Tuberculosis Mortality Research Articles

Africa Health Research Institute (AHRI) Household Contact study: a study protocol, statistical analysis and modelling plan

Household case-contact studies are an established method to estimate the relative infectiousness of people with pulmonary tuberculosis. Testing of child household contacts with a QuantiFERON TB Gold plus (QFT) assay provides a proxy measure of M. tuberculosis infection in exposed household members. This study aims to generate data about the effect of antiretroviral treatment (ART) and of tuberculosis symptoms on risk of intra-household M. tuberculosis transmission to children and investigate the conditions under which symptom-agnostic screening should be considered, which could provide evidence to support a paradigm shift in tuberculosis screening strategy. Index people diagnosed with bacteriologically-confirmed pulmonary tuberculosis who have been identified by routine health services and starting tuberculosis treatment at one of the 12 health facilities serving the population of the Africa Health Research Institute health and demographic surveillance area will be eligible for recruitment. For each consenting index participant, we will enroll all household members aged 2-14 years who will undergo a symptom screen and provide a blood sample for a QFT and HIV test. We will compare the proportion of child contacts who are QFT-positive in households of (i) index adults who are living with HIV and taking ART vs not taking ART and (ii) index adults engaged in ART care who report no symptoms vs those who report symptoms. We will use a novel mathematical model, incorporating new insights into TB natural history and transmission, to determine the circumstances under which screening for TB, regardless of reported symptoms, would have most impact on tuberculosis incidence and mortality, and explore comparative cost-effectiveness of interventions along the diagnostic pathway at different levels of the health system. Estimates of relative risk of intra-household M. tuberculosis transmission, combined with healthcare utilisation and cost data, will allow us to generate mathematical model estimates of the potential epidemiological impact and relative cost-effectiveness of different approaches to tuberculosis case-finding including symptom-agnostic tuberculosis screening at different levels of the health system.

A predictive score for early in-patient tuberculosis mortality: A case-control study

IntroductionIn-hospital mortality rates for tuberculosis (TB) patients are high within the first seven days of admission. This study sought to identify predictors of early inpatient mortality and assess the performance of a predictive score for early mortality in a Ugandan tertiary hospital. Materials and methodsA case-control study was conducted at Kiruddu National Referral Hospital in Kampala, Uganda. Cases included patients admitted with TB who died within seven days of admission, while controls survived beyond this period. Logistic regression was utilized to identify early mortality predictors. The performance of an adapted predictive score (PROS score) was evaluated, assigning scores based on the following criteria: Pulse rate >100 beats/min (1 point), Respiratory rate >20 breaths/min (2 points), Oxygen saturation <92 % (4 points), and Systolic blood pressure <90 mmHg (2 points). ResultsOf 602 hospitalized TB patients, 187 (31.0 %) died during admission. Among these, 78 (41.7 %) died within seven days. Wasting (adjusted odds ratio [aOR] = 5.76, 95 % confidence interval [CI] 2.12–15.63, p = 0.001) and respiratory rate >20 breaths/min (aOR = 2.89, 95 % CI 1.19–7.00, p = 0.019) predicted early mortality. PROS score of ≥1 demonstrated a sensitivity of 87.8 % and negative predictive value of 90.0 %. The ultimate TB treatment success rate of all hospitalized patients (n = 599) was 47.4 % with 275 (45.9 %) dying during TB treatment. ConclusionEarly and long term mortality rates among hospitalized TB patients are high. Wasting and tachypnea predict early inpatient mortality. The PROS score could be useful in ruling out low-risk patients in low-resource settings.

Ecological-level factors associated with tuberculosis incidence and mortality: A systematic review and meta-analysis.

Globally, tuberculosis (TB) is the leading infectious cause of morbidity and mortality, with the risk of infection affected by both individual and ecological-level factors. While systematic reviews on individual-level factors exist, there are currently limited studies examining ecological-level factors associated with TB incidence and mortality. This study was conducted to identify ecological factors associated with TB incidence and mortality. A systematic search for analytical studies reporting ecological factors associated with TB incidence or mortality was conducted across electronic databases such as PubMed, Embase, Scopus, and Web of Science, from each database's inception to October 30, 2023. A narrative synthesis of evidence on factors associated with TB incidence and mortality from all included studies, alongside random-effects meta-analysis where applicable, estimated the effects of each factor on TB incidence. A total of 52 articles were included in the analysis, and one study analysed two outcomes, giving 53 studies. Narrative synthesis revealed predominantly positive associations between TB incidence and factors such as temperature (10/18 studies), precipitation (4/6), nitrogen dioxide (6/9), poverty (4/4), immigrant population (3/4), urban population (3/8), and male population (2/4). Conversely, air pressure (3/5), sunshine duration (3/8), altitude (2/4), gross domestic product (4/9), wealth index (2/8), and TB treatment success rate (2/2) mostly showed negative associations. Particulate matter (1/1), social deprivation (1/1), and population density (1/1) were positively associated with TB mortality, while household income (2/2) exhibited a negative association. In the meta-analysis, higher relative humidity (%) (relative risk (RR) = 1.45, 95%CI:1.12, 1.77), greater rainfall (mm) (RR = 1.56, 95%CI: 1.11, 2.02), elevated sulphur dioxide (μg m-3) (RR = 1.04, 95% CI:1.01, 1.08), increased fine particulate matter concentration (PM2.5) (μg/ m3) (RR = 1.33, 95% CI: 1.18, 1.49), and higher population density (people/km2) (RR = 1.01,95%CI:1.01-1.02) were associated with increased TB incidence. Conversely, higher average wind speed (m/s) (RR = 0.89, 95%CI: 0.82,0.96) was associated with decreased TB incidence. TB incidence and mortality rates were significantly associated with various climatic, socioeconomic, and air quality-related factors. Intersectoral collaboration across health, environment, housing, social welfare and economic sectors is imperative for developing integrated approaches that address the risk factors associated with TB incidence and mortality.

Scientific knowledge in the 21st century on social and economic factors that influence mortality due to tuberculosis: A bibliometric review

This research presents a bibliometric review of scientific production on the social and economic factors that influence mortality from tuberculosis between the years 2000 and 2024. The analysis covered 1742 documents from 848 sources, revealing an annual growth of 6% in scientific production with a notable increase starting in 2010, reaching a peak in 2021. This increase reflects growing concern about socioeconomic inequalities affecting tuberculosis mortality, exacerbated in part by the COVID-19 pandemic. The main authors identified in the study include Naghavi, Basu and Hay, whose works have had a significant impact on the field. The most prominent journals in the dissemination of this research are Plos One, International Journal of Tuberculosis and Lung Disease and The Lancet. The countries with the greatest scientific production include the United States, the United Kingdom, India and South Africa, highlighting a strong international contribution and a global approach to the problem. The semantic development of the research shows a concentration on terms such as “mortality rate”, “risk factors” and “public health”, with a thematic map highlighting driving themes such as “socioeconomic factors” and “developing countries”. The theoretical evolution reflects a growing interest in economic and social aspects to gender contexts and associated diseases. This study provides a comprehensive view of current scientific knowledge, identifying key trends and emerging areas for future research.

Tuberculosis-related deaths at a tertiary hospital in Zambia: Insights into the prevalence and associated factors.

Tuberculosis (TB) mortality remains a significant public health concern globally. This study aimed to determine the prevalence of tuberculosis-related deaths and associated factors among patients at Livingstone University Teaching Hospital (LUTH) Chest Clinic, Zambia. We conducted a retrospective cross-sectional study among 694 individuals (507 adult and 187 children) diagnosed with drug susceptible TB disease between January 1, 2021, and December 31, 2022. Demographic and clinical information were collected from medical records using a data collection form. Multivariable logistic regression was used to determine factors associated with TB-related death. Statistical significance was set at p < 0.05. STATA version 15 was used for all data analysis. The prevalence of TB-related death among adults (above 19 years old) was 18.4% (n = 93) whereas that in children (below 19 years old) was 7.0% (n = 187). Living with HIV (AOR 1.75, 95% CI 1.00-3.08, p = 0.049) was positively associated with TB-related death among the adult patients while being on a family based direct observation therapy (DOT) plan was negatively associated with TB-related death both among adults and among children, (AOR 0.24, 95% CI 0.13-0.45, p <0.001) and (AOR 0.2, 95% CI 0.03-0.99, p = 0.039) respectively. This study found a high TB-related mortality rate, both among adults and children, exceeding the national target of 5% and it was significantly associated with HIV status and DOT plan. There is therefore a need to enhance strategies aimed at reducing TB-related deaths, especially among those living with HIV.

Estimation of tuberculosis mortality burden in spain: a review of the major data sources

IntroductionIn Spain, notifications of cases of tuberculosis (TB) are registered through the National Epidemiological Surveillance Network (RENAVE). The Minimum Basic Data Set (CMBD) provides information on hospital discharge and the Statistics National Institute (INE) draws on medical death certificates. This study aimed to describe TB mortality in Spain and to compare estimates across data sources, as well as with EU/EEA countries.Material and MethodsA retrospective study of TB data between 2008 −2021 was performed. Mortality rates (MR) were calculated for the three databases as well as fatality rates (CFR) for TB location and HIV status using RENAVE data. Time trends were calculated and the average MR and annual average percentage change for Spain were compared with EU/EEA countries.ResultsBetween 2008 and 2021, 4127 TB deaths were reported to RENAVE, 3877 to INE and 4775 to CMBD. The MR was 0.62 per 100,000 inhabitants for RENAVE, 0.59 for INE and 0.72 for CMBD. A statistically significant downward annual trend was observed. Highest MR across all databases were found in men and in those over 80 years old. CFR was higher for meningeal TB and for HIV patients with a risk ratio of 2.02 (95%CI: 1.82-2.2; p&lt;0.05).ConclusionAlthough the TB MR in Spain has followed a downward annual trend, it is necessary to continue improving prevention, diagnosis and treatment. This will require comprehensive measurement, better knowledge and better use of all information to complement surveillance systems.

Comparative assessment of the epidemic state of tuberculosis before and during the war in Ukraine

BACKGROUND. The war has a negative impact on patient care and the efficiency of the health care system; access to medical care is limited, coverage of preventive examinations and detection of tuberculosis (TB) are deteriorating. There is a threat of exacerbation of the epidemic situation with TB in Ukraine. OBJECTIVE. To assess the epidemic situation with TB during the war in Ukraine. MATERIALS AND METHODS. Comparison of data from the Ministry of health on TB (epidemiological indicators and indicators on detection, diagnosis and prevention) in the pre-war (2018-2021) and war (2022-2023) periods. RESULTS. The following were revealed: 1) a positive trend towards a decrease in epidemiological indicators of TB in 2018-2020, which slowed down in 2021 due to the COVID-19 pandemic, and a negative trend towards an increase in almost all indicators of TB incidence, separate indicators of mortality from TB and its prevalence in 2022-2023; 2) significant increase in the incidence of TB among contacts and children; 3) increase by ⅓-. of mortality from TB in certain regions; 4) correlation between regional rates of morbidity, mortality and prevalence of TB. In 2018-2023, the following decreased: fluorography examination, tuberculin diagnostics, detection of TB during preventive examinations (by 2-4 times), preventive vaccinations for children of the first year of life, detection of newly diagnosed and recurrent TB by smear, preventive treatment in contacts. CONCLUSIONS. Incidence is a marker of response to negative external factors and the main criterion for assessing the epidemic state of TB during the war. Fluorography examination, tuberculin diagnostics, detection of TB during professional examinations, preventive vaccinations for children of the first year of life, detection of newly diagnosed and recurrent TB by smear, preventive treatment of contacts are the main criteria for evaluating the activity of the anti-TB service during the wartime, since they are the first to significantly respond to the challenges of war.

Cause of death in patients with tuberculosis: A study based on epidemiological and autopsy records of Western Norway 1931-47

BackgroundWithout treatment, nearly 50 % of tuberculosis (TB) patients die. World Health Organization’s definition of TB deaths does not take into consideration whether the cause of death was TB or other non-TB co-morbid conditions. We aimed to improve our knowledge of the causes of death in patients with TB. MethodsSingle-center retrospective study conducted at Gade Institute of Pathology, Haukeland University Hospital, Bergen, Norway. Autopsy data of 269 patients with TB was collected from autopsy journals, and epidemiological data was collected from Norwegian Official Statistics books for period 1931–1947. ResultsOf all TB deaths reported in epidemiological reports, pulmonary TB accounted for 81 % and extrapulmonary TB for 19 %. However, in autopsy records, only 21 % of cases with active pulmonary TB died because of TB. Extrapulmonary involvement was significantly associated with higher mortality (OR EPTB as compared to PTB; 3.27, CI 1.91 – 5.61) and constituted 79 % of deaths attributable to TB. A significant burden of extrapulmonary TB was found in autopsy records (63 %), while in epidemiological records, only 4 % of cases were reported. ConclusionsExtrapulmonary involvement was a predictor of mortality due to TB in hospitalized TB patients. The contribution of extrapulmonary TB to TB mortality seems to be underestimated because extrapulmonary TB largely remains underdiagnosed and underreported in epidemiological data.

Clinical characteristics and mortality of tuberculosis among adults living with HIV/AIDS: A single center, retrospective cohort study in Thailand.

Tuberculosis (TB) among people living with HIV/AIDS (PLWHA) contributes substantially to morbidity and mortality, particularly in high TB burden countries. Our objective is to investigate the clinical characteristics and mortality rates associated with TB among adult PLWHA over a 10-year period at an urban HIV clinic situated in a high TB burden country. A retrospective cohort study was conducted in 2022. The primary endpoints were clinical characteristics and mortality rate of TB, determined as per 100 person-years among adult PLWHA, presented with a 95% confidence interval. Univariable and multivariable Cox proportional regression analyses were performed to determine risk factors for TB mortality. From January 2012-December 2022, 155 PLWHA receiving a diagnosis of TB were enrolled. The median age was 29 (26.5-48.5) years, and the median CD4 + T cell count was 141 (41.8-252.8) cells/µL, with 60.0% of patients with TB manifesting as disseminated infection. The most involved organs were pulmonary (89.7%), lymph nodes (39.4%) and pleura (14.8%). The treatment outcomes exhibited success in 63.2% of cases, relapse in 5.2%, loss to follow up in 17.4% and death in 14.2%. The overall mortality rate was 18.8 per 100 person-years. Multivariable analyses showed significant factors affecting mortality, including lymph node involvement (adjusted HR 3.5; 95% CI 1.1-10.8) and thrombocytopenia (adjusted HR 74.2; 95% CI 10.0-551.4). TB in PLWHA, commonly presenting as disseminated infection, contributes to high mortality. Lymph node involvement and thrombocytopenia are significant factors contributing to mortality. Tuberculosis preventive treatment should be considered for improved prevention strategies among PLWHA, particularly in high TB burden countries.

Tuberculosis morbidity and mortality during the COVID-19 pandemic: a life-threatening complex challenge.

Tuberculosis morbidity and mortality during the COVID-19 pandemic: a life-threatening complex challenge.

The temporal trend of tuberculosis burden in an aging population in China: a secondary data analysis from the GBD 2019

BackgroundThe rapid population aging in China has been a big challenge to achieve the goal of ending the global tuberculosis (TB) epidemic. This study aimed to describe the temporal trend of TB burden in China during 1990 ∼ 2019 and to evaluate the effect of age, period, and birth cohort on domestic TB burden, with a specific focus on the elderly.MethodsThe trends of incidence, mortality, and disability-adjusted life years (DALYs) of TB among human immunodeficiency virus (HIV) negative people were described using the data from the Global Burden of Disease 2019 study. Join-point regression model was applied to calculate the average annual percentage change (AAPC) of TB burden for different age groups. Age-period-cohort (APC) model was fitted for incidence and mortality, and relative risks (RR) were computed for each age group.ResultsIn 2019, the highest TB deaths (5.23 thousand, 95% uncertainty interval [UI]: 4.38 ∼ 6.17) and DALYs (155.18 thousand, 95%UI: 126.47 ∼ 190.55) were observed in the HIV-negative population aged 70 ∼ 74 years in China. The proportion of those aged ≥ 60 years in newly diagnosed TB patients without HIV coinfection increased from 23.82% in 1990 to 37.54% in 2019, while TB deaths rose from 48.70 to 68.64%. During the past 30 years, the AAPC of age-standardized mortality (-7.77, confidence interval [CI]: -8.44∼ -7.10) and DALYs (-7.48, 95% CI: -7.98∼ -6.97) among HIV-negative individuals have shown a decrease, while much slower in the age groups above 70-year-old. The period effect and cohort effect contributed to the decline of TB incidence and mortality, but the age effect led to increasing TB mortality, especially among the ages of 85 ∼ 89 years (RR = 4.59, 95% CI: 4.25 ∼ 4.95).ConclusionsThe burden of TB remains considerable in the elderly population in China. More actions should be taken to improve case finding and the quality of TB healthcare for this high-risk population.

Quantum Dot-Based Nanosensors for In Vitro Detection of Mycobacterium tuberculosis.

Despite the existing effective treatment methods, tuberculosis (TB) is the second most deadly infectious disease, its carriers in the latent and active phases accounting for more than 20% of the world population. An effective method for controlling TB and reducing TB mortality is regular population screening aimed at diagnosing the latent form of TB and taking preventive and curative measures. Numerous methods allow diagnosing TB by directly detecting Mycobacterium tuberculosis (M.tb) biomarkers, including M.tb DNA, proteins, and specific metabolites or antibodies produced by the host immune system in response to M.tb. PCR, ELISA, immunofluorescence and immunochemical analyses, flow cytometry, and other methods allow the detection of M.tb biomarkers or the host immune response to M.tb by recording the optical signal from fluorescent or colorimetric dyes that are components of the diagnostic systems. Current research in biosensors is aimed at increasing the sensitivity of detection, a promising approach being the use of fluorescent quantum dots as brighter and more photostable optical tags. Here, we review current methods for the detection of M.tb biomarkers using quantum dot-based nanosensors and summarize data on the M.tb biomarkers whose detection can be made considerably more sensitive by using these sensors.

Host Risk Factors for Tuberculosis.

Tuberculosis (TB) spreads through droplets that contain Mycobacterium tuberculosis (Mtb) and can infect susceptible people. Due to different risk factors, people have different susceptibility ranges towards TB. The risk factors are classified into three main groups, includ-ing bacterial, environmental, and host factors. Literature review reveals that the most important host risk factors are aging, male gender, genetics, epigenetics, having an impaired immune system, diabetes, malignancy, malnutrition, anemia, and pregnancy. The risk factors contribute to the increase in TB cases through inflammation, increased contact with TB patients, disrup-tion of immune genes, changes in gene expression, increased activity of Mtb, damage to cellu-lar immunity, reactivation of Latent TB Infection (LTBI), increased susceptibility to TB, com-promised immunity, and changes in the proportion of T cell subgroups, respectively. Therefore, identification of the infection source and high-risk people and timely treatment of the patients can reduce TB mortality and help control the disease.

Elevated Plasma Matrix Metalloproteinases Are Associated With Mycobacterium tuberculosis Bloodstream Infection and Mortality in Human Immunodeficiency Virus-Associated Tuberculosis.

Mortality from human immunodeficiency virus (HIV)-associated tuberculosis (TB) is high, particularly among hospitalized patients. In 433 people with HIV hospitalized with symptoms of TB, we investigated plasma matrix metalloproteinases (MMP) and matrix-derived biomarkers in relation to TB diagnosis, mortality, and Mycobacterium tuberculosis (Mtb) bloodstream infection (BSI). Compared to other diagnoses, MMP-8 was elevated in confirmed TB and in Mtb-BSI, positively correlating with extracellular matrix breakdown products. Baseline MMP-3, -7, -8, -10, and PIIINP were associated with Mtb-BSI and 12-week mortality. These findings implicate MMP dysregulation in pathophysiology of advanced HIV-TB and support MMP inhibition as a host-directed therapeutic strategy for HIV-TB.

Determinant of Successful Tuberculosis Treatment in UPT Puskesmas Singosari Working Areas in 2020-2022

Background: Indonesia is one of the countries that contribute the most mortality of Tuberculosis (TB) in the world. The tuberculosis treatment success rate in Indonesia is 86% which is still far from the target coverage of the TB treatment success rate (90%). This study was conducted to determine the determinant factors associated with successful TB treatment in Puskesmas Singosari.Methods: A cross-sectional design study was constructed for this study and used SITB including form TB as a research instrument. The population of this study were all drug-sensitive TB patients who had completed treatment at the Puskesmas Singosari in 2020, 2021, and QI-QII in 2022. The sample of this study was 71 people from 99 total population. The dependent variable is the success of drug-sensitive TB treatment. Independent variables are sex, age, weight, regular use of anti-tuberculosis drugs, and comorbidities. The data processing and analysis are being conducted using SPSS software.Result: Chi-square analysis showed that the variable weight changes has a significant relation to successful tuberculosis treatment (p = 0.014; OR = 9.818). This study found that the mean weight gain in patients who succeeded in TB treatment was approximately 2.19 kg.Conclusion : Puskesmas Singosari's TB Team can collaborate with the nutritionist team to optimize TB treatment through monitoring the nutritional status and weight gain of drug-sensitive TB patients.

Factors associated with hospitalization and mortality in adult and pediatric extrapulmonary tuberculosis at a tertiary care hospital in Central India

Background Comorbidities complicate the management of tuberculosis (TB) and have become an essential part of the end TB strategy to eradicate TB. However, pulmonary TB has received the most attention, and little is known about the impact of comorbidities and other factors on outcomes in patients with extrapulmonary tuberculosis (EPTB). Objectives Our aim was to analyze the factors associated with hospitalization and mortality in EPTB at a hospital in Central India, using non-TB patients with similar clinical presentations as a comparison. Methods Patients with presumptive EPTB were prospectively enrolled and followed up until the end of treatment or for at least 6 months. Detailed demographic and clinical information was collected for all participants, and patients were categorized as TB or non-TB using a composite reference standard. Multivariate logistic regression was used to analyze the impact of various clinical findings and risk factors on hospitalization and mortality. Results A total of 276 patients were categorized as TB cases and 175 as non-TB cases. Factors associated with hospitalization in children were younger age and non-adenitis site of disease. In adults, factors associated with mortality were older age, non-adenitis site of disease and HIV infection regardless of TB diagnosis, while diabetes mellitus increased the odds of mortality in EPTB patients. Conclusion Our results show that comorbidities increase the odds of death in both TB and non-TB patients in low-resource settings. This argues for a shift away from the traditional vertical management of diseases in these areas and supports a continued focus on building robust healthcare systems.

Risk factors underlying racial and ethnic disparities in tuberculosis diagnosis and treatment outcomes, 2011–19: a multiple mediation analysis of national surveillance data

Despite an overall decline in tuberculosis incidence and mortality in the USA in the past two decades, racial and ethnic disparities in tuberculosis outcomes persist. We aimed to examine the extent to which inequalities in health and neighbourhood-level social vulnerability mediate these disparities. We extracted data from the US National Tuberculosis Surveillance System on individuals with tuberculosis during 2011-19. Individuals with multidrug-resistant tuberculosis or missing data on race and ethnicity were excluded. We examined potential disparities in tuberculosis outcomes among US-born and non-US-born individuals and conducted a mediation analysis for groups with a higher risk of treatment incompletion (a summary outcome comprising diagnosis after death, treatment discontinuation, or death during treatment). We used sequential multiple mediation to evaluate eight potential mediators: three comorbid conditions (HIV, end-stage renal disease, and diabetes), homelessness, and four census tract-level measures (poverty, unemployment, insurance coverage, and racialised economic segregation [measured by Index of Concentration at the ExtremesRace-Income]). We estimated the marginal contribution of each mediator using Shapley values. During 2011-19, 27 788 US-born individuals and 57 225 non-US-born individuals were diagnosed with active tuberculosis, of whom 27 605 and 56 253 individuals, respectively, met eligibility criteria for our analyses. We did not observe evidence of disparities in tuberculosis outcomes for non-US-born individuals by race and ethnicity. Therefore, subsequent analyses were restricted to US-born individuals. Relative to White individuals, Black and Hispanic individuals had a higher risk of not completing tuberculosis treatment (adjusted relative risk 1·27, 95% CI 1·19-1·35; 1·22, 1·11-1·33, respectively). In multiple mediator analysis, the eight measured mediators explained 67% of the disparity for Black individuals and 65% for Hispanic individuals. The biggest contributors to these disparities for Black individuals and Hispanic individuals were concomitant end-stage renal disease, concomitant HIV, census tract-level racialised economic segregation, and census tract-level poverty. Our findings underscore the need for initiatives to reduce disparities in tuberculosis outcomes among US-born individuals, particularly in highly racially and economically polarised neighbourhoods. Mitigating the structural and environmental factors that lead to disparities in the prevalence of comorbidities and their case management should be a priority. US Centers for Disease Control and Prevention National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention Epidemiologic and Economic Modeling Agreement.

“Lansia Berdaya” Program Penguatan Posyandu Lansia Dusun 2 Desa Karangwuni Sebagai Upaya Peningkatan Pengetahuan dan Pencegahan Hipertensi

Hypertension, a non-communicable disease, exhibits significant death and suffering rates worldwide, including in Indonesia. Hypertension ranks as the third leading cause of mortality in Indonesia, following strokes and tuberculosis, primarily impacting the older population. Dusun 2 Karangwuni is a region that experiences a high mortality rate due to hypertension. The hypertension screening findings revealed that out of the 49 elderly visitors to Posyandu, 41 of them were found to have hypertension. The team's objective is to implement the dedication of Lansia Berdaya's activities in managing hypertension in Dusun Two village, Karangwuni, Weru district. The Lansia activities occur in Dukuh Ngampas, Dusun 2, Village KarangWuni, district Weru, Sukoharjo. Activities encompass kader upgrading training, hypertension assessment, rehabilitation, and elderly gymnastics. The sequence of events will occur in February 2023. The intended recipients are 17 healthcare professionals, whereas the intended recipients are 47 individuals. Activities are evaluated by examining the level of knowledge, which is determined using pre-test and post-test values. Heath cadre training was conducted with 17 audiences. Hypertension screening, senior gymnastics, and health education activities were conducted and attended by 47 seniors. The hypertension exercise video has been distributed to the health cadre. The video is anticipated to serve as a comprehensive manual for gymnastics exercises at Posyandu Lansia to establish a long-lasting and sustainable devotion program.

Association between Age and the 28-Day All-Cause Mortality in Tuberculosis Complicated by Sepsis in ICU Patients: A Retrospective Cohort Study [Response to Letter

Association between Age and the 28-Day All-Cause Mortality in Tuberculosis Complicated by Sepsis in ICU Patients: A Retrospective Cohort Study [Response to Letter

Hubungan Efek Samping Obat Anti Tuberkulosis (OAT) dengan Kepatuhan Berobat Pada Pasien Tuberkulosis di Puskesmas Jongaya Makassar

Tuberculosis is a direct infectious disease caused by Mycobacterium tuberculosis, which mainly affects the lungs and is transmitted through airborne droplets or sputum from TB patients with positive BTA. The morbidity and mortality of tuberculosis is a serious problem, mainly due to the side effects of Anti-Tuberculosis Drugs (OAT). This study aims to determine the relationship between OAT side effects and treatment compliance of pulmonary tuberculosis patients at the Jongaya Makassar Health Center. This study used a cross-sectional approach with quantitative methods, involving 49 respondents selected using the Slovin formula. The research instruments were OAT side effects questionnaire and treatment compliance questionnaire, with data analysis conducted univariately and bivariately using Chi Square test. The results showed that most respondents experienced low side effects and had a high level of treatment compliance. In conclusion, there is a significant relationship between OAT side effects and treatment compliance of tuberculosis patients at the Jongaya Makassar Health Center, where the lower the perceived side effects, the higher the level of treatment compliance.