Treatment Of Pulmonary Tuberculosis Patients Research Articles

Delays in Diagnosis and Treatment of Pulmonary Tuberculosis Patients during the COVID-19 Pandemic in Dushanbe, Tajikistan, 2022

The objective: to study delays in provision of medical care to pulmonary tuberculosis patients above 15 years old with laboratory confirmation of the diagnosis before and during the COVID-19 pandemic in Dushanbe, Tajikistan.Subjects and Methods. A retrospective cohort study was conducted among new pulmonary tuberculosis patients above 15 years old with laboratory confirmation of the diagnosis registered by TB Control Centers in Dushanbe in 2019–2021. Information was collected from medical records, medical databases, and patient questionnaires. Two types of delays were detected during the provision of medical care: delays related to the patient (defined as >14 days between onset of tuberculosis symptoms and the first visit to a health unit); delays related to health system (defined as >3 days from the first visit to TB unit to the initiation of tuberculosis treatment).Results. Of the 472 patients enrolled in the study, 276 were registered during the COVID-19 pandemic (2020–2021) and 196 patients were registered before the pandemic (2019). Frequency of delays was similar (83% vs 82%, p=0.8) during and before the COVID-19 pandemic. The frequency of delay related to health system was statistically significantly lower during the pandemic versus the period before the pandemic (34% vs 44%, p=0.023). The median duration of delays associated to the patient before the pandemic (60 days, IQR: 15–541) and during the pandemic (60 days, IQR: 15–360, р=0.6) was also similar as well as delays related to health system (before the pandemic – 7 days, IQR: 4–336) and during the pandemic (7 days, IQR: 4–225, р=0.6).Conclusion. Contrary to the expected result, no significant difference in delays related to the patient before and during the pandemic was found, and the frequency of delay related to health system during the pandemic significantly reduced compared to the period before the pandemic.

Evaluation of effectiveness of transcranial mesodiencephalic modulation within comprehensive treatment of pulmonary tuberculosis patients with various comorbidities

The objective: to study the impact of transcranial mesodiencephalic modulation on eff ectiveness of comprehensive treatment of pulmonary tuberculosis patients with various comorbidities.Subjects and Methods. 48 patients who received standard regimens of anti-tuberculosis chemotherapy participated in the study; the patients were divided into two groups. In Group 1, patients additionally underwent sessions of mesodiencephalic modulation (MDM), while in Group 2, no MDM was administered.Results. Two months after the start of the study, in Group 1, positive radiological changes were recorded more often – in 91,7% (22/24), in Group 2, positive changes were observed in 62,5% (15/24) of patients (p=0,047; χ2); the same pattern was observed with positive changes of laboratory rates – 91,7% (22/24) versus 66,7% (16/24), (p=0,033; χ2), respectively. In patients of Group 1 compared to Group 2, symptoms of tuberculosis and comorbid conditions fully disappeared or became less intensive in 79,2% (19/24) versus 41,7% (10/24), (p=0,009; χ2). In Group 1, adverse drug reactions were registered in 16,7% (4/24), in Group 2 – 43,5% (10/24), (p=0,05; χ2).

The Efficacy and Safety of Bedaquiline in the Treatment of Pulmonary Tuberculosis Patients: A Systematic Review and Meta-Analysis.

Bedaquiline (BDQ) has been designated as a Group A drug by the World Health Organization (WHO) for the management of multi-drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). This systematic review and meta-analysis aim to evaluate the efficacy and safety of BDQ-containing regimens for the treatment of patients with pulmonary TB. PubMed (MEDLINE), Elton B. Stephens Company (EBSCO) database, the Cochrane Register of Controlled Trials, and the China National Knowledge Infrastructure (CNKI) database were initially searched on 15 June 2022 and again on 20 March 2023. We included randomized controlled trials (RCTs) and non-randomized studies (NRSs) that administered BDQ to TB patients. The outcomes of interest were as follows: (1) efficacy, including the rate of sputum culture conversion at 8 weeks, 24 weeks, and during follow-up, as well as the rates of completion cure, death, treatment failure, and loss at follow-up and at the end of the treatment; and (2) safety, which encompassed the incidences of cardiotoxicity, hepatotoxicity, and grade 3-5 adverse events during the treatment period. A total of 29 articles were included in this meta-analysis, representing 23,358 individuals. Patients who were treated with BDQ were compared with patients who were not exposed to BDQ. The use of BDQ-containing regimens demonstrated improved rates of sputum conversion in RCTs at 24 weeks (RR = 1.27, 95% CI: 1.10 to 1.46) and during follow-up (RR = 1.33, 95% CI: 1.06 to 1.66). Additionally, BDQ-containing regimens showed increased cure rates (RR = 1.60, 95% CI: 1.13 to 2.26) and decreased failure rates (RR = 0.56, 95% CI: 0.56 to 0.88). In NRSs, BDQ-containing regimens improved the sputum culture conversion rate during follow-up (RR = 1.53, 95% CI: 1.07 to 2.20), increased the rate of cure (RR = 1.86, 95% CI: 1.23 to 2.83), reduced deaths from all causes (RR = 0.68, 95% CI: 0.48 to 0.97), and reduced failure rates (RR = 0.57, 95% CI: 0.46 to 0.71). However, the use of BDQ-containing regimens was associated with increased incidences of cardiotoxicity (RR = 4.54, 95% CI: 1.74 to 11.87) and grade 3-5 adverse events (RR = 1.42, 95% CI: 1.17 to 1.73) in RCTs. NRSs also showed an association between BDQ-containing regimens and cardiotoxicity (RR = 6.00, 95% CI: 1.32 to 27.19). No significant differences were observed between intervention groups and control groups with respect to other outcomes. Data from both RCTs and NRSs support the efficacy of BDQ for the treatment of pulmonary tuberculosis. However, the use of BDQ is associated with a higher incidence of cardiotoxicity and serious adverse events. Comparative data on efficacy and safety are limited, and further confirmation is required, due to potential bias and discrepancies in the available studies.

Effect of face-to-face psychoeducation intervention combined with motivational interviewing on adherence in prevention and treatment of pulmonary tuberculosis patients

Introduction: TB can be cured if patients routinely seek treatment for six months without breaking. Poor adherence to tuberculosis treatment is a global health challenge. Whereas adherence to the treatment regimen is important for tuberculosis (TB) control. The consequences of this non-compliance lead to treatment failure and the risk of infection of the disease is widespread. Objectives: The objective of the study is to examine what Face-to-Face Psychoeducation Intervention Combined with Motivational Interviewing effective to improve Adherence in Prevention and Treatment of Pulmonary Tuberculosis Patients. Methods: The research design used quantitative with experimental quasi research design t. The research was conducted at 4 Community Health Centers (Puskesmas), namely Puskesmas Takal, Puskesmas Perak, Puskesmas Pegirian and Puskesmas Sutopo in Surabaya. Through purposive sampling, the sample number was 60 respondents, divided by 30 respondents for the intervention group and 30 respondents for the control group. Results: There was a significant difference after the intervention. In the intervention group, there were changes in outcomes in both preventive adherence (12.37) and medication adherence (4.52). While in the control group, only the value of prevention compliance experienced a change of 5.67. Conclusions: Face-to-face method combined with motivation interviewing is effective in improving prevention and treatment adherence in TB patients. Motivational interviewing has a tendency to reduce hopelessness, an increasing motivation to recover and the admonition of taking medication in tuberculosis patients.

Clinical effect of MRZE chemotherapy combined with cluster nursing intervention in the treatment of patients with pulmonary tuberculosis and its influence on the levels of inflammatory factors and CT signs

ABSTRACT The study aimed to analyze the clinical effect of MRZE chemotherapy combined with cluster nursing intervention and treatment of pulmonary tuberculosis patients and its influence on CT signs. A total of 94 patients treated in our hospital from March 2020 to October 2021 were selected as the research object. Both groups were treated with MRZE chemotherapy regimen. Patients in the control group received routine nursing mode on this basis, and patients in the observation group received cluster nursing on the basis of the control group. The clinical efficacy, adverse reactions, compliance and nursing satisfaction, detection rate of immune function pulmonary oxygen index and pulmonary function CT signs and the level of inflammatory factors before and after nursing were compared between the two groups. The total effective rate of the observation group was significantly higher than that of the control group. The compliance rate and nursing satisfaction of the observation group were significantly higher than those of the control group. The differences of adverse reactions between the observation and control groups were statistically significant. After nursing, the scores of tuberculosis prevention and control of tuberculosis infection route, tuberculosis symptoms, tuberculosis policy and tuberculosis infection awareness in the observation group were significantly higher than those in the control group, and the differences were statistically significant. MRZE chemotherapy combined with cluster nursing intervention model for pulmonary tuberculosis patients can effectively improve the treatment compliance and nursing satisfaction of patients, and it is worthy of clinical promotion and application.

Relationship Between Knowledge Level and Compliance in Tuberculosis Patients

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis which mostly attacks other organs of the body. The source of transmission is TB patients, especially patients who contain TB germs in their sputum. Someone who has high knowledge has also high awereness of health and high motivation to recover. In the treatmnet of tuberculosis succes depends on the support of the family and the knowledge of the patient. If treatment is not complete, it can lead to the emergence of drug- resistant tuberculosis bacteria. If this happens, the germs will spread and control efforts will be more difficult. Purpose: The purpose of this study was to determine whether there was a relationship between the level of knowledge and adherence to the treatment of pulmonary tuberculosis patients. This study uses a analcyticcal sucrvey design with a cross sectional approach with data collection using a questionnaire to respondents of pulmonary tuberculosis patients who meet the inclusion criteria. The data obtained were collected and analyzed using the SPSS program. The results of the chi-square analysis showed 0.05%, 0.036, which means that there is a significant relationship between the level of knowledge and adherence to the treatment of pulmonary tuberculosis patients.

Analysis of the effect of anti-tuberculosis therapy combined with all-in-one nursing care on the alleviation of inflammation in patients with pulmonary tuberculosis.

To analyze the application effect of anti-tuberculosis therapy (ATT) combined with all-in-one nursing care on pulmonary tuberculosis (PT). Seventy-four PT patients who received ATT in our hospital between December 2015 and June 2016 were selected as the research participants and randomized into a research group (RG; n=37) and a control group (CG; n=37) that were given all-in-one nursing care and routine care, respectively. The cure rate and treatment compliance were compared between groups, and the awareness of disease prevention and treatment was investigated. Patients' psychological status and quality of life were evaluated using the Self-Rating Depression/Anxiety Scale (SAS/SDS) and the Quality of Life Questionnaire Core 30 (QLQ-C30), respectively. RG and CG were not statistically different in the clinical cure rate (P>0.05), but the X-ray cure rate was higher and the recurrence rate was lower in RG (P<0.05). In addition, RG showed higher medication compliance rate, regular reexamination rate and awareness of disease prevention and treatment than CG (P<0.05). Reductions in SAS/SDS scores were observed in both groups after care, with even lower levels in RG, while the QLQ-C30 score increased and was higher in RG as compared to CG (P<0.05). Therefore, All-in-one nursing care can effectively enhance the level of treatment compliance and awareness of disease prevention and treatment of PT patients. In the future, when treating PT patients in the clinic, the effectiveness of ATT can be improved by implementing all-in-one nursing care to provide more reliable prognosis for patients.

Circulating mitochondrial cell-free DNA dynamics in patients with mycobacterial pulmonary infections: Potential for a novel biomarker of disease.

Human mitochondrial cell-free DNA (Mt-cfDNA) may serve as a useful biomarker for infectious processes. We investigated Mt-cfDNA dynamics in patients with pulmonary mycobacterial infections to determine if this novel biomarker could be used to differentiate disease states and severity. Patients with pulmonary tuberculosis (PTB), latent tuberculosis infection (LTBI), and nontuberculous mycobacterial-lung disease (NTM-LD) were enrolled at a tertiary care hospital in Taiwan between June 2018 and August 2021. Human Mt-cfDNA and nuclear-cfDNA (Nu-cfDNA) copy numbers were estimated by quantitative polymerase chain reaction. Variables associated with PTB and 2-month sputum culture-positivity, indicating poor treatment response, were assessed using logistic regression. Among 97 patients with PTB, 64 with LTBI, and 51 with NTM-LD, Mt-cfDNA levels were higher in patients with PTB than in LTBI (p=0.001) or NTM-LD (p=0.006). In the Mycobacterium tuberculosis-infected population, Mt-cfDNA levels were highest in smear-positive PTB patients, followed by smear-negative PTB (p<0.001), and were lowest in LTBI persons (p=0.009). A Mt-cfDNA, but not Nu-cfDNA, level higher than the median helped differentiate culture-positive PTB from culture-negative PTB and LTBI (adjusted OR 2.430 [95% CI 1.139-5.186], p=0.022) and differentiate PTB from NTM-LD (adjusted OR 4.007 [1.382-12.031], p=0.011). Mt-cfDNA levels decreased after 2 months of treatment in PTB patients (p=0.010). A cutoff Mt-cfDNA level greater than 62.62 x 106 copies/μL-plasma was associated with a 10-fold risk of 2-month culture-positivity (adjusted OR 9.691 [1.046-89.813], p=0.046). Elevated Mt-cfDNA levels were associated with PTB disease and failed sputum conversion at 2 months in PTB patients, and decreased after treatment.

An Analysis of Factors Influencing the Compliance to Treatment of Pulmonary Tuberculosis Patients Through Family Resilience

Background: Family holds an important role in the care of patient’s health against a disease or illness. The majority of pulmonary TB (tuberculosis) patients have poor social support systems and compliance. Problems with pulmonary TB patients have an impact on families and family unpreparedness, lack of family knowledge about tuberculosis, and the impact of discrimination (stigma) are some of the factors that need to be considered. The family resilience model to improve the compliance of pulmonary TB patients in carrying out treatment programs still requires further study. Research Objectives: To develop a model of family resilience as an effort to improve compliance to treatment for pulmonary TB patients. Research Methods: This study adopted a cross-sectional design. It was conducted in the work areas of Puskesmas in Surabaya City from August to December 2019. A sample of families with pulmonary TB patients containing 160 respondents was calculated using the Rule of Thumb formula, using a multistage random sampling technique. Research variables included: 1) individual factors: age, gender, education, knowledge, position of the patient in the family, personal motivation, 2) family factors: family type, family structure, family health care function, 3) social factors: social support, stigmas, 4) family stressors, including loss, illness and care, tension, 5) individual stress, including depression, anxiety, stress, 6) family stress, 7) family problem solving and coping skills, 8) family resilience, including survival, adaptation, acceptance, growing stronger, helping others, 9) individual belief, including susceptibility, severity, barriers, benefits, cues to action and self-efficacy, and 10) medication compliance included medication compliance and BTA conversion results. Data were collected using a questionnaire which was developed and analyzed using SEM-PLS. Research Results: The family resilience model as an effort to improve treatment compliance for pulmonary TB patients was a fit model with good predictive relevance (SRMR=0.053&lt;0.081; NFI=0.919&gt;0.90; Q2&gt;0). Individual factors (t-stat=3.048) and family stress (t-stat=4.923) have an effect on the pulmonary TB patients. Individual stress (t-stat=2.642) and family resilience (t-stat=5.163) have an effect on individual beliefs. Patient factors (t-stat=2.429), family factors (t-stat=2.999), social factors (t-stat=2.745), and family stressors (t-stat=3.345) have an effect on family stress. Family stress affects family problem solving and coping skills (t-stat t=3.606). Problem solving ability and family coping skills affect family resilience (t-stat=2.116). Family resilience affects medication compliance (t-stat=7.407), while the patient's belief affects compliance (t-stat=2.881). Conclusions: There is better increased compliance to treatment through family resilience compared to individual beliefs of pulmonary TB patients. Family plays an important role in the care of sick family members, and one of the family functions is health care. Family as a group can cause, prevent, ignore, or remedy health problems in the group.

Adjunctive corticosteroid therapy in patients with pulmonary tuberculosis.

SUMMARYOBJECTIVES:In tuberculosis treatment, corticosteroids are used as adjuvants, especially in meningeal/pericardial tuberculosis. In other forms of the disease, especially in severe tuberculosis requiring mechanical ventilation, its use is controversial. The aim of the present study is to assess whether the use of corticosteroids in the treatment of pulmonary tuberculosis patients in mechanical ventilation is associated with in-hospital mortality.METHODS:This is a retrospective cohort study. Tuberculosis patients >18 years requiring mechanical ventilation, admitted to the emergency department or intensive care unit, were included. Data on corticosteroid use and mortality were collected.RESULTS:In total, 467 patients were included in the analysis; 399 used corticosteroids and 68 were noncorticosteroid users. The mortality rate was higher among corticosteroid users (59.9%) than in noncorticosteroid users (41.2%) (p=0.010). The total dose of corticosteroid in prednisone equivalents was not different between survivors and nonsurvivors (median [interquartile range]: 80 mg [5–56.6 mg] vs. 80 mg [50–135 mg]; p=0.881).CONCLUSIONS:Tuberculosis patients in mechanical ventilation who used corticosteroids had a higher mortality rate than those who did not use corticosteroids. The role of corticosteroids in pulmonary tuberculosis, especially in critically ill patients, remains unclear and needs further evaluation in prospective studies.

Hubungan Pengetahuan, Sikap dengan Dukungan Keluarga sebagai Pengawas Kepatuhan Minum Obat Penderita Tuberkulosis Paru

Tuberculosis (TB) is an infectious infectious disease caused by the bacterium mycobacterium tuberculosis that attacks various organs, especially the lungs. Family support greatly supports the successful treatment of Pulmonary TB patients by reminding patients to take medication. Meanwhile, the family support provided is closely related to the knowledge and attitudes possessed. The purpose of this study is to find out the relationship between knowledge and attitudes with family support as supervisors of taking drugs in patients with pulmonary tuberculosis in the Bontoa Health Center Working Area, Maros Regency. This type of research is analytical research with a cross-sectional study approach. The population in this study was the families of patients as supervisors of taking drugs as many as 44 people and the sample who became drug supervisors (PMO) amounted to 35 people using accidental sampling techniques with questionnaire sheet instruments to take respondent data. The results showed that 20 respondents (57.1%) had knowledge in the good category and 19 respondents (54.3%) had a positive attitude, and there was a relationship between knowledge (p = 0.021) and attitude (p = 0.009) with the support of families as supervisors of taking drugs in patients with pulmonary tuberculosis in the Bontoa Health Center Work Area, Maros Regency. The conclusion in this study is that there is a relationship between knowledge and attitudes with family support as supervisors of taking drugs in pulmonary tuberculosis sufferers in the work area of the bontoa health center in Maros district, and advice to the government through relevant health officials to improve the knowledge and attitudes of drug-taking supervisors (PMO) in their area in order to increase support for family members suffering from pulmonary TB, so that it can increase the cure rate of sufferers. .

Gender Differences in Factors Associated with the Total Delay in Treatment of Pulmonary Tuberculosis Patients: A Cross-Sectional Study in Selangor, Malaysia.

Background: Gender plays a significant role in health-care-seeking behavior for many diseases. Delays in seeking treatment, diagnosis, and treatment for pulmonary tuberculosis (pTB) may increase the risk of transmission in the community and lead to poorer treatment outcomes and mortality. This study explores the differences in factors associated with the total delay in treatment of male and female pTB patients in Selangor, Malaysia. Methods: A cross-sectional study was conducted from January 2017 to December 2017. Newly diagnosed pTB patients (≥18 years) were recruited from selected government health clinics and hospitals in Selangor during the specified study period. An interviewer-administered questionnaire was used to collect information on sociodemographic characteristics, lifestyle, knowledge about pTB, stigma, distance to the nearest health facility, and chronology of pTB symptom onset, diagnosis, and treatment. The total delay was measured as the length of time between the onset of pTB symptoms to treatment initiation. Factors significantly associated with a longer total delay among men and women were identified using binary logistic regression. Results: A total of 732 patients (61.5% men, 38.5% women) were enrolled in the study. The median total delay was 60 days. Men who have weight loss as a symptom (AOR: 1.63, 95%CI: 1.10–2.41) and are employed (1.89, 1.15–3.11) were more likely to have a longer total delay, while those who know others who have had pTB (0.64, 0.43–0.96) were less likely to have a longer total delay. On the other hand, among women, having a stigma towards TB (0.52, 0.32–0.84) and obtaining a pTB diagnosis at the first medical consultation (0.48, 0.29–0.79) were associated with a shorter total delay. Conclusion: Factors associated with the total delay in pTB treatment were different for male and female pTB patients. Increasing awareness of pTB symptoms and the importance of seeking early medical consultation and a prompt diagnosis among the general public may reduce total delay in pTB treatment.

Search for ways to improve the effectiveness of treatment of pulmonary tuberculosis patients with multiple resistance of mycobacterium tuberculosis to anti-tuberculosis drugs

Aim. To conduct a comparative study of the effectiveness of treatment of MDR-TB patients by using short-term and individual chemotherapy regimens and including the drug Cholecalciferol in the treatment complex.Material and methods. The group of MDR-TB patients with a short-term treatment regimen included 40 patients, and 40 patients were included in the group of MDR-TB patients with an individual treatment regimen. Both observation groups were divided into two subgroups of patients with MDR-TB of the lungs (20 people from each group). In one group treatment included Cholecalciferol 300,000 U intramuscularly weekly (6-8 times in total) in the complex of the above treatment; comparison groups: patients with MDR-TB of the lungs (20 people from each group) received a complex of the above chemotherapy without the drug Cholecalciferol.Results. In the group of patients with the inclusion of Cholecalciferol in a short-term treatment regimen, a favorable treatment outcome was noted in 100% of cases, while in the group of patients without Cholicalciferol - in 80% of cases. With an individual treatment regimen in the group of patients with the inclusion of Cholecalciferol, conversion by sputum culture also occurred in 100% of cases, while in the group of patients without Cholicalciferol - in 70% of patients.Conclusion. Thus, the introduction of a new short-term chemotherapy regimen for MDR-TB patients has increased the effectiveness of their treatment. In two subgroups of MDR-TB patients with different chemotherapy regimens, who received injections of Cholecalciferol in the chemotherapy treatment plan, the effectiveness of treatment based on the results of the timing of the development of conversion by sputum culture was assessed as significantly higher than in the subgroups that did not receive vitamin D3.

THE CORRELATION THE ROLE OF SUPERVISOR TAKING MEDICINE WITH THE SUCCESS OF TREATMENT OF LUNG TB IN PUBLIC HEALTH CENTER GERAK MAKMUR SAMPOLAWA, SOUTH BUTON

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterum Tuberculosis which can spread through droplets that have been infected with TB bacilli. In 2018, there was increasing case of lung TB about 33 people (4 people is broken up treatmment and failed, 29 is healed). The purpose of this study was to determine the relationship between the assistance of taking medication with the success of the treatment of pulmonary TB patients and the relationship of mentoring for repeat treatment at the puskesmas with the success of the treatment of pulmonary TB patients at Gerak Makmur Puskesmas, Sampolawa Subdistrict, South Buton District. This type of research is quantitative research using cross sectional design. The number of samples in this study were 33 people. Sampling in this study uses total sampling, which is the sample taken entirely from the population who finished treatment at the prosperous Gerak Community Health Center. Data analysis performed was univariate and bivariate analysis with chi square test. The results showed that there was a relationship between the role of the supervisor of taking drugs with the success of pulmonary TB treatment in the working area of Gerak Makmur Selatan Buton South Puskesmas with a value (p = 0,000&lt;0,05) and there is a relationship between medical assistance and the success of pulmonary TB treatment in the working area of Gerak Makmur Selatan Buton Puskesmas with a value (p = 0.008&lt;0,05). shows that there is a relationship between the role of the supervisor of taking drugs with the success of pulmonary TB treatment and there is a relationship between the assistance of taking drugs with the success of pulmonary TB treatment, and there is a relationship between mentoring repeat treatment with the success of pulmonary TB treatment at Gerak Makmur Selatan Buton Selatan health center.Keywoard: pulmonary TB successful treatment, supervision of taking medication

Evaluation of prognostic significance of hematological profiles after the intensive phase treatment in pulmonary tuberculosis patients from Romania.

We evaluated in this cohort study the predictive ability of 23 peripheral blood parameters and ratios for treatment outcomes after the 2-month intensive phase in patients with PTB. In 63 patients out of 90 that turned culture negative, a significant decrease in white blood cell count, neutrophils, monocyte, hemoglobin, platelet, plateletcrit, erythrocyte sedimentation rate, MLR, NLR, PLR and SII values after anti-TB therapy compared to pretreatment was observed (p <0.001). Logistic regression analysis generated a model of predictors consisting of nine covariates. Spearman’s correlation analysis revealed significant positive correlations between NLR with NEU (r = 0.79, p<0.01), SII with NEU (r = 0.846, p<0.01), PLT with SII (r = 0.831, p<0.01), PLT with PCT (r = 0.71, p<0.01) and MPV with P-LCR (r = 0,897, p<0.01) in 63 patients out of 90 that turned culture negative after 2 months of treatment. ROC curve analysis indicated that all areas under the curve (AUC) revealed no statistically significant results, except lymphocyte for culture conversion. In summary, here we observed a set of hematological parameters that declined significantly as the disease was treated in patients that turned culture negative. Despite some limitations, our findings are useful for further studies aiming to identify hematological profiles that could predict the treatment outcome.

The Correlations of Knowledge, Attitude and Practice with Compliance in Treatment of Pulmonary Tuberculosis Patients in Puskesmas Cakranegara

Patient compliance refers to the suitability of behavior against treatment recommendations include timing, dose and frequency of treatment. Compliance to tuberculosis treatment was actually very complex and dynamic with various factors that interacted each other, and therefore it will influence on patient’s behavior decision. Patient who has a good compliance will increase success to his recovery. This study was carried out to determine the correlation between tuberculosis patient behavior which consists of the domain of knowledge, attitudes and practices with compliance to taking anti-tuberculosis drugs at the Puskesmas Cakranegara commencing on July to November 2020. This research was an observational analytic study using a cross sectional method. Population sample was patients who diagnosed with pulmonary tuberculosis which undergoing category 1 treatment at Puskesmas Cakranegara. The data used in the study was primary data established from interviewing patients using a questionnaire on selected Pulmonary TB patients including respondents who eligible as the inclusion and exclusion criteria. The number of samples in this study were 30 infected-people. The data obtained were analyzed using the Spearman correlation test. The correlation test of the study showed that there was no significant correlation between variable of knowledge and medication compliance (p = 0.079, r = 0.325). However, the attitude variables had a significant correlation with medication compliance (p = 0.000, r = 0.715). Similarly, the practices variable has a significant correlation to the medication compliance (p = 0.000, r = 0.656). This study found that there was no significant correlation between knowledge and compliance taking anti-tuberculosis drugs. However, it was found that there was a significant correlation between attitudes and practices with compliance to taking anti-tuberculosis drugs.

Short course treatment of pulmonary tuberculosis patients suffering from multiple drug resistance. The current situation and future perspectives

The article presents a review of 70 publications. It describes relevant data on drugs, timing, indications, efficacy, and safety of short-term treatment regimens for multiple drug resistant tuberculosis.

Risk factors for death during treatment in pulmonary tuberculosis patients in South India: A cohort study

ObjectiveIdentifying the risk factors for deaths during tuberculosis (TB) treatment is important for achieving the vision of India's National Strategic Plan of ‘Zero Deaths’ by 2025. We aimed to determine the proportion of deaths during TB treatment and its risk factors among smear positive pulmonary TB patients aged more than 15 years. Study designWe performed a cohort study using data collected for RePORT India Consortium (Regional Prospective Observational Research in Tuberculosis). SettingRevised TB Control Program (RNTCP) in three districts of South India. ParticipantsThe cohort consisted of newly diagnosed drug sensitive patients enrolled under the Revised National TB Control Program during 2014–2018 in three districts of southern India. Information on death was collected at homes by trained project staff. Primary outcome measuresWe calculated ‘all-cause mortality’ during TB treatment and expressed this as a proportion with 95% confidence interval (CI). Risk factors for death were assessed by calculating unadjusted and adjusted relative risks with 95% CI. ResultsThe mean (SD) age was of the 1167 participants was 45 (14.5) years and 79% of them were males. Five participants (0.4%) were HIV infected. Among the males, 560 (61%) were tobacco users and 688 (75%) reported consuming alcohol. There were 47 deaths (4%; 95% CI 3.0–5.3) of which 28 deaths (60%) occurred during first two months of treatment. In a bi-variable analysis, age of more than 60 years (RR 2.27; 95%CI: 1.24–4.15), male gender (RR 3.98; 95% CI: 1.25–12.70), alcohol use in last 12 months (RR 2.03; 95%CI: 1.07–3.87), tobacco use (RR 1.87; 95%CI: 1.05–3.36) and severe anaemia (RR 3.53: 95%CI: 1.34–9.30) were associated with a higher risk of death. In adjusted analysis, participants with severe anaemia (<7gm/dl) had 2.4 times higher risk of death compared to their counterparts. ConclusionThough deaths during TB treatment was not very high, early recognition of risk groups and targeted interventions are required to achieve zero TB deaths.

The multicenter observational non-interventional study of combination anti-tuberculosis drugs used in treatment of pulmonary tuberculosis patients

The objective of the study:to run a multicenter non-interventional observational study to assess treatment outcomes in tuberculosis patients receiving combination drugs with fixed doses, and to evaluate tolerability and safety of these drugs.Subjects and methods.13 TB units participated in this study which lasted from 2016 to 2018. The primary population (PP) included of 489 patients, after applying the exclusion criteria – the subpopulation (subPP) included 267 patients with newly detected pulmonary tuberculosis and relapses who received treatment as per chemotherapy regimen I or III. Descriptive statistics methods were used for statistical data processing.Results.Of all PP, 267 (54.6%) completed the main course of chemotherapy. (subPP). Out of 489 patients, treatment was discontinued in 118 (24.1%) of them. Primary drug resistance was detected in 30 (6.1%) patients out of 489 patients, secondary drug resistance – in 74 (15.1%) of 489. In subPP, by the end of the intensive phase the sputum conversion was achieved in 78 (96.3%) of 81 patients. Clinical and X-ray changes had been observed in this subgroup for 106.2 to 63.3 days (median 90). The duration of the intensive phase in the subPP made 107.9 ± 50.5 days. In safety assessment, 191 adverse events (AE) were registered in 149 (30.5%) of 489 patients. By severity, most AEs were minor (164 out of 191), moderate AEs were less frequent (20 out of 191), and there were 7 cases of serious AEs. 61 AEs in 57 (38.2%) out of 149 patients were confidently associated with in-take of the studied drugs. The structure of those AEs, transient transaminase level elevation prevailed (45 (73.8%) of 61 AEs, but there was a single case (1.6%) drug-induced hepatitis). Among the serious AEs, two cases were safely resolved by the end of the protocol, two of them were fatal in TB/HIV co-infection, and three cases were diagnosed with cancer.

Increased vegetable and fruit intake is associated with reduced failure rate of tuberculosis treatment: a hospital-based cohort study in China.

Increased intake of vegetables and fruits has been associated with reduced risk of tuberculosis infection. Vegetables and fruits exert immunoregulatory effects; however, it is not clear whether vegetables and fruits have an adjuvant treatment effect on tuberculosis. Between 2009 and 2013, a hospital-based cohort study was conducted in Linyi, Shandong Province, China. Treatment outcome was ascertained by sputum smear and chest computerised tomography, and dietary intake was assessed by a semi-quantitative FFQ. The dietary questionnaire was conducted at the end of month 2 of treatment initiation. Participants recalled their dietary intake of the previous 2 months. A total of 2309 patients were enrolled in this study. After 6 months of treatment, 2099 patients were successfully treated and 210 were uncured. In multivariate models, higher intake of total vegetables and fruits (OR 0·70; 95 % CI 0·49, 0·99), total vegetables (OR 0·68; 95 % CI 0·48, 0·97), dark-coloured vegetables (OR 0·61; 95 % CI 0·43, 0·86) and light-coloured vegetables (OR 0·67; 95 % CI 0·48, 0·95) were associated with reduced failure rate of tuberculosis treatment. No association was found between total fruit intake and reduced failure rate of tuberculosis treatment (OR 0·98; 95 % CI 0·70, 1·37). High intake of total vegetables and fruits, especially vegetables, is associated with lower risk of failure of tuberculosis treatment in pulmonary tuberculosis patients. The results provide important information for dietary guidelines during tuberculosis treatment.