain the disease's spread. Tuberculosis has a profound social, mental, and financial impact on individuals and communities. Public health efforts, such as the National Tuberculosis Control Program (NTP) and international partnerships, have been created to eradicate tuberculosis, although considerable hurdles persist. This study investigates the mechanisms contributing to the growth in tuberculosis cases in Pakistan, the implications for public health, and multifaceted approaches to prevention and control.

Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme.

We describe the programmatic scale-up of stool testing using Xpert® MTB/RIF Ultra (Ultra), as recommended by the WHO to improve childhood pulmonary TB (PTB) diagnosis. USAID's Alliance for Combating TB in Bangladesh Activity, in collaboration with the National TB Control Programme, is implementing a stool-based diagnostic approach at 51 healthcare facilities in Bangladesh to improve PTB detection. Specimens from children (<15 years) with presumptive TB were tested using 'stool Ultra' with routine TB diagnostics. Physicians confirmed TB diagnosis and provided treatment as per national guidelines. Between March 2022 and December 2023, 16,429 specimens were tested, 871 (5.3%) were positive, and 642 (73.7%) showed 'trace detected' results. Positivity was significantly higher among females, and children presented with 'only cough ≥2 weeks', 'cough ≥2 weeks + weight loss', or 'fever ≥2 weeks, weight loss, fatigue + contact history'. Positivity was higher among '10-14 years old' children; however, 'trace detected' was highest among '5-9 years', followed by children aged '>2-<5 years' and '0-2 years'. Testing stools using Ultra provides a more effective way of diagnosing bacteriologically positive PTB in children. However, positivity varies with presenting symptoms/criteria, highlighting the need for careful diagnostic evaluation to ensure optimum use of limited diagnostic resources.

Knowledge and perception about tuberculosis among general population attending community pharmacies in Mosul: A cross-sectional study.

To evaluate people's knowledge and perceptions regarding tuberculosis. The cross-sectional study was conducted at 10 community pharmacies in Mosul, Iraq, from December 2021 to March 2022, and comprised individuals of either gender aged >18 years. Data was collected using a 17-item questionnaire, with 12 questions related to knowledge and 5 related to perception regarding tuberculosis. Data was analysed using SPSS 25. Of the 200 participants with mean age 38.79+/-13.72 years, 113(56.5%) were females and 101(50.5%) had education up to university level. Overall, 85(42.5) subjects could differentiate between tuberculosis and pulmonary tuberculosis, and 176(88%) knew TB was curable. Besides, 135(67.5%) subjects said they would not visit patients with tuberculosis. The national tuberculosis control programme in Iraq seemed to have improved public awareness regarding tuberculosis.

Factors Influencing the Practices and Adherence of Isoniazid Prophylactic Therapy Among Under 5 Years Children in Tb Referral Units, Peshawar

&amp;lt;i&amp;gt;Importance&amp;lt;/i&amp;gt;: The under 5 years children of house hold contact with active tuberculosis cases is one of the main cause for the transmission of TB in pediatrics population, responsible for many complications and childhood mortality. &amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: To determine the factors influencing the practice and adherence of Isoniazid Prophylactic Therapy (IPT) among under 5 years children of house hold with cases of active pulmonary tuberculosis. &amp;lt;i&amp;gt;Design: &amp;lt;/i&amp;gt;The study’s design was cross sectional. &amp;lt;i&amp;gt;Setting: &amp;lt;/i&amp;gt;This study was conducted in TB referral units of the National Tuberculosis Control Program in Peshawar City. &amp;lt;i&amp;gt;Participants&amp;lt;/i&amp;gt;: The study participants included patients with sputum-positive pulmonary TB having at least one under-5 years’ child in their household. Secondly, the doctors who were directly dealing with TB patients for diagnosis and treatments in referral units of the respective hospitals. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: Most of the patients reported that doctors neither got some information about the under-5 years&amp;apos; children at their family nor to bring them for TB screening. Just 13.2% patients (36 out of 273) conceded that doctors mentioned them for prophylactic treatment with Isoniazid (INH) medication for their contact positive under-5years children. But only 4 of these 36 patients [(11.11%) 1.46%of the aggregate] completed the IPT course for their under-5 year children for 6 months duration. (Table 2) All the doctors claimed that they got information about the presence of under five years household contact in the family of TB patients. While the majority of the doctors/physicians (80%) had recognized that they neither requested the patients for screening from their family contact nor to give INH medication for their prophylaxis. This study showed that the practice of IPT was 13.2% and the adherence rate was just 11.11%, and the main factors for this poor result were poor healthcare system, lack of awareness, financial constraint and attitude of the patients. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;This study concludes that the extremely poor practice and adherence to isoniazid prophylactic therapy by doctors and patients in TB referral units in Peshawar city for under-5-year-old children of households with active tuberculosis patients was primarily caused by a lack of awareness, financial constraints, patient attitudes, and an inefficient healthcare system.

Health-seeking behaviour and patient-related factors associated with the time to TB treatment initiation in four African countries: a cross-sectional survey

IntroductionIn 2022, tuberculosis (TB) was the second-leading cause of global deaths from a single infectious agent. Delays in initiating TB treatment can lead to increased morbidity and mortality. We describe...

The effect of a health education programme on Tuberculosis infection prevention and control practices among HIV-positive patients at three tertiary hospitals in Ogun state, southwest Nigeria

Objective: This research evaluated the impact of a peer-support health education programme on tuberculosis infection prevention and control practices among HIV-positive patients receiving anti-retroviral therapy (ART) in a tertiary hospital. Methods: A quasi-experimental design was used for this study. Forty respondents were randomly selected between January and April 2023. Two tertiary health institutions in Ogun State, Nigeria with Direct Observation Treatment Shortcut programme were purposively selected. Systematic sampling was used to select the participants from the selected facilities and they were grouped into one experimental group (EG) and one control Group (CG). The intervention was implemented for six weeks and data were collected at baseline, immediate post-intervention and at 12th-week follow-up. Results: At the 12th-week follow-up, the peer-supported health education intervention had a significant effect (t78=14.21, effect size =3.09, p &lt;0.05) on the Intervention Group with a mean score (X̅) of 6.85±0.86 compared to the Control Group (CG) with a mean score (X̅) of 3.95±0.96. Furthermore, among the Intervention Group, there is a significant difference (t39=19.0, effect size =3.06, p &lt;0.05) in the effect of the peer-supported health education intervention program on TB infection prevention practices of participants at baseline (X̅ =3.98±0.73) and also at 12th weeks follow-up (X̅ =6.90±0.71). Conclusion: There was a significant association between the intervention and improvement in TB infection prevention and control practices. More focus should be placed on peer-supported health education TB prevention interventions among HIV patients. Also, the National Tuberculosis Control Programme should adopt peer-supported health education interventions to improve prevention practices.

Impact of COVID-19 on child tuberculosis hospitalization.

Morocco has made remarkable progress in the fight against tuberculosis, but the Covid-19 pandemic has affected tuberculosis control worldwide, with notable fluctuations in tuberculosis epidemiology during and after the pandemic. To describe the impact of the Covid-19 pandemic on the rate of hospitalization for tuberculosis and its different localizations in children. We conducted a retrospective study based on the analysis of medical records of TB patients hospitalized within the Children's Hospital in Casablanca, during the periods before (2018-2019), during (2020) and after (2021-2022) Covid-19 quarantine. Throughout the study period (2018-2022), the total number of patients hospitalized in our department was 7390, including 283 children were hospitalized for tuberculosis, with a mean age of 6 years. Before the Covid-19 pandemic, the average number of tuberculosis cases was 49 per year, of which the percentage of pulmonary tuberculosis was 32% and extra-pulmonary tuberculosis 68%. The number of cases was 23 per year during the quarantine period, with a percentage of pulmonary tuberculosis of 26% and extra-pulmonary tuberculosis of 74%. After the quarantine period, this number rose to 81 cases per year, of which 21% were pulmonary tuberculosis and 79% extrapulmonary tuberculosis (pleural tuberculosis was predominant in 44.1% of cases). These results are consistent with data published by the World Health Organization, and with the findings of another study we carried out on the impact of COVID-19 on hospital admissions for acute lower respiratory tract infections. It is very likely that the reduction in the number of tuberculosis cases during the quarantine period is due to social distancing, which leads to a reduction in the transmission of tuberculosis between people as well as to the disruption of the national tuberculosis control program in Morocco, when positive cases are identified.

"Healthcare providers' perspectives on Tuberculosis control in a district of Southern India – Insights from 2022 sub-national TB free certification"

BackgroundIn response to the persistent TB challenge, the National Tuberculosis Elimination Programme (NTEP) of India, formerly known as the Revised National Tuberculosis Control Programme (RNTCP), set a strategic goal to eliminate the nation's TB burden by 2025, five years ahead of the Sustainable Development Goals. In recognition of this challenge, the Indian Government launched the Sub-national Certification initiative in 2021, fostering competition among states and districts to attain TB-free status and offering recognition and incentives to the best-performing entities. Leveraging verification methods such as TB scores, treatment data, and community-level incidence estimation, this study seeks to provide a comprehensive view of the landscape. Materials & methodsThe study targeted healthcare providers encompassing doctors and chemists employed in both public and private sectors. A non-probability sampling technique, specifically, the convenient sampling method, was utilized. Two Nominal Group Technique (NGT) sessions were conducted. The first NGT comprised 8 healthcare providers, while the second NGT included 10 healthcare providers, while 14 participants were interviewed for KII. ResultsUtilizing the nominal group technique, the following results were derived: approximately 20 % of patients opt for treatment in the private sector, and pharmacies notifying TB cases comprise around 70 % of the cases. Additionally, most participants concurred that there has been a reduction in TB cases over recent years. ConclusionStudy's findings shed light on healthcare providers' perspectives on various facets of TB control, including incidence trends, patient preferences, drug choices, and compliance.

Opinion review of drug resistant tuberculosis in West Africa: tackling the challenges for effective control.

Drug-resistant (DR) tuberculosis (TB) is a major public health concern globally, complicating TB control and management efforts. West Africa has historically faced difficulty in combating DR-TB due to limited diagnostic skills, insufficient access to excellent healthcare, and ineffective healthcare systems. This has aided in the emergence and dissemination of DR Mycobacterium tuberculosis complex (MTBC) strains in the region. In the past, DR-TB patients faced insufficient resources, fragmented efforts, and suboptimal treatment outcomes. However, current efforts to combat DR-TB in the region are promising. These efforts include strengthening diagnostic capacities, improving access to quality healthcare services, and implementing evidence-based treatment regimens for DR-TB. Additionally, many West African National TB control programs are collaborating with international partners to scale up laboratory infrastructure, enhance surveillance systems, and promote infection control measures. Moreso, novel TB drugs and regimens, such as bedaquiline and delamanid, are being introduced to improve treatment outcomes for DR-TB cases. Despite these obstacles, there is optimism for the future of DR-TB control in West Africa. Investments are being made to improve healthcare systems, expand laboratory capacity, and support TB research and innovation. West African institutions are now supporting knowledge sharing, capacity building, and resource mobilization through collaborative initiatives such as the West African Network for TB, AIDS, and Malaria (WANETAM), the West African Health Organization (WAHO), and other regional or global partners. These efforts hold promise for improved diagnostics, optimized treatment regimens, and provide better patient outcomes in the future where drug-resistant TB in WA can be effectively controlled, reducing the burden of the disease, and improving the health outcomes of affected individuals.

Impact of the Stool-Based Xpert Test on Childhood Tuberculosis Diagnosis in Selected States in Nigeria.

In Nigeria, most children with tuberculosis (TB) present at primary health clinics where there are limited personnel skilled in collecting appropriate respiratory specimens from those who cannot produce sputum. KNCV Nigeria, in collaboration with the National Tuberculosis Control Program, implemented a modified simple, one-step (SOS), stool-based Xpert MTB/RIF method for diagnosis of TB in children who cannot expectorate sputum. We evaluated the impact of its implementation on childhood TB diagnosis. A cross-sectional study was conducted across 14 selected states using secondary data of children presumed to have TB. Stool was collected from children presumed to have TB and processed using Xpert. Out of 52,117 presumptive TB cases, 52% were male and 59.7% were under 5 years old. A total of 2440 (5%) cases were diagnosed with TB, and 2307 (95%) were placed on treatment. Annual TB notifications increased significantly after the introduction of the stool-based Xpert test when compared to those in the pre-implementation period. Increasing contributions from stool testing were observed throughout the implementation period, except in 2020 during the COVID-19 era. Overall, stool Xpert testing improved childhood TB notification in the studied states. Interventions aimed at awareness creation, capacity building, and active case finding improved the performance of the test.

Prevalence, Clinical Characteristics and Determinants of Unsuccessful Treatment Outcomes Among Pulmonary Tuberculosis Patients: A 5-Year Registry-Based Retrospective Cohort Study.

Despite the existence of effective medications, pulmonary tuberculosis (PTB) remains a significant global public health concern, The evaluation and feedback of national TB control programs are crucial, requiring diligent monitoring of TB treatment outcomes and analysis of the factors influencing these outcomes. This study aims to provide valuable insights into the challenges faced by TB patients, which can inform better strategies for treatment and management in the future. We conducted a study in King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia (KSA), from January 1, 2018 to December 31, 2023. The study was a registry-based retrospective cohort study. Patients' data were sourced from the National Tuberculosis Registry database of Saudi Arabia. Treatment outcomes were determined as either success or failure, considering clinical evaluation, changes in chest X-rays, and the results of subsequent sputum examinations during follow-up. To evaluate the data, SPSS version 28.0 was used. A total of 427 PTB patients participated in the study. The results show successful treatment outcomes among 88.5% of patients. Among the patients, males exhibited a higher likelihood of treatment failure as compared to females (aOR 1.3; 95%Cl 1.2-1.5, p < 0.001). Patients with positive sputum smear (aOR 1.3; 95%Cl 1.1-1.3 p < 0.00) and the presence of cough were associated with an increased risk of treatment failure (aOR1.5; 95%Cl 1.1-1.4, p < 0.001). This study shows that the percentage of unsuccessful treatment outcomes is high, ie, 11.5%, due to patients' deaths and loss to follow-up. Enhanced supervision and treatment monitoring for tuberculosis patients at high risk of treatment failure can lead to improved treatment success rates in Saudi Arabia.

Predictors of quality of life of TB/HIV co-infected patients in the Northern region of Ghana

BackgroundTuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-morbidity continues to be a serious worldwide health issue, particularly in Sub-Saharan Africa. Studies on the quality of life (QOL) of TB/HIV co-infected patients guide stakeholders on the delivery of patient-centred healthcare. This study evaluated QOL of TB/HIV co-infected individuals and its contributing factors.MethodsWe conducted a cross-sectional study among TB/HIV co-infected patients, receiving treatment at clinics in the Northern Region of Ghana. Simple random sampling technique was used to select 213 patients from 32 clinics. We gathered information on patients’ QOL using the World Health Organization QOL-HIV BREF assessment tool. At a 5% level of significance, multiple logistic regression analyses were carried out to find correlates of QOL among the patients.ResultsThe mean age of the patients was (38.99 ± 14.00) years with most, 33.3% (71/213) aged 30–39 years. Males constituted 54.9% (117/213). About 30.0% (64/213) of the patients reported a good QOL. Being employed (aOR = 5.23, 95% CI: 1.87 – 14.60), and adhering to treatment (aOR = 6.36, 95% CI: 1.51 – 26.65) were significantly associated with a good QOL. Being depressed (aOR = 0.02, 95% CI: 0.03 – 0.29), stigmatized (aOR = 0.31, 95% CI : 0.11 – 0.84), and not exercising (aOR = 0.28, 95% CI: 0.12 – 0.67) were negatively associated with a good QOL.ConclusionLess than one-third of TB/HIV co-infected patients in the region have good QOL. To guarantee good QOL, modifiable predictors such as patients’ physical activity and medication adherence should be targeted by the National AIDS and TB Control Programs.

Tuberculosis Co-infection among HIV/AIDS Cases Attending an Anti-retroviral Therapy Center: A Retrospective Cohort Study from Pakistan

Objective: The co-occurrence of tuberculosis (TB) and human immunodeficiency virus (HIV) results in heightened morbidity and mortality, placing an increased burden on healthcare systems. This study aims to assess the incidence and identify associated risk factors for TB/HIV co-infection, with the objective of enhancing the survival rates of co-infected patients in Pakistan. Methods: This retrospective cohort investigation took place at the Anti-Retroviral Treatment Center in Islamabad, Pakistan. Data spanning a decade (January 2006 to December 2016) were extracted from 2,542 people living with HIV using a pre-tested data extraction tool. Results: Following the exclusion of 156 ineligible participants, records of 2,386 individuals were analyzed over 4,433 person-years. The cumulative incidence and incidence rate of TB among HIV/AIDS patients were 446 (18.7%) and 0.001 cases/10,000 person-years, respectively. The majority (81%) of incident TB cases occurred within one year, predominantly manifesting as pulmonary TB. Of the TB-infected individuals, 98.6% received TB medication, with 0.7% prescribed Isoniazid prophylaxis. Significant associations with TB were identified in relation to work abroad history, patient age, and current HIV stage (P&lt;0.05). Binary logistic regression indicated a 3.1 times higher likelihood of TB infection in the anemic group compared to the non-anemic group. HIV/AIDS infection emerged as a consistent TB risk factor irrespective of CD4 count and WHO HIV staging. Conclusion: This study highlights a substantial incidence of TB co-infection among HIV patients in Pakistan, emphasizing the need for comprehensive efforts by the National AIDS Control and National TB Control Programs to effectively manage co-infection.

Diagnosis and Management of Latent Tuberculosis Infection: Updates.

India has the largest problem of tuberculosis (TB) infection globally (estimated at about 35-40 crores cases), and around 18-36 lakh develop active tuberculosis annually. Latent TB is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens with no evidence of clinically manifested active TB. The progression of a latent infection to active tuberculosis increases several-fold in children < 5 years of age and in people with some or the other form of an immunocompromising condition. Therefore, to cater to this gigantic problem of tuberculosis, it is necessary to have awareness about latent tuberculosis infection (LTBI) amongst clinicians and to prioritise its diagnosis and treatment in high-risk groups. India plans to end TB well before the deadline set by the World Health organisation (WHO). However, this can only be achieved with effective strategies targeting LTBI. Multiple treatment regimens have been approved for LTBI treatment, and all have comparable efficacy. The selection of one regimen over the other depends on various factors, such as availability, risk of adverse events, age, and drug interactions. Recently, the WHO, as well as the Revised National TB Control Programme (RNTCP), have updated their guidelines on TB preventive treatment in 2020 and 2021, respectively. This review has been especially prepared to acknowledge the differences in approach to LTBI in developed and developing countries.

Factors Affecting the Success of the National Tuberculosis Control Program in Hospitals in Indonesia Based on the National Hospital Accreditation Standards (SNARS): A Scoping Review

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Tuberculosis (TB) is an infectious disease that is one of the leading causes of health problems worldwide and in developing countries. Hospitals have a very important role in the success of Tuberculosis control programs. Tuberculosis prevention and control encompass a range of health initiatives that are designed to safeguard public health, mitigate morbidity, disability, and death rates, disrupt the spread of the illness, combat medication resistance, and alleviate the adverse consequences associated with Tuberculosis. This scoping review aims to assess the factors that influence the success of the national tuberculosis control program in hospitals based on the National Hospital Accreditation Standards. A scoping review was conducted in this work, utilizing four databases: Google Scholar, Ebsco, Pro Quest, and Science Direct. The PRISMA Flowchart is a tool used to guide the process of selecting research publications. The inclusion exclusion criteria in the article search were limited to the last 10 years, starting from 2014 to 2023. The results of the scoping review showed that the factors influencing the success of the national tuberculosis program in hospitals based on the National Hospital Accreditation Standards are health promotion, early detection of tuberculosis or health screening, tuberculosis surveillance, risk factor control, surveillance of tuberculosis case finding and treatment, provision of immunity with vaccines and provision of tuberculosis preventive drugs. And in an effort to enhance the effectiveness of the Tuberculosis program, the government, hospitals, and communities should prioritize the implementation of the Directly Observed Treatment Shortcourse program in hospitals to ensure its smooth execution&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Tuberculosis, Hospital, Program&lt;/em&gt;&lt;/strong&gt;

Tuberculosis Death and Associated Risk Factors in Hulu Langat District

Introduction: Addressing the challenge of mortality among tuberculosis (TB) patients undergoing treatment is a significant concern in Malaysia. It is essential to identify the factors linked to TB mortality to evaluate national TB control programs and identify high-risk individuals. The objective of this study was to assess the percentage of TB mortality among patients receiving treatment over a three-year duration and identify the associated factors in Hulu Langat District. Method: The study used secondary data collected from the national TB registry from 2019 to 2021, and all registered TB cases that met the inclusion and exclusion criteria were included. The data in the study were tested using regressions. Results: The results showed that 11.5% of total registered TB patients had died during their course of treatment, and multiple logistic regression identified several significant factors associated with TB mortality, including gender (aOR= 0.75, 95%CI: 0.58, 0.97; p=0.026), age (aOR= 16.94, 95%CI: 5.14, 55.81; p&lt;0.001), household income level (aOR= 1.56, (95%CI: 1.22, 1.99; p&lt;0.001), living area (aOR= 1.53, 95%CI: 1.00, 2.32; p=0.048) education level (aOR= 1.89, 95%CI: 1.06, 3.35; p=0.030), the severity of chest x-ray (aOR= 5.03, 95%CI: 2.95, 8.58; p&lt;0.001), and HIV status (aOR= 3.72, 95%CI: 2.71, 5.19; p&lt;0.001). Conclusion: TB mortality in the Hulu Langat district is a significant public health concern and interventions such as intensified case finding, home visits for elderly patients, and health promotion are needed to reduce TB mortality and achieve the WHO End TB strategy milestone.

Designing an operational research TB training program in Zambia

&lt;sec&gt;&lt;title&gt;BACKGROUND&lt;/title&gt;The USAID-funded Eradicate TB Project (ETB) partnered with the National Tuberculosis and Leprosy Control Program (NTLP) to establish an operational research (OR) training program in order to generate local evidence to enhance TB care in Zambia.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;METHOD&lt;/title&gt;Between 2017 and 2021, healthcare workers (HCWs) from district teams underwent two 10-day intensive training sessions. The program evolved to include a competitive application process and an additional primer workshop on developing feasible research questions.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;RESULTS&lt;/title&gt;Of the 36 enrollees in the OR training program, 26 (72.2%) completed it, leading to nine OR studies that informed interventions for TB care improvement. Notable achievements include reduced TB mortality, increased pediatric notifications, and enhanced sputum courier systems, with all studies disseminated at national and international conferences, four submitted to peer-reviewed journals, of which three were published. Two studies were replicated by the NTLP at provincial and national levels.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;CONCLUSIONS&lt;/title&gt;Integrating OR training into TB initiatives is feasible and beneficial. The program's phased execution and adaptive strategies provide valuable insights for similar settings, although challenges in sustainability of mentorship and funding persist. This success underscores the importance of continuous OR capacity strengthening among HCWs in Zambia.&lt;/sec&gt;

Impacts of armed conflicts on tuberculosis burden and treatment outcomes: a systematic review

ObjectivesThis systematic review aimed to summarise existing literature on the impacts of armed conflicts on tuberculosis burden and treatment outcomes.DesignA systematic review following the Preferred Reporting Items for Systematic Reviews...