Care Of Tuberculosis Patients Research Articles

Human resource implications of expanding latent tuberculosis patient care activities.

The World Health Organization (WHO) declared increasing services for latent tuberculosis infection (LTBI) a priority to eliminate tuberculosis (TB) by 2035. Yet, there is little information about thehuman resource needs required to implement LTBI treatment scale-up. Our study aimed to estimate the change in healthcare workers (HCW) time spent on different patient care activities, following an intervention to strengthen LTBI services. We conducted a time and motion (TAM) study, observing HCW throughout a typical workday before and after the intervention (Evaluation and Strengthening phases, respectively) at 24 health facilities in five countries. The precise time spent on pre-specified categories of work activities was recorded. Time spent on direct patient care was subcategorized as relating to one of three conditions: LTBI, active or suspected TB, and non-TB (i.e., patients with any other medical condition). A linear mixed model (LMM) was fit to estimate the change in HCW time following the intervention. A total of 140 and 143 HCW participated in the TAMs during the Evaluation and Strengthening phases, respectively. Results from intervention facilities showed an increase of 9% (95% CI: 3%, 15%) in the proportion of HCW time spent on LTBI-related services, but with a corresponding change of -11% (95% CI: -21%, -1%) on active TB services. There was no change in the proportion of time spent on LTBI care in control facilities; this remained low in both phases of the study. Our findings suggest that additional HCW personnel will be required for expansion of LTBI services to ensure that this expansion does not reduce the time available for care of active TB patients.

Healthcare professionals’ intention to adopt mobile phone-based SMS and its predictors for adherence support and care of TB patients in a resource-limited setting: a structural equation modelling analysis

ObjectiveTo assess healthcare providers’ intentions and the associated factors to use mobile phone-based short message service (SMS) to support adherence and care of tuberculosis (TB) patients in the Oromia region...

Integration Challenges and Opportunity of Implementing Non-Communicable Disease Screening Intervention with Tuberculosis Patient Care: A Mixed Implementation Study.

Despite the comorbidity, early detection and treatment of the two diseases are highly recommended; however, a few pilot studies were conducted, which are mainly focused on diabetes mellitus screening and the integration opportunity and challenges were not known. The study aimed to identify integrated implementation challenges and opportunities of non-communicable disease and risk factors screening intervention with tuberculosis patient care. A mixed implementation study design was used. Data were collected from a sample of 443 tuberculosis patients, 21 key informants and facility observations. For quantitative data, descriptive statistics for proportion were summarized in tables and figures. Four distinct implementation frame was adapted for thematic analysis of audio recordings, daily verbatim transcription, and descriptive field notes. The prevalence of hypertension and diabetes mellitus among tuberculosis patients were 6.55% and 5.64%, respectively. Totally 9 subthemes and 21 new codes were developed, of which 13 and 8 new codes were developed for integrated implementation challenges and opportunities, respectively. The absence of medical equipment, skill and knowledge training, record and report system, cooperative integration, feedback, referral system, shortage of supporting agencies, and services not free were external challenges, whereas lack of trained health workers, focal persons, and increased workload and absence of awareness creation were internal challenges. Despite the challenges, the presence of health extension programs, non-governmental organizations, community health care insurance and associations for diabetes mellitus were external opportunities. Availability of assigned focal persons, trained stakeholders, guidelines, information systems and compatible tuberculosis program structure were internal opportunities. The majority of TB patients were not comorbid with NCDs. We build a favourable system for integrated implementation developing an integration platform and structural authority at a different organization by addressing identified challenges and applying facilitators is crucial.

Impact of the COVID-19 Pandemic on tuberculosis management in India: A Brief Overview

Chronicles suggests that emerging and re-emerging viral infections disrupting the normal lifestyle of humankind, whether in the form of HIV, Ebola, Influenza, Nepah, or the current SARS-CoV-2 pandemic. Such viral infections disrupt the healthcare system along with the prevention and control of epidemics and pandemics, resulting in an increased burden of such diseases in the post-pandemic period. Tuberculosis (TB) routine services are interfered with by severe lockdowns due to the new COVID-19 virus. This article tried to measure the long-term epidemiological effects of such interruptions on TB prevalence in high-burden countries. The participating facilities performed a comprehensive review based on modifications to the care of TB patients during the COVID-19 pandemic. Retrospectively, clinical factors and household contact information were collected from a literature survey. Researchers looked at numerous strategies over the following five years to see whether they might lessen the effects on TB incidence and death. Present comprehensive literature was collected and analyzed using suitable keywords such as "COVID-19," "Pandemics," "Tuberculosis," and "India" during the current COVID-19 pandemic to investigate the influence of COVID-19 on tuberculosis management. The present article looks at the effects of the breaks in the delivery of TB care in hospital and primary care settings. Lockdown, social isolation, measures to prevent viral transmission, and public health guidelines impacted tuberculosis care. The present study revealed that the COVID-19 pandemic has adversely affected numerous TB prevention, monitoring, and treatment programs. Still, these adverse effects are diminished by the prompt restoration of TB services and the application of particular therapies as soon as restrictions are lifted.

Periodontal Status of Tuberculosis patients - Inter linked with each other

Background: Evidence suggests periodontitis may contribute to the development and progression of respiratory illnesses. However, few studies currently look at the coexistence of periodontitis and tuberculosis. The current study investigates the relationship between periodontal health and tuberculosis. Aim: To assess various clinical dental parameters of periodontal health among patients with and without TB. Methods: The participants in the present case-control study were individuals who obtained informed permission forms to participate when they were patients in the outpatient dentistry department. The current study included 585 patients in total. Three hundred-one individuals with normal pulmonary function were added to the control group, whereas 284 patients with tuberculosis were added to the cases group. The diagnosis of the pulmonary conditions was confirmed using spirometry. Using SPSS software 21, we evaluated the demographics & clinical indicators such as plaque, different gingival parameters of periodontitis, Gingival bleeding, and gingival index (GI), and compared cases and controls. Results: The population comprised two hundred eighty-seven women (49.1%) and 298 men (50.9%). There was a significant association between tuberculosis and periodontitis, and it has been observed that 159 (56%) tuberculosis patients had 6.23 (4.2 – 9.1) times higher effects on oral periodontitis issues (P<0.001*). Patients with gingivitis had a significantly higher number of bleeding, accounting for 241 (72.8), p<0.001. Practical implication: The study suggests that healthcare providers, particularly those involved in the treatment of TB, should consider incorporating oral health screening and assessment as part of the overall care for TB patients. This could help identify and address periodontal issues that may exist, hence dental professionals can play a role in the early detections of TB Conclusion: This study suggest that important relationship between TB and periodontitis. TB patients should be educated about the potential impact of their disease on periodontal health and encouraged to maintain regular dental visit and oral hygiene. Keywords: Tuberculosis (TB), Periodontitis (PD), Gingival bleeding, and gingival index (GI)

Depression, anxiety and medication adherence among tuberculosis patients attending treatment centres in Fako Division, Cameroon: cross-sectional study

Tuberculosis remains a public health problem, particularly in developing countries. Patients with tuberculosis often suffer from anxiety and depression, which is likely to affect adherence to the long course of tuberculosis treatment. This study sought to investigate depression, anxiety and medication adherence among Cameroonian tuberculosis patients. A cross-sectional study was conducted from March to June 2022 across five treatment centres in Fako Division, Southwest Region, Cameroon. Data were collected via face-to-face interviews with tuberculosis patients using a structured questionnaire. Sociodemographic information was obtained, and the following tools were administered to participants: the Hospital Anxiety and Depression Scale, the Oslo Social Support Scale, and the Medication Adherence Rating Scale. Multiple logistic regression models were fitted to investigate determinants of depression and anxiety. A total of 375 participants were recruited (mean age: 35 ± 12.2 years; 60.5% male). The prevalence rates of depression and anxiety among tuberculosis patients were 47.7% and 29.9%, respectively. After adjusting for confounders, the odds of depression were significantly increased by having extrapulmonary tuberculosis, non-adherence to treatment, having no source of income, household size <5 and poor social support. Predictors for anxiety included extrapulmonary tuberculosis, defaulting tuberculosis treatment for ≥2 months, family history of mental illness, HIV/tuberculosis co-infection, being married, poor social support and non-adherence to treatment. The prevalence of depression and anxiety in tuberculosis patients is relatively high, and diverse factors may be responsible. Therefore, holistic and comprehensive care for tuberculosis patients by mental health practitioners is highly encouraged, especially for the high-risk groups identified.

Ismael Cosío Villegas. Principales acciones contra la tuberculosis en México, 1929–1965

The article is a biographical study centered around the professional development of the Mexican pulmonologist Ismael Cosío Villegas (1902–1985), through which we address and understand tuberculosis care practices in Mexico during the first half of the 20th century. Important health actions are owed to Ismael Cosío Villegas in the fight against this disease, so his contribution to medicine is recognized for the work dedicated to the care of tubercu-losis patients and respiratory diseases. The biography proposed here derives mainly from the interview made to Dr. Cosío Villegas by the ‘Oral History’ program in 1977 and from the documents related to his professional career. The purpose of this study is to demonstrate the incidence that Ismael Cosío Villegas had in 20th century Mexican medicine.

Trends in tuberculosis epidemiology in the Republic of Crimea for the period 2014-2021

Aim. To assess the epidemiological situation on tuberculosis (TB) in the Republic of Crimea in 2014­2021 based on the study of morbidity, prevalence and mortality.Materials and methods. The analysis was conducted based on official data presented by the Crimean Republican Clinical Center of Phthisiology and Pulmonology.Results. During the study period in the Republic of Crimea the TB incidence decreased in 2.1 times. The downward tendency of both the incidence of all forms of TB (the growth rate is 51.7%) and pulmonary TB (growth rate is 50.2%) has been de­tected. The incidence of destructive forms of TB in Crimea reduced by 1.6 times, the proportion of destructive forms among first-time detected cases of TB was 48.2%. The peak of TB prevalence in the Republic of Crimea was in 2014 (132.1 cases per 100,000 population). In the following years there was a positive trend and by 2021 the rate decreased by 1.7 times, amounting to 77.8 cases per 100 thousand population. During the study period in the region there was a 2-fold decrease in the TB mortality rate from 17.1 in 2014 to 8.3 cases per 100 thousand population in 2021 (growth rate -51.5%). Despite the steady decrease in the mortality rate from all forms of TB in the region, there is still a stable high proportion of TB patients who died before the first year of follow-up. One of the reasons for the negative situation should be called the late diagnostics of the pathology under study, which is confirmed by the average percentage for the period 2014-2021 of untimely detected cases of TB, as well as neglected forms of TB (33.7% and 22.5%, respectively). During the period when the Republic of Crimea was a part of the Russian Federation, the financing of TB service increased by 2.1 times and, accordingly, the possibility of improving the quality and efficiency of medical care for TB patients increased, which is certainly one of the important reasons for the positive trends in improving the epidemiological situation of TB in the re­gion for the period 2014-2021.Conclusion. Over the period 2014-2021 in the Republic of Crimea, against the background of significant improvement in the financing of TB services in the region, positive dynamics in the main indicators of the epidemiological situation of TB (morbidity, prevalence and mortality) were observed. At the same time, the part of TB patients who died before the first year of follow-up remained high.

GAMBARAN PENGETAHUAN DAN TINGKAT KEMANDIRIAN PENGAWAS MINUM OBAT (PMO) DALAM PERAWATAN PASIEN TUBERKULOSIS (TB) DI PUSKESMAS NUSA INDAH KOTA BENGKULU

Tuberculosis (TB) is an infectious infectious disease caused by the bacterium Mycobacterium tuberculosis. Drug taking supervisor (PMO) is a person or family in charge of direct supervision of pulmonary TB patients when taking medication every day based on short-term medication guidelines. PMO knowledge is a collection of information obtained by a person about TB, such as what TB is, how to treat it and how it is transmitted to prevent TB disease. PMO independence is the ability to decide and take an action independently or without the help of others. The ability in question is the person's effectiveness in doing all kinds of work. The purpose of this study was to describe the knowledge and level of independence of drug-taking supervisors (PMO) in the care of tuberculosis (TB) patients. This type of research uses quantitative descriptive analysis, the sample technique used is total sampling, with 23 respondents as research respondents. The results showed good knowledge as much as 95.65%, sufficient knowledge as much as 4.35% and the level of independence of the respondents obtained independent results as much as 86.96%, and those who were not independent as much as 13.04%. The conclusion in this study is that the knowledge and level of independence of PMO is very influential for the care of TB patients at home, because of their duties and roles in carrying out care. The importance of knowledge and the level of independence for the role of PMO can increase the cure rate of TB patients and reduce the mortality rate caused by TB disease

Risk Factors Associated with Treatment Default Among Tuberculosis Patients in Adamawa State, Nigeria

Background. Tuberculosis is an infectious disease caused by bacteria called Mycobacterium tuberculosis. The treatment of drug-resistant tuberculosis is complex, costly, and usually has poor outcomes. Treatment default is well known as a very significant factor associated with drug-resistant tuberculosis.&#x0D; The aim of this study was to investigate the hazard ratios associated with treatment default among tuberculosis patients in Adamawa State, Nigeria.&#x0D; Materials and Methods. The Cox proportional hazards regression was used to determine the hazard ratios associated with tuberculosis patient treatment default in Adamawa State, Nigeria. The Kaplan-Meier method was used to analyze time-to-event data. The study assessed the survival status and treatment outcomes of tuberculosis patients over a six-month period (January 2019 to June 2019). Data analysis was done using R - Programming Software and the statistical significance was considered at p &lt; 0.05.&#x0D; Results. Out of the 197 (124 males and 73 females) tuberculosis patients, 148 (75.1%) individuals were diagnosed with pulmonary tuberculosis and 49 (24.9%) individuals were diagnosed with extrapulmonary tuberculosis. The treatment outcomes were as follows: 33 (16.8%) patients were cured; 36 (18.3%) individuals completed their treatment; 3 (1.5%) patients died during treatment; 105 (53.3%) subjects defaulted; 8 (4.1%) patients were lost to follow-up; the remaining 12 (6.1%) individuals were still on treatment at the end of the study. According to the Cox proportional hazards analysis, HIV-positive status (p &lt; 0.05, 95% CI [0.361 - 0.879]), primary education level (p &lt; 0.01, 95% CI [1.248 - 3.354]), poor quality of life (p &lt; 0.01, 95% CI [1.239 - 3.511]) and age over 60 years old (p &lt; 0.05, 95% CI [0.569 - 2.206]) were significant hazard ratios to experience the event (treatment default) in the study area.&#x0D; Conclusions. This study revealed that HIV-positive tuberculosis patients, older patients, patients with primary education, and those with poor quality of life are significant risk factors to experience treatment default in the study area. Therefore, it is recommended that stakeholders managing the treatment and care of tuberculosis patients should be dedicated and intentional in the provision of psychosocial therapy to patients with poor quality of life.

Assessing the staffing needs for primary health care centers in Cross River State, Nigeria: a workload indicators of staffing needs study

BackgroundA major human resources for health challenge for Nigeria is ensuring the availability and retention of adequate competent health workers in the right mix to provide health care particularly at primary health care facilities in remote and rural communities. This study applied the Workload Indicators of Staffing Need (WISN) method to determine the numbers of nurses, midwives, community health officers (CHOs), community health extension workers (CHEWs), and junior community health extension workers (JCHEWs) required to cope with health care service delivery at primary health care facilities in Cross River State; compare workloads of different cadres at selected health facilities, and identify facilities with highest workload pressure.MethodsCross River State in Nigeria has 18 local governments, 196 wards, and an estimated population of over three million people. We used the WISN method to estimate the numbers of nurses/midwives, CHOs/CHEWs, and JCHEWs required to cope with the workload in the 196 ward-level primary health care facilities.FindingsBasic services provided by nurses/midwives, and CHOs/CHEWs were typical of the primary health care level. They are antenatal care, routine immunization, child welfare clinic, family planning, treatment of minor ailments, assisted and normal deliveries, postnatal care, emergencies, care of tuberculosis patients, and referrals. Findings show that available nurses/midwives for the 196 PHC facilities were 79, and the calculated requirement was 209, WISN ratio of 0.4 and difference of − 130; the existing number of CHOs/CHEWs was 808, the calculated requirement was 1,258, WISN ratio of 0.6, with a difference of − 450; and the number of existing JCHEWs was 258, the calculated requirement was 203, WISN ratio of 1.3 with a difference of 55. Cross River State had only 40% of required nurses and midwives; and 60% of CHOs/ CHEWs needed to provide health services in the ward-level PHC facilities.ConclusionThe findings from this study indicated marked shortages of needed health workforce particularly nurses and midwives at the primary level of care; and overlap in some of the tasks performed by nurses/midwives, CHO/CHEWs, and JCHEWs.

EFFECTS OF SOCIAL STIGMA ON TUBERCULOSIS CARE: CASE STUDIES IN MAHA SARAKHAM PROVINCE, THAILAND

Tuberculosis (TB) is a public health issue that relies on the participation of health networks and the care of tuberculosis patients systematically and effectively. This study aimed to investigate the effects of social stigma on continuous tuberculosis patient care. This qualitative research study employed a case study approach to investigate the effects of social stigma on the continuous tuberculosis patient care in Maha Sarakham Province, Thailand. The current study also explored tuberculosis patients’ health service information. An interview form was used as a research instrument to collect data. Interviews were conducted to collect the data from 42 tuberculosis patients and eight members of the tuberculosis caregiver community network. The research results revealed that the tuberculosis patients who received ongoing consultations and treatments from public health officers could develop positive incentives and expectations of the tuberculosis treatments. Family members had improved their supportive skills and could lower the stigma of their household patients. Consequently, people in the community built a network of mental health care and social support to reduce the stigmatization of tuberculosis patients. Counseling skills and knowledge of patient care are essential in caring for mental health patients. When people who are close to the patients develop essential skills for patient care, the stigmatization of tuberculosis patients can be reduced.

Causes of death in patients with tuberculosis and human immunodeficiency virus co-infection

Objectives. The aim of the study was to investigate the cause of death of tuberculosis patients infected with the human immunodeficiency virus (HIV). Many researchers and experts note the urgency of the problem of tuberculosis combined with HIV infection in the world and in Russia. One of the main criteria for assessing the effectiveness of medical care for tuberculosis patients infected with the human immunodeficiency virus is the mortality rate.Materials and methods. For a detailed study of the causes of death of patients with tuberculosis in combination with HIV infection, we analyzed the causes of death of this contingent of patients in 5 regions of the Russian Federation.Results. The social characteristics of patients, the forms and course of the disease, the main and immediate causes of death of 223 patients with co-infection with HIV and tuberculosis were studied.Conclusion. Half of the deaths of tuberculosis patients infected with human im­munodeficiency virus were not associated with tuberculosis. Among these cases, there was either the presence of several infections at the same time, equally leading to death, or separate opportunistic infections (candidiasis, Pneumocystis pneumonia, toxoplasmosis), or cancer. In addition, the lifestyle of patients often became the cause of deaths, namely: drug poisoning and accidents, or cirrhosis of the liver, which develops as a result of alcoholism or hepatitis C infection which occurred during intravenous administration of drugs.

Revised guidelines for Australian laboratories performing mycobacteriology testing

Mycobacteriology laboratories play a key role in tuberculosis (TB) control by providing phenotypic and molecular diagnostics, by performing molecular typing to aid contact tracing, and by supporting research and similar laboratories in Australia's neighbouring countries where TB is prevalent. The National Tuberculosis Advisory Committee (NTAC) published a set of laboratory guidelines in 2006 aiming to document the infrastructure, equipment, staffing and work practices required for safe high-quality work in Australian mycobacteriology laboratories. These revised guidelines have the same aims and have been through a similar extensive consultative peer-review process involving the Mycobacterium Reference Laboratory (MRL) network, the Mycobacterium Special Interest Group (SIG) of the Australian Society for Microbiology (ASM), and other relevant national bodies. This revised document contains several significant changes reflecting the publication of new biosafety guidelines and tuberculosis standards by various national and international organisations, technology developments - such as the MPT64-based immunochromatographic tests (ICTs) and the Xpert MTB/RIF assay, and updated work practices in mycobacteriology laboratories. The biosafety recommendations affirm the latest Australian/New Zealand Standard 2243.3: 2010 and promote a biorisk assessment approach that, in addition to the risk categorisation of the organism, also considers the characteristics of the procedure being performed. Using this biorisk assessment approach, limited manipulations, such as Ziehl-Neelsen (ZN) microscopy, MPT64 ICTs, and culture inactivation/DNA extraction for molecular testing, may be performed on a positive TB culture in a PC2 laboratory with additional features and work practices. Other significant changes include recommendations on the integration of MPT64 ICTs and novel molecular tests into TB laboratory workflows to provide rapid accurate results that improve the care of TB patients. This revised document supersedes the original 2006 publication. NTAC will periodically review these guidelines and provide updates as new laboratory technologies become available.

Clinical audit of management of smear positive adult pulmonary tuberculosis in PR1 tuberculosis clinic, KK Bandar Miri.

Malaysian tuberculosis (TB) clinical practice guideline (CPG) standardises the management of TB to improve the quality of care for TB patients. Not all primary care providers adhere to this guideline, however. This audit aims to improve the management of smear positive adult pulmonary TB by identifying areas of concern and developing action plans. Data for the audit were gathered from August 2018 to August 2019 from medical records of diagnosed smear positive pulmonary TB patients. Patients were included based on inclusion and exclusion criteria. Forty-eight smear positive pulmonary TB patients were recruited. The majority of patients were male (54.2%) and Malay (33.2%). TB symptoms were assessed for 29.2% of patients at two weeks and then in 81.3% at one month, 97.9% at two months, 16.7% at three months, 95.8% at four months, 22.9% at five months and 95.8% at six months. Medication side effects were assessed at two weeks for only 2.1% of patients, then for 8.3% of patients at one month, 2.1% at two months and 0% at subsequent months. At diagnosis, 25% and 4.2% of patients had their visual acuity and colour vision, respectively, assessed. Only 6.3% of patients were referred to pre-pregnancy counselling. Weights were recorded for 87.5% of patients at diagnosis, then for 27.1% at two weeks, 81.3% at one month, 91.7% at two months, 77.1% at three months, 97.9% at four months, 79.2% at five months and 93.8% at six months. Baseline investigations and Mycobacterium tuberculosis culture and sensitivity were conducted for all patients, but only 81.3% of patients were traced. No patients were referred to pharmacy for medication counselling. This audit shows that there is a difference between current practice and the national guideline. There are some downfalls in management and proper documentation, so interventions should be carried out to improve those aspects.

Barriers to accessing TB clinics among Myanmar TB patients attending a Thailand‐Myanmar border hospital: a qualitative approach

PurposeThis qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar living on the Thailand-Myanmar border.Design/methodology/approachTwenty-two participants were asked to provide information. In-depth interviews were used to gather the information. Each interview lasted 40 min.FindingsTB patients from Myanmar experience several barriers to accessing TB treatment and care at Mae Sai Hospital, such as language and economic problems, although they are very satisfied with the quality of service and positive attitude of the health care providers. A long waiting time and lack of explanation of the pathogenesis of TB were noted as negative aspects by the patients and their relatives. The medical staff at the TB clinic were negatively affected by the excessive workload and unsuitability of some methods or technologies. Using budgetary subsidies from agencies to fund TB care and treatment was not sustainable. Foreign TB patients are not subsidized by the national universal insurance scheme of Thailand, and sending TB patients back to their home country is sometimes unavoidable.Originality/valueThailand and Myanmar should strengthen their collaboration and develop a system to improve the quality of TB patient care and management for those who are living in poverty and lack education, by focusing on reducing language and economic barriers to accessing health care services including support for medicines and laboratory materials related to TB case management among these populations.

Red Nacional de Gestión de Conocimiento, Investigación e Innovación en Tuberculosis en Colombia

RESUMENEl Ministerio de Salud y Protección Social de Colombia, en colaboración con el Instituto Nacional de Salud y la Organización Panamericana de la Salud, convocaron en 2018 a todos los actores asociados al Programa Nacional de Prevención y Control de la Tuberculosis (PNPCT) y el Sistema Nacional de Ciencia, Tecnología e Innovación a la conformación de una red nacional que coordinara la investigación operativa (IO) relacionada con la tuberculosis (TB) en el país. Se realizaron siete talleres en los que se llegó al consenso de establecer la Red Nacional de Gestión de Conocimiento, Investigación e Innovación en Tuberculosis en Colombia (Red TB Colombia). Con más de 180 participantes, organizados en un nodo central y cinco nodos regionales que agrupan a las 37 entidades territoriales, en 2019 la Red TB Colombia realizó cuatro jornadas de capacitación en IO y definió 65 temas priorizados de investigación, ajustados a las líneas estratégicas establecidas por el PNPCT: prevención y atención integral, con foco en los afectados por la TB (41 temas en tres módulos) y compromiso político, protección social y sistemas de apoyo (24 temas en cuatro módulos). La priorización se realizó por el método de comparación por pares. La Red TB Colombia sigue activa y contribuye a la gestión del conocimiento dirigido a eliminar la TB en el país y ha permitido avanzar en la construcción de planes y la ejecución de proyectos locales de IO que generan resultados científicamente validados para fortalecer el PNPCT y mejorar la atención de los pacientes con TB.

The introduction of new technologies for out-patient care for tuberculosis patients during the COVID-19 pandemic in the Republic of Sakha (Yakutia)

During the COVID-19 pandemic in the Russian Federation associated with restrictions and quarantine, in order to ensure the quality and availability of tuberculosis medical care to the population of the Republic of Sakha, it became necessary to improve and search for new organizational forms of out-patient care.The objective of the study: to analyze the use of new technologies in out-patient care for tuberculosis patients in the Republic of Sakha (Yakutia) during the COVID-19 pandemic.Result: Scientific Practical Phthisiology Center introduced the following information and digital technologies to ensure the availability and quality of medical services to the population of the republic during the COVID-19 pandemic: Cloud Polyclinic, Telemedical Consultations, Radiological Information System of APK ArchiMed , Video-Controlled Treatment at Home, and Hospital at Home.All technologies have demonstrated their efficacy for remote medical consultations and contacting patients online. Based on practical experience, these technologies provided the following: improvement of medical care provided to the population through consultations, maintaining good contact with the patient, monitoring patients' well-being, and drug in-take. They assured compliance with general federal and regional anti-epidemic recommendations to prevent the spread of the new coronavirus infection.

Awareness about new guidelines of national tuberculosis elimination program among medical college faculty

Background: Physicians and faculty working in Medical Colleges play a major role in tuberculosis (TB) control. Their knowledge, attitude, and practices can affect the treatment and care of TB patients significantly.Objectives: The objectives were to assess the awareness about new guidelines of National TB Elimination Program (NTEP) among medical college faculty.Methods: A cross-sectional study was carried out among 95 faculties. They were given anonymous self-administered questionnaire with 23 questions. One mark was given for each correct answer. We classified correct knowledge as score >10 and poor knowledge as score <10. Yates-corrected Chi-square was used to study the association between variables and outcomes. P 0.05 was considered as statistically significant.Results: Questions about case detection rate, cure rate, incentives to private practitioner, bedaquiline, and follow-up of patients after completion of treatment were very poorly answered (<10 persons had correct knowledge). Only 17 could answer about the fixed-dose combinations, 10 about 99 Directly Observed Treatment Short-Course (DOTS) chemotherapy, and 13 about the choice of treatment in HIV-TB. Best answered questions were about the drugs used in each DOTS category, categories of DOTS, what are multidrug-resistant TB, extensive drug-resistant TB, and definition of presumptive case of TB. Overall, 58 faculties (61.1%) had poor knowledge with a score <11. The remaining 37 (38.9%) had correct knowledge with a score 11 or more. Correct knowledge was not found to be associated with age, sex, and designation but was associated with professional experience, with higher experience being associated with poor knowledge (P < 0.05).Conclusion: Majority of the faculty in the studied medical colleges had poor knowledge about new updates/guidelines in the NTEP. Professional experience was found to be significantly associated with the correct knowledge on recent updates in NTEP.

Respiratory tuberculosis: epidemiological monitoring and prevention

Aim. The analysis of epidemiological monitoring of respiratory tuberculosis in the Russian Federation, the Far Eastern Federal District and the Amur Region is carried out, which makes it possible to assess the levels and regional features of the spread of pathology among the population and territorial entities, the dynamics of morbidity and the effectiveness of preventive measures. Materials and methods. For the organization of the study, the methods of structural and comparative analysis, statistical and information-analytical methods, databases of the Ministry of Health of the Russian Federation and the Federal State Statistics Service of the Russian Federation (Rosstat) were used. Results. The analysis shows that tuberculosis is an important medico-social problem due to the high level of prevalence and adverse outcomes of its clinical course, representing a serious threat to human health and plays a large role in the formation of high social burden. At the same time, in recent years, in the territory of the Russian Federation as a whole and the Amur Region in particular, significant success has been achieved in the area of improving the efficiency and effectiveness of medical care for tuberculosis patients. Since 2010, primary incidence rates and the number of tuberculosis patients have decreased by 37 and 38%, respectively, and in the Amur Region – by 2.4 and 2.0 times. The share of destructive forms of pulmonary tuberculosis among newly diagnosed patients has decreased by 9.7% since 2005, and the microbiological coverage of patients with pulmonary tuberculosis in the region is almost 100%, while the level of bacterial excretion among newly diagnosed pulmonary tuberculosis in the Amur Region is the lowest among the subjects of the Far Eastern Federal District (16.1 per 100 000 population). The coverage of the population with routine inspections using fluorography methods in the Amur Region is the highest among the subjects of the Far Eastern Federal District and amounted to 94.0% in 2017. The effectiveness of treatment of patients with respiratory tuberculosis is significantly increased. As a result, the mortality rate of the population due to tuberculosis has decreased 3.9 times since 2005. At the same time, the Amur Region is included in the list of 8 subjects of the Russian Federation, where a high incidence of tuberculosis is combined with a high level of organization in the detection and treatment of the disease.