Adult Tuberculosis Patients Research Articles

The effect of a mhealth intervention on anti-tuberculosis medication adherence in Delhi, India: A quasi-experimental study.

Suboptimal adherence to anti-tuberculosis medication in patients is associated with adverse treatment outcomes including treatment failure, relapse, and emergence of drug resistance. : We conducted the present study with the objectives of evaluating the effectiveness of a mHealth package on the medication adherence of patients with tuberculosis (TB) on antitubercular (directly observed treatment short-course [DOTS]) treatment. We conducted Quasi-experimental study at six DOTS centers of Delhi among 220 newly diagnosed TB patients. We included adult TB patients (18 years and above) who were on DOTS therapy ≥30 days, had access to a mobile phone and were able to read messages and receive calls. We excluded patients with impaired hearing, blindness and those on non-DOTS therapy or having multidrug-resistant/extensively drug-resistant TB. Participants in the intervention group received amHealth package for 90 days. The medication adherence of the study participants was measured using Morisky, Green, and Levine Adherence Scale. A total of 130 men and 90 women were recruited for the study. Occupational interference and forgetfulness were the most common reasons for medication nonadherence in the patients. In the intervention group, the medication adherence to antitubercular medication (daily DOTS regimen) was 85.5% at baseline which increased to 96.4% at endline (postintervention) (P = 0.004). No significant change was observed in the control group (P = 0.328). The increase in adherence was observed across the following subgroups: age, gender, education, and Socioeconomic status. The mHealth intervention in TB patients was effective in improving the adherence to DOTS therapy.

PENGARUH PMR DENGAN KARTU PENGINGAT TERHADAP KEPATUHAN DAN KESESUAIAN PENGOBATAN PASIEN TUBERKULOSIS

The duration of tuberculosis treatment affects patient adherence. The pharmacist monitors the patient's medication by providing an intervention in the form of a reminder card. The research objective was to use a reminder card to determine the compliance level of tuberculosis patients. The design of this study was a pre-experimental one group pretest-post test from December 2019 - January 2020. The study sample was 133 adult tuberculosis patients who received detached drugs and had undergone treatment >1 month at the Pulmonary Poly Outpatient Waluyo Jati Kraksaan Hospital. The level of adherence with the reminder card intervention was calculated using the pill count method and analyzed using the Wilcoxon test. The result of tuberculosis patient adherence level increased significantly (p<0.05) after giving the reminder card from 50.00% to 99.37%. Providing a reminder card is an effort that can improve adherence to treatment of tuberculosis patients.

Prevalence of undernutrition among adult tuberculosis patients in Ethiopia: A systematic review and meta-analysis

BackgroundUndernutrition and tuberculosis are the major public health problems of people living in middle and low-income countries. Even though single studies have been reported from different areas of Ethiopia, there is no national-level study that estimates the overall burden of undernutrition among tuberculosis patients. Therefore, this study aimed to estimate the overall magnitude of undernutrition among adult tuberculosis patients in Ethiopia. MethodsWe searched out records from databases such as PubMed/MEDLINE, HINARI, EMBASE, Scopus, Google Scholar, and African journals and the online Ethiopian University repositories for published and unpublished articles. The data were extracted using a standardized data extraction format. Meta-analysis was computed using STATA version 11 software. The Cochrane Q-test and I2 with its corresponding p-value were used to assess the heterogeneity of the study. The presence of publication bias was evaluated using Egger’s test and presented with funnel plots. The random-effects meta-analysis model was computed to estimate the pooled prevalence of undernutrition among adult tuberculosis patients. ResultsA total of Twelve observational studies with 4963 study participants were included in this systematic review and meta-analysis. The pooled prevalence of undernutrition among tuberculosis patients in Ethiopia was 50.8% (95% CI 43.97, 57.63). The results of subgroup analysis showed that the highest prevalence of undernutrition among TB patients was observed from studies done in the Amhara region (65.63%). In this meta-analysis, the pooled prevalence of undernutrition among TB-HIV co-infected patients was 45.45% (95%CI 21.85, 56.07). ConclusionThe prevalence of undernutrition among TB patients in Ethiopia was noticeably high. The result of this study showed that undernutrition is more severe in the Amhara regional state. Additionally, TB-HIV co-infected patients are highly affected by undernutrition. Therefore, the Ministry of Health in collaboration with clinicians should give special attention to provide nutritional care and support for TB patients as part of regular care. Moreover, special nutritional support should be designed for TB-HIV co-infected patients.

Confirmatory factor analysis of the Patient Health Questionnaire-9: A study amongst tuberculosis patients in the Free State province.

BackgroundThere is growing evidence that depression is frequently comorbid with tuberculosis (TB) and is often associated with a decreased quality of life and poor treatment outcomes. The Patient Health Questionnaire (PHQ-9) is widely used to screen for depression in clinical settings in low-and middle-income countries. This study examined the construct validity and reliability of an interviewer-administered PHQ-9 in a sample of new TB patients in the Free State province of South Africa.MethodsA pilot study was conducted in 2019 amongst 208 new adult TB patients attending primary healthcare facilities in the Lejweleputswa District in the Free State. Trained fieldworkers administered a structured questionnaire comprising of questions on patient’s socio-demographic characteristics and the nine-item PHQ-9 to the patients. Confirmatory factor analysis and Cronbach’s alpha were respectively used to investigate the construct validity and internal consistency of the PHQ-9.ResultsThe model was a good fit, with a Tucker–Lewis index of 0.976, a comparative fit index of 0.982 and a root mean square error of approximation of 0.062 (90% CI: 0.032–0.089). All indicators showed significant positive factor loadings, with standardised coefficients ranging from 0.467 to 0.799. The PHQ-9 was characterised by a single factor latent structure – depression – underlying all items. The Cronbach’s alpha of the scale was 0.84.ConclusionThe results support a unidimensional structure of the PHQ-9, with satisfactory internal consistency implying that the scale is valid and reliable. The TB programme can confidently consider the PHQ-9 for the routine assessment of depression amongst TB patients in the Free State province and similar settings.

GeneXpert MTB/RIF and Mycobacterium tuberculosis Sputum Culture in Establishing the Diagnosis of Pulmonary Tuberculosis and Rifampicin Resistance in Suspected Childhood Pulmonary Tuberculosis in Soetomo Hospital

The diagnosis of childhood tuberculosis remains a challenge worldwide. The GeneXpert MTB/RIF test, a rapid Mycobacteria tuberculosis diagnostic tool, was recommended for use in children. No pediatric studies of GeneXpert MTB/RIF assessing pulmonary tuberculosis within a hospital setting has been done in Indonesia. We evaluated the performance of the GeneXpert MTB/RIF test compared with sputum culture on Lowenstein-Jensen (LJ) for the diagnosis of childhood pulmonary tuberculosis. This study was conducted in pediatric respirology inpatient and outpatient Dr. Soetomo Hospital, a tertiary care facility in Surabaya between June and August 2015 with a cross-sectional design. We consecutively enrolled 27 children aged 3 months to 14 years who had history of close contact with adult tuberculosis patients and showed symptoms of pulmonary tuberculosis. Sputum collection was performed by induced sputum and three examination methods were performed (microscopic, GeneXpert MTB/RIF and sputum culture) simultaneously followed by a drug sensitivity test for specimens detected with MTB growth. The GeneXpert MTB/RIF test had a sensitivity of 100% (95% CI 100-100) and a specificity of 95% (95% CI 85-100). The positive predictive value for diagnosing pulmonary TB was 89% (95% CI 68-100), the negative predictive value was 100% (95% CI 100-100) and positive likelihood ratio was 20 (95% CI 2.82-128). The GeneXpert MTB/RIF test on one sputum sample rapidly and correctly identified all children with culture-confirmed pulmonary tuberculosis with high specificity. Similar results were obtained between GeneXpert MTB/RIF and sputum culture based on age groups and clinical manifestations. Rifampicin resistance were both detected in GeneXpert MTB/RIF and MTB sensitivity test

Validity and Reliability of Indonesian Languages Version of Zung Anxiety Self-Assessment Scale Questionnaire for Pulmonary Tuberculosis Patients

Background: Patients with chronic disease, including tuberculosis, often get anxiety in their daily life.Valid and reliable instrument needed to detect anxiety in Tuberculosis patients in Indonesia. Therefore, ZungAnxiety Self-Assessment Scale questionnaire in the Indonesian language version should be validated andproved as a reliable instrument.Objective: The purpose of this research is to validate and to get the scientific evidence of reliability onIndonesian language version of Zung Anxiety Self-Assessment Scale questionnaire.Methods: The design of this study is cross sectional. Zung Anxiety Self-Assessment Scale questionnairesthat have been translated to Indonesian language are given and filled by 129 pulmonary tuberculosis patients.We used Corrected Item-Total Correlation table for validity test and Cronbach’s Alpha value for reliabilitytest.Results: Almost all of the questions (19 questions) are valid because Corrected Item-Total Correlationvalues for all the questions are more than r table (>0,174). One question, question number 17, is not valid andwas deleted because had negative r value. The questionnaire is also reliable with r Alpha value (Cronbach’sAlpha) 0,892.Conclusion: Indonesian language version of Zung Anxiety Self-Assessment Scale questionnaires is a validand reliable instrument to be used for detecting anxiety in adult pulmonary tuberculosis patients.

Frequency of MTB and rifampicin resistance MTB using Xpert-MTB/RIF assay among adult presumptive tuberculosis patients in Tigray, Northern Ethiopia: A cross sectional study.

Multidrug-resistant tuberculosis (MDR-TB) continues to be a global health problem. Data on rifampicin resistance MTB using Xpert- MTB/RIF assay in Ethiopia, particularly in the study area is limited. The aim of this study was to determine the frequency of MTB and rifampicin resistant-MTB among presumptive tuberculosis patients in Tigray, Northern Ethiopia. A multicenter retrospective study was conducted among presumptive TB patients from five governmental hospitals and one comprehensive specialized teaching hospital in Tigray regional state. Records of sputum sample results of presumptive MTB patients with Xpert-MTB/RIF assay from January 2016 to December 2019 were investigated. Data extraction tool was used to collect data from registration books and analyzed using SPSS ver.21 statistical software. Statistical significance was set at p-value ≤ 0.05. Of the 30,935 presumptive adult TB patients who have provided specimens for TB diagnosis from January 2016 to December 2019, 30,300 (98%) had complete data and were included in this study. More than half, 17,471 (57.7%) were males, and the age of the patients ranged from 18-112 years, with a median age of 40.65 (interquartile 29.4-56.5 years). Majority, 28,996 (95.7%) of the participants were treatment naïve, and 23,965 (79.1%) were with unknown HIV status. The overall frequency of MTB was 2,387 (7.9% (95% CI: 7.6-8.2%); of these, 215 (9% (95% CI: 7.9-10.2%) were rifampicin resistant-MTB. Age (18-29 years), HIV positive and previous TB treatment history were significantly associated with high MTB (p < 0.001), whereas gender (being female) was associated with low MTB (p < 0.001). Likewise, rifampicin resistant-MTB was more prevalent among relapse (p < 0.001) and failure cases (p = 0.025); while age group 30-39 years was significantly associated with lower frequency of rifampicin resistant-MTB (p = 0.008). Frequency of MTB among tuberculosis presumptive patients was low; however, the problem of rifampicin resistant-MTB among the tuberculosis confirmed patients was high. The high frequency of MTB and RR-MTB among previously treated and HIV positive patients highlights the need for more efforts in TB treatment and monitoring program in the study area.

Burden of stigma among tuberculosis patients in a pastoralist community in Kenya: A mixed methods study.

Tuberculosis (TB) stigma remains a barrier to early diagnosis and treatment completion. Increased understanding of stigma is necessary for improved interventions to minimise TB stigma and its effects. The purpose of this study is to quantitatively measure TB stigma and to explore qualitatively its manifestation among TB patients in a rural Kenyan community. This hospital based study using explanatory sequential mixed methods approach was conducted in 2016. In the quantitative part of the study, a questionnaire containing socio-demographic characteristics and scales measuring perceived TB stigma and experienced TB stigma, was administered to 208 adult pulmonary TB patients receiving treatment in West Pokot County. Respondents with high stigma were purposively selected to take part in in-depth interviews and focus group discussions. The qualitative data were collected through 15 in-depth interviews and 6 focus group discussions with TB patients. Descriptive and bivariate analysis was done for the quantitative data while the thematic analysis was done for qualitative data. The internal consistency reliability coefficients were satisfactory with Cronbach alphas of 0.87 and 0.86 for the 11-item and 12-item stigma measurement scale. The investigation revealed that TB stigma was high. The key drivers of TB stigma were the association of TB with HIV/AIDS and the fear of TB transmission. TB stigma was exemplified through patients being isolated by others, self-isolation, fear to disclose TB diagnosis, association of TB with human immunodeficiency virus (HIV) and lack of social support. Being a woman was significantly associated with high levels of both experienced stigma (p = 0.007) and perceived stigma (p = 0.005) while age, marital status, occupation and the patient's religion were not. There is a need to implement stigma reduction interventions in order to improve TB program outcomes.

Tuberculosis Knowledge and Attitude of Patients in Community Health Center in Payakumbuh

&lt;p align="center"&gt;&lt;strong&gt;&lt;em&gt;Abstract &lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;Background. Tuberculosis (TB) remains an issue in Payakumbuh. A good knowledge and attitude have a crucial role towards TB control. The objective of this study was to assess knowledge and attitude related to TB among patients in Payakumbuh with structured questionnaire. Methods. Adult tuberculosis patients were selected randomly from eight community health centers in Payakumbuh during February to April 2018. Data were analysed using descriptive statistics. Result. A total of 32 patients were participated in this survey. From the finding, 68,75% respondents were male and 31,25 % were female. Of them 65% of respondents got information about TB from health care professional. Over 80% respondents have known that TB is a communicable disease. The fact that TB is caused by bacteria was known by 75% respondent. Surprisingly only 31,25% respondents who answered that smoking is not the cause of TB. All of respondents believed that TB is curable. Majority of the respondents 90,625% said that the proper medication from community health center is the best way to treat the disease. Conclusion. This study shows that patients had good attitude toward TB while improvement of knowledge is still needed&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;

Diabetes Mellitus and Tuberculosis Comorbidity and Associated Factors Among Bale Zone Health Institutions, Southeast Ethiopia.

BackgroundGlobally, tuberculosis and diabetes mellitus co-morbidity is higher than tuberculosis and human immunodeficiency virus comorbidity. Considering this, the World Health Organization and the International Union against tuberculosis and lung disease recommend bi-directional screening of the two diseases. However, in Ethiopia, bi-directional screening has not been started yet.ObjectiveThe objective of this study was to assess the prevalence of diabetes mellitus and tuberculosis comorbidity and its predictors among adult tuberculosis patients in Bale Zone Health Institutions, Southeastern Ethiopia.Materials and MethodsInstitutional-based cross-sectional study carried out using interviewer administered questionnaire, registration review, anthropometric and blood glucose level measurement from March, 30, 2019 to April, 30, 2019. Three hundred twenty-one tuberculosis patients were selected from tuberculosis registration log book using lottery methods. The collected data were checked for completeness, coded and entered in to EpiData3.0.2 and exported to SPSS version 20. Independent variables that had p value less 0.25 were used as candidates for multiple logistic regressions to control confounders. Variables that had significant association were identified by calculating odds ratio, with 95% confidence interval, and p value less than 0.05 used to declare statistical significance.ResultsDiabetes mellitus and tuberculosis comorbidity among adult tuberculosis patients was 5.1% (95% CI: 2.7%, 7.5%). Age with ≥50 years (AOR=3.98, 95% CI: 1.13, 14.36), having extra pulmonary tuberculosis (AOR=3.31, 95% CI: 1.16, 9.44) and being females (AOR=3.8, 95% CI: 1.17, 12.33) were significantly associated with the comorbidity of the two diseases.Conclusion and RecommendationThe prevalence of diabetes mellitus and tuberculosis comorbidity was high. Female tuberculosis patients, tuberculosis patients with age ≥50 years and those having extra pulmonary tuberculosis patients should be screened for diabetes mellitus.

Tubercular infection in children living with adults receiving Directly Observed Treatment Short Course (DOTS): a follow up study

BackgroundChildren living with sputum smear-positive adult tuberculosis (TB) patients are vulnerable to acquire tubercular infection. Contact tracing is an important strategy to control tubercular infection in the community. This study was done to find out prevalence of tuberculosis and tubercular infection in children living with sputum smear-positive adult patients receiving DOTS at recruitment and to find out incidence of tubercular infection and disease in these children on follow up.MethodChildren (< 15 years) living in contact with adults on DOTS were grouped as < 6 years and 6–14 years. They were further sub grouped as being - uninfected, infected, diseased and on prophylaxis and were followed at 3, 6 and 9 months. Tuberculin skin test (TST) and chest X-ray were done.ResultsAt recruitment 152 children were enrolled and 21.1% (n = 32) had TB. On follow up, 4.3% (n = 5), 5.8% (n = 6) and 11.6% (n = 11) children developed TB after 3, 6 and 9 months respectively.9 children did not come for the last follow up so the overall prevalence of TB disease at 9 months was 37.7% (n = 54). Out of the 128 children with TST reading 23.4% (n = 30) child contacts were found to be infected already at recruitment. The incidence of TST conversion was 20.7% (n = 18), 26.9% (n = 18) and 16.3% (n = 7) respectively. The overall prevalence of tubercular infection in the children, who were in contact with TB patients for 9 months was 74.5% (n = 73).ConclusionAbout half the children were either suffering from TB or tubercular infection on recruitment. During 9 months follow up 22 unaffected children developed disease and 43acquired infection.

Delay for Tuberculosis Treatment and Its Predictors among Adult Tuberculosis Patients at Debremarkos Town Public Health Facilities, North West Ethiopia.

Background Delay in the diagnosis and treatment of tuberculosis exacerbates the disease and clinical outcomes. It further enhances transmission of the infection in the society as well as increased the severity of the illness and raised rate of mortality. Objectives The major goal of this study is to determine the magnitude of delays in tuberculosis treatment and factors affecting tuberculosis treatment among adult tuberculosis patients at Debremarkos town, North West Ethiopia, 2018. Methods Institution-based cross-sectional study design was employed. Systematically selected 300 adult TB patients were recruited to the study. The study was conducted at Debremarkos town public health facilities from March 1 to April 30, 2018. Logistic regression models were fitted to identify the predicting variables and control confounder's of the outcome variables. P value ≤ 0.05 with 95% CI was considered as an indicator for the presence of statistically significant association. The result revealed that the median total delay was 23 days (IQR: 19-28 days). The median patient and health system delays were 20 days (IQR: 15-20 days) and 4 days (IQR: 3-5 days), respectively. Tuberculosis patients living in a rural area were 1.14 times more likely to delay for the TB treatment (AOR: 1.141, 95% CI (1.106, 2.608)). Patients who were unable to read and write have almost two times a chance of being delayed (AOR: 2.350, 95% CI (1.630, 2.608)). Monthly income of patients has found another predictor for delay; patients with low monthly income were about six times more likely to delay for TB treatment (AOR: 6.375, 95% CI: (1.733, 23.440)). Those TB patients who had visiting traditional healers before arrival to health facilities were about 2.7 times more likely to delay for TB treatment(AOR: 2.795, 95% CI (1.898, 8.693)). Conclusion and Recommendation. The significant proportion of delays in tuberculosis treatment was found in this study. Living in the rural area, unable to read and write, lower monthly income, and visiting traditional healers were found independent predictors of TB treatment delay. The regional and zonal health administrator shall design various awareness creation mechanisms to educate the public about timely initiation of tuberculosis treatment.

Epidemiological, Mycobacteriological, and Clinical Characteristics of Smoking Pulmonary Tuberculosis Patients, in Lambaréné, Gabon: A Cross-Sectional Study.

Gabon carries a high burden of both tuberculosis (TB) and smoking. This study examines the disease characteristics of smoking pulmonary TB patients in Lambaréné. We interviewed adult pulmonary TB patients in Lambaréné, between March 2016 and April 2019. Clinical and biological patient characteristics were collected. Bivariate and logistic regression analyses were performed to assess factors associated with smoking. The mean age of patients included was 31 years (±13). The proportion of smokers in our study was 30% (89/295). Smoking was significantly associated with patient-related diagnostic delay (adjusted odds ratio [AOR] = 8.18; 95% CI = 3.67-19.56), a higher number of pulmonary TB signs and symptoms (AOR = 2.74; 95% CI = 1.18-6.73), and a higher sputum mycobacterial load (AOR = 3.18; 95% CI = 1.33-8.11). The prevalence of smoking among TB patients is high, and leading to aggravated disease as compared with controls. Our study findings suggest that smoking patients should be regularly screened for TB, to reduce diagnostic delay and TB transmission within community. Smoking cessation activities should be included in the national TB control program in Gabon.

Factors associated with treatment initiation delay among new adult pulmonary tuberculosis patients in Tigray, Northern Ethiopia.

Delayed treatment initiation of Tuberculosis patients results in increased infectivity, poor treatment outcome, and increased mortality. However, there is a paucity of evidence on the delay in new adult pulmonary Tuberculosis patients to initiate treatment in Tigray, Northern Ethiopia. To assess the factors associated with treatment initiation delay among new adult pulmonary tuberculosis patients in Tigray, Northern Ethiopia. The study design was cross-sectional. A total of 875 new adult pulmonary tuberculosis patients were recruited from 21 health facilities from October 2018 to October 2019. Health facilities were selected by simple random sampling technique and tuberculosis cases from the health facilities were consecutively enrolled. Data were collected using structured questionnaire within the first 2 weeks of treatment initiation. Delay was categorized as patient, health system and total delays. Data were analyzed using SPSS version 21 and logistic regression was used to identify factors associated with the odds of delays to initiate treatment. A p-value of less than 0.05 was reported as statistically significant. The median patient, health system and total delays were 30, 18 and 62 days, respectively. Rural residence, being poor, visiting non-formal medication sources, being primary health care and the private clinic had higher odds of patient delay whereas being HIV positive had lower odds of patient delay. Illiteracy, first visit to primary health care and private clinic had higher odds of health system delay whereas a visit to health facility one time and have no patient delay had lower odds of health system delay. The median patient delay was higher than the median health system delay before initiating treatment. Hence, improved awareness of the community and involving the informal medication sources in the tuberculosis pathways would reduce patient delay. Similarly, improved cough screening and diagnostic efficiency of the lower health facilities would shorten health system delay.

Nutritional Status of Patients with Tuberculosis and Associated Factors in the Health Centre Region of Burkina Faso.

Extreme hunger and poverty remain a significant barrier to maintaining a normal and healthy life, and increase the burden of tuberculosis (TB) in sub-Saharan African countries. The purpose of this study was to assess the prevalence and factors associated with undernutrition among adult patients with TB in Burkina Faso. In the Health Centre Region of Burkina Faso, we conducted a cross-sectional survey with face-to-face interviews of patients aged 15 years and older with TB (n = 302), from March to April 2019. Undernutrition was defined as a body mass index of <18.5 kg/m2. Multiple logistic regression analyses were performed to determine the correlates of undernutrition. The prevalence of undernutrition was 35.8%, in which severe, moderate, and mild thinness were 7.7%, 8.9%, and 19.5%, respectively. Low food frequency per day (adjusted odds ratio [aOR] = 3.28, confidence interval [CI]: 1.42–7.55, p = 0.005), human immunodeficiency virus infection (aOR = 6.18, CI: 2.26–16.88, p < 0.001), and diabetes mellitus (aOR = 17.52, 95% CI: 1.88–162.97, p = 0.012) and young age (45–54 years vs. 65 years and older, aOR = 2.93, 95% CI: 1.11–7.70, p = 0.029) were associated with increased odds of undernutrition. We concluded that the assessment of comorbidity and nutritional status should be part of the treatment for adult TB patients.

How Much Depressed are Lung Tuberculosis Patients in Tangerang, Banten Province, Indonesia?

&lt;p&gt;&lt;strong&gt;Introduction : &lt;/strong&gt;Tuberculosis is an infectious disease caused by Mycobacterium Tuberculosis (MTB) and mostly attacks the lung and other organs. In patients with pulmonary tuberculosis, depression can occur and the factors that can cause it are age, sex, marital status, level of education, emplyment, long suffering from pulmonary tuberculosis and comorbidities. The purpose of this study is to show the prevalence and also degree of depression in patients with lung Tuberculosis in Tangerang, Banten Province, Indonesia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods : &lt;/strong&gt;The study design is cross sectional by asking participants to fill Zung Self-Rating Depression Scale that have been translated to Indonesian language. Participants were 129 patients with lung tuberculosis in Siloam General Hospitals Lippo Karawaci, Puskesmas Kutai and Puskesmas Curug.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results : &lt;/strong&gt;Mean age of the 137 patients with lung tuberculosis is 47.73 &lt;span style="text-decoration: underline;"&gt;+&lt;/span&gt; 8.50 years old, and the mean of their height and weight are 163.94&lt;span style="text-decoration: underline;"&gt;+&lt;/span&gt; 7.59 centimeters and 51.10 &lt;span style="text-decoration: underline;"&gt;+&lt;/span&gt; 7.40 kilograms. More than a half of the patients are male (69%), almost a half of the patients are low educated (48%) and almost all of the patients have been married (93.8%). More than a half of the lung tuberculosis patients experience deppression (70,5%). Approximately a half of the lung tuberculosis patients are having mild depression (50.4%). There is 1 patient is having severe depression (0.8%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion : &lt;/strong&gt;Degree of depression in adult patients suffer from lung Tuberculosis in Tangerang, Banten Province, Indonesia is high. More than a half of adult lung Tuberculosis patients are having depression. Depression is one of problems that should be concerned and also treated in patients with lung tuberculosis. Psychiatrist involvement in managing patients with lung tuberculosis is needed.&lt;/p&gt;

Undernutrition and Mortality among Adult Tuberculosis Patients in Addis Ababa, Ethiopia.

Background In developing countries, there are several adult tuberculosis (TB) patients suffering from profound undernutrition. Undernutrition is a significant risk factor for developing tuberculosis. In the world, TB is one of the top ten and leading causes of death. To appropriately intervene death of adult TB patients, it is crucial to understand the magnitude of undernutrition and its associated factors among them. The study assessed undernutrition and mortality among adult tuberculosis patients in Addis Ababa, Ethiopia. Methods Institutional-based retrospective study was conducted in Addis Ababa, Ethiopia, from January 2019 to August 2019. The total sample size of the study was 284. The source populations were TB patients who have followed up for TB treatment at public health facilities of Addis Ababa. The sample size was allocated to the selected health facilities proportional to their size, and study subjects were enrolled to the study during the study period. Data were collected by a structured data sheet from the selected health center registration book. Data were entered into Epi Data software and analyzed by using SPSS version 20. Descriptive statistical methods were used to summarize the sociodemographic characteristics of the study participants. Survival curves were generated using the Kaplan–Meier method for all TB patients. Result A total of 284 study participants were included in the study. It was found that 46.8% of the study population have undernutrition (BMI <18.5 kg/m2) at the time of registration for treatment. Out of undernourished patients, 54 (19.0%) had severe malnutrition and 78 (27.5%) had moderate undernutrition. At the end of the two-month intensive treatment period, the under nutrition prevalence declined to 38.7%. Of the 284 patients, 17 (6.0%) died before completing anti-TB treatment. Three quarters of all forms of TB deaths occurred within 57 days after the start of anti-TB treatment. The proportion of deaths by nutritional status at treatment initiation among normal, moderate acute malnutrition, and severe acute malnutrition TB patients was 3.1%, 8.9%, and 16.3%, respectively. Conclusion Almost half of the TB patients were undernourished at the start of anti-TB treatment based on BMI. From the malnourished, less than 20% of the participants gained weight and moved to normal weight at the end of the two-month intensive treatment period. The high death rate was reported among severely malnourished tuberculosis patients, but it needs a larger study to further understand predictors. To enhance the increment of nutritional status during treatment, the government should give attention to support nutritional supplements for TB patients.

Risk Factors of Extrapulmonary Tuberculosis in Children

Background: Tuberculosis (TB) continues to result in high morbidity and mortality in children from resource-limited settings. Extrapulmonary TB had several of clinical appearance and complications. Hence it is important to identify the risk factors for early detection and treatment. The objective of this study is to identify factors associated with extrapulmonary TB in children.Methods: Observational study conducted at Dr. Soetomo Hospital, Surabaya, Indonesia. Data was collected from medical records of patients who were diagnosed with extrapulmonary TB, aged 1-18 years old in the period of 2010-2018. Data were collected as risk factors were age, nutritional status, BCG (Bacille Calmette-Guerin) immunization status, contact history with adult TB patients, and HIV (human immunodeficiency virus) infection. Each risk factor was analyzed using Chi-square. Risk factors which were statistically significant (p 5 years old (52,8%). Most of them already got BCG immunization (72,9%) and had normal nutritional status (73,9%). Lymphadenitis TB, bone/joint TB and miliary TB were the most extrapulmonary TB in this study. Factors associated with extra pulmonary TB were age (PR 0.51; 95% CI=0.38-0.68; p<0.001), nutritional status (PR 3.14; 95% CI=2.29-4.29; p<0.001), and HIV infection (PR 3.66; 95% CI=2.21-6.06; p<0.001). In multivariate analysis, age, nutritional status, and HIV infection were statistically significant associated with extrapulmonary.

Patient factors related to pre-treatment delay of pulmonary tuberculosis: A retrospective cohort study in Bangladesh

BackgroundBurden of tuberculosis (TB) is still high in Bangladesh. Pre-treatment delay is a hindrance in reducing this burden by early diagnosis and prompt treatment of TB. The study was conducted to identify the patient factors related to pre-treatment delay of pulmonary TB. MethodsThis retrospective cohort study was performed during January to June 2018 in a cohort of 240 consecutively enrolled; newly detected adult pulmonary TB (PTB) patients initiated anti-TB therapy during the study period. Two DOTS were selected randomly using cluster sampling and all the PTB patients enrolled in the DOTS centres formed the study population. Informed written consent was obtained from the patients, prior to data collection. Data were collected by face-to-face interview and reviewing medical records using a semi-structured questionnaire and checklist respectively. ResultsAge of the patients was associated with pre-treatment delay of TB (p < 0.05) with predominance in elderly (75.0%). Delay in care seeking was associated with inability to make decision (RR = 1.84; AR: 35.84%) and awareness of patients (RR = 0.33; AR = −40.0%). Delay in diagnosis was associated with economic problem (RR: 1.63; AR: 28.85%); work barrier (RR: 1.75; AR: 35.03%); inability to make decision (RR: 1.93; AR: 40.65%); delayed investigation (RR: 2.88; AR: 56.17%); others’ assistance (RR: 1.77; AR: 28.53%); and symptomatic treatment (RR: 6.43; AR: 65.14%). Delay in treatment initiation was associated with repeated investigations (RR = 1.52; AR: 23.29%) and smear positivity (RR: 0.64; AR: 23.11%). Awareness of patients regarding symptoms and smear positivity were revealed as protective factors for pre-treatment delay of TB. ConclusionDelay in care seeking, diagnosis, and treatment initiation contribute substantially to pre-treatment delay of PTB. Considerable reduction in pre-treatment delay may be achieved through changes in awareness of patients and ensuring early diagnosis and prompt treatment of PTB under DOTS programme.

Nutritional status of adult Tuberculosis patients in Burdwan municipality area of West Bengal

Background: Nutritional status of a Tuberculosis (TB) patient plays a role in disease manifestation. Aims &amp; Objective: To assess the nutritional status of adult tuberculosis patients under intensive phase of treatment. Settings and Design: A descriptive study with cross-sectional design was conducted at Burdwan Municipality of West Bengal. Methods and Material: In this study, TB patients aged 18 years and above receiving intensive phase of treatment, registered in the Tuberculosis units in the months of October-December, 2018 and residing in the municipality were approached. Nutritional status was evaluated through two approaches - dietary intake by twenty-four hours recall method and anthropometric status by measuring weight, height, BMI and MUAC. Data were analysed using SPSS v20. Results: Out of 113 study subjects, under-nutrition was present in 61.9% and inappropriate MUAC was observed in 68.1%. Interestingly, intake of Cereals and Millets among food groups was found to be deficient. The adjusted odds ratio for having under-nutrition among new cases compared to previously treated was 0.16 (0.33-0.82). Conclusions: For combating protein energy malnutrition in TB patients, emphasis should be given on balanced diet intake.