Tuberculosis Patients Research Articles

The impact of screening for tuberculosis exposure in the household in children with tuberculosis disease: A difficult riddle to solve.

Tuberculosis (TB) infection is transmitted by sharing the same airway with people with active TB. Children are often not considered the source of TB bacilli, and index case investigation is carried out after diagnosis. Here, we describe the impact of the presence of a household index case on childhood TB disease. The data of patients aged between 1 month and 18 years who were diagnosed with TB were collected. We compared patients according to whether they had an index case in the household or not. A total of 202 TB patients were enrolled, of whom 62 (30.7%) had a household index case. There was no significant difference in having a household index case between TB patients under the age of five (23.3%) and older children (33.8%) (p = .140). Pulmonary TB was present in 61.4% of the cases, and extrapulmonary TB was present in 38.6% of the cases. The rate of patients who had a household index case was significantly higher in pulmonary TB (46.8%) compared to extrapulmonary TB (5.1%) (p < .001). Pulmonary TB patients with a history of household contact were more likely to have diagnostic radiological findings (93.1%) compared to those without (75.8%) (p = .009). However, pulmonary TB patients without household contact history had a higher rate of diagnostic microbiological findings (59.1%) and constitutional symptoms (63.6%) (p = .019 and p = .013, respectively). Household contact research is an important epidemiological tool. However, considering the contact rates in the household, new and more comprehensive public health programs are required to prevent the spread of childhood tuberculosis.

Immunological reactivity and natural resistance in patients with tuberculosis, toxocariasis and tuberculosis associated with toxocariasis

Introduction. Parasitic diseases continue to affect the population of many countries of the world. About 2 billion people on the planet are infected with helminths, including Toxocara canis. Invasion with Toxocara canis represents a strong endogenous factor in the formation of the regulatory imbalance of the immune system. The integral evaluation of these indices serves as an important criterion in the diagnosis of toxocarosis and the effectiveness of the applied therapy. In the context of the above, information about research on immune reactivity and natural resistance of tuberculosis patients in association with toxocariasis is of interest. Material and methods. This article is a systematic review of the relevant literature between the year 2001 and 2022. The material for the study was electronic sources published through the web Medline, EMBASE, Global Health, Scopus and Web of science; PubMed; crossref; Google Scholar and others. The following keywords were used “immunological reactivity”, “natural resistance”, “parasitic diseases”, “toxocara canis”, “tuberculosis and toxocariasis”, “immunity”, “helminthiasis”, “toxocariasis”. Bibliographic resources have been systematized by subject and content. The results were grouped and systematized according to the relevant criteria and the level of scientific evidence. Results. Parasites, in particular, Toxocara canis and M. tuberculosis use different mechanisms to alter the immune response, but these mechanisms can interact with significant consequences for the immunological reactivity of each infection. Chronic helminthic infection causes a wide range of changes in the immune system. Conclusion. The immune reactivity and natural resistance of tuberculosis patients in association with toxocarosis is insufficiently elucidated.

Barriers and Facilitators in Implementation of Nutritional Benefit Transfer to Tuberculosis Patients

Abstract Background Malnutrition &amp; Tuberculosis (TB) form a vicious cycle. Nikshay Poshan Yojana (NPY) is a key strategy for a TB free India, that seeks to provide financial assistance for nutritional support to TB patients. The study is a qualitative study to identify operational challenges and facilitators in implementation of NPY Methods In Depth Interview (IDI) of 18 Senior Treatment Supervisor (STS) at Tuberculosis Unit (TU) and 19 Tuberculosis Health Visitor (TB HV) at Designated Microscopy Centre’s (DMC) was done. For further insights, the STS, at District Tuberculosis Centre, Lucknow was also interviewed. Informal discussion was done with about 50 Tuberculosis patients. We explored providers perspective on impact of NPY on other duties/services, case load, hours dedicated to NPY, practice protocols, record keeping and data management, compliances, capacity building needs, quality protocols, key enablers, motivating factors, challenges, best practices and beneficiary’s perspectives on quality of life, facilitators and challenges in availing services. Results Motivating leadership, supportive staff, good working relationship and seamless communication, teamwork, use of technology, supportive supervision &amp; collaboration and support of NGO for private sector were the key facilitators. Barriers comprised system level barriers (Budget constraints, issues with NIKSHAY software and bank account), provider level barriers (shortage of human resource, nonfunctional tablets) and patient level barriers (stigma and bank account related challenges). The encouraging finding was majority of recipients, responding that they used the incentive to purchase ration, vitamin supplements etc. Conclusions NPY is having its intended benefit but there are barriers that need to be resolved for successful roll out. The study yield suggestions for removing barriers and found a set of innovations that can be replicated across other settings with high Tuberculosis burden Key messages • Malnutrition and Tuberculosis form a vicious cycle. Nutritional support to TB patients improves treatment outcome and can save lives. • Operational research on implementation of NPY offers insights for successful roll out of this key initiative across other resource limited settings in developing countries.

A Rare Case of Tremor Induces by Cycloserine in Drug-Resistant Tuberculosis Patient

Background: Tuberculosis is a contagious disease that generated by Mycobacterium tuberculosis. Drug-Resistant tuberculosis (DR-TB) is inculpated the use of the second-line anti-tubercular treatment which is associated with many drug side effects or so called, Adverse Drug Reactions (ADR). Cycloserine (Cs) is an important drug against drug resistant tuberculosis (DR-TB). Cycloserine has been used in tuberculosis therapy since the late 1950s. Identical with most drug, Cycloserine can cause many Adverse Drug Reactions (ADR). Case Illustration: A 23-year-old woman diagnosed with drug-resistant tuberculosis is undergoing long-term treatment. The patient received treatment for DR-TB with the Bdq-Lfx-Cfz-Cs-E regimen. After the patient underwent the 10th month of advanced phase treatment, the patient complained of shaking in both hands (tremors). The tremor is felt to be more severe in the right hand and the patient cannot grip objects tightly. Discussion: Cycloserine (Cs) play an important role in second-line drug management of DR-TB. Cs-Induced psychosis and other neurological side-effects can be detrimental towards patients yet they are rarely reports in DR-TB cases. Cs is correlated with severe psychiatric cases and Central Nervous System related ADRs. Cs-associated ADR is most likely because of production of gamma-aminobutyric acid as a result of inhibition of glutamic decarboxylase. Study Shown that among 132 patients who reported side effects in the cycloserine group, 2 (1.4%) experienced major side effects, namely tremors. Side effects possibly or probably related to Cs appeared after a median of 71 days (range 10–331 days) of Cs treatment. Conclusion: the drug side effects such as tremors are very rare in drug-resistant tuberculosis patients. In this case, the patient's complaint of tremors could be caused by cycloserine as an anti-tuberculosis drug.

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

Effectiveness of Mobile Application-Based Intervention on Medication Adherence Among Pulmonary Tuberculosis Patients: A Systematic Review.

To analyze the effectiveness of mobile application-based interventions on medication adherence among pulmonary tuberculosis patients. Intervention articles involving patients with pulmonary tuberculosis and/or their families, utilizing mobile application-based intervention research designs, assessing patients individually or in groups with or without a control group, using mobile application-based interventions that can be accessed via a browser, utilizing adherence to treatment as the primary outcome, and written in English and Indonesian were included. The articles published from 2012 to 2022 were obtained from EBSCO Host, ProQuest, GARUDA, PubMed, Scopus, and Cochrane Online Library databases. The Critical Assessment Standards Program was used to assess the trustworthiness, relevance, and results of the published articles. The quality of the articles was assessed according to Johns Hopkins Nursing Evidence-Based Practice guidelines. Seven studies reported that mobile application-based interventions can improve medication adherence, including treatment success, number of missed drugs, correct intake of medications, adherence to health programs, timeliness, and frequency of clinic visits. This review only analyzed the impact of mobile application-based interventions on patients, and their effects on the family, social, and health services were not covered.

Prevalence of rifampicin and isoniazid mono-resistance among cases of pulmonary tuberculosis from Western Uttar Pradesh, North India.

Mono-resistance to rifampicin/isoniazid increases poor treatment outcomes and the risk of multi-drug resistance (MDR) in tuberculosis (TB) patients. Limited information exists about mono-resistance status of TB patients in Uttar Pradesh, North India. This study aimed to estimate the burden of rifampicin and isoniazid mono-resistance in Western Uttar Pradesh. 153 sputum samples of suspected pulmonary tuberculosis patients were processed to isolate Mycobacterium tuberculosis using the Lowenstein-Jensen (L-J) culture medium. The isolates were identified using an immuno-chromatographic test and IS6110 PCR. The confirmed Mycobacterium tuberculosis isolates were tested for drug susceptibility testing against rifampicin and isoniazid anti-tuberculosis drugs. The results of the drug susceptibility testing were compared with demographic information and analyzed statistically. Out of 153 sputum samples, 83 (54.24%) samples were positive for growth on L-J medium, including 82 (98.79%) Mycobacterium tuberculosis isolates. Of the 82 Mycobacterium tuberculosis isolates, 16 (19.51%), 7 (8.54%), and 5 (6.10%) isolates were MDR, mono-resistant to rifampicin and isoniazid, respectively. The occurrence of RIF/INH mono-resistant-TB was higher in patients of male gender, age above 45 years, living in rural conditions, history of weight loss, and previous anti-TB treatment, but the effect was not statistically significant. The study reported the status of rifampicin and isoniazid mono-resistance among TB patients and highlighted the need for continuous monitoring and improved intervention for the initial detection of mono-drug-resistant cases. This will improve clinical treatment outcomes and decrease the rate of drug-resistant TB in Uttar Pradesh, North India.

Prevalence of anti-Toxoplasma gondii antibodies in tuberculosis patients

Despite the proven association between a co-infection of Mycobacterium tuberculosis and Toxoplasma gondii, few studies address how this relationship could interfere with latent infection or prognosis of tuberculosis or toxoplasmosis. Therefore, the objective of this study was to evaluate the prevalence of anti-T. gondii antibodies in patients with tuberculosis and their clinical-epidemiological association. Methods: Were evaluated antibodies anti-T. gondii in patients diagnosed with tuberculosis and in treatment. Clinical, laboratory and radiological data were obtained from medical records. The present study demonstrated a seroprevalence of anti-T. gondii antibodies (80%), despite that, none of the characteristics evaluated among the TB patients were associated with the presence of anti-T. gondii antibodies. Hence, it’s possible to conclude that patients with tuberculosis (TB) have a high prevalence of anti-T. gondii antibodies, and it’s recommended to evaluate the presence of IgM and IgG antibodies against T. gondii in patients recently diagnosed with tuberculosis and throughout anti-TB treatment to evaluate possible complications.

Determinants of unsuccessful tuberculosis treatment outcome in Southwest Ethiopia regional state public hospitals, 2022: a multi-center case control study

BackgroundTuberculosis is the major cause of morbidity, and it is one of the top ten causes of death globally. In Africa, the overall pooled estimate of unsuccessful tuberculosis treatment outcome was reported to be 21.1%, which is above the World Health Organization defined threshold of 15%. Unsuccessful treatment outcomes result in drug resistance, prolonged periods of infection, and increased morbidity and mortality. Therefore, this study aimed to assess determinants of unsuccessful treatment outcomes among tuberculosis patients in Southwest Ethiopia regional state public hospitals, in 2022.MethodA retrospective unmatched case–control study was employed by recruiting 570 study units (190 cases and 380 controls) in three randomly selected public hospitals from 1 August 2022 to 21 August 2022. Data were collected by using a data extraction checklist adapted from tuberculosis registration logbook. Bivariate and multivariate logistic regression models were employed. A predictor variable with a p-value of less than 0.05 in the multivariate logistic regression model was taken as statistically significant. The odds ratio and 95% confidence level were used to measure the strength of the association.ResultA total of 561 records (187 cases and 374 controls) were included from tuberculosis registers. In this study, the factors independently associated with unsuccessful tuberculosis treatment outcome were older age (AOR = 1.68, 95% CI: 1.142, 2.472), rural residence (AOR = 1.548, 95% CI: 1.055, 2.272), retreatment category (AOR = 2.12, 95% CI: 1.339, 3.357), underweight (BMI &amp;lt; 18.5 kg/m2) (AOR = 1.952, 95% CI: 1.240, 3.071), being HIV positive (AOR = 2.144, 95% CI: 1.372, 3.349) and having no treatment adherence support (AOR = 2.016, 95% CI: 1.270, 3.201).Conclusion and recommendationIn this study, socio-demographic, clinical, and treatment-related factors contributed to the risk of unsuccessful treatment outcomes. Targeted interventions should be taken into consideration to diminish poor tuberculosis treatment outcomes among high-risk groups throughout the whole tuberculosis treatment course.

Alterations in purine and pyrimidine metabolism associated with latent tuberculosis infection: insights from gut microbiome and metabolomics analyses.

Individuals with latent tuberculosis infection (LTBI) account for almost 30% of the population worldwide and have the potential to develop active tuberculosis (ATB). Despite this, the current understanding of the pathogenesis of LTBI is limited. The gut microbiome can be altered in tuberculosis patients, and an understanding of the changes associated with the progression from good health to LTBI to ATB can provide novel perspectives for understanding the pathogenesis of LTBI by identifying microbial and molecular biomarkers associated therewith. In this study, fecal samples from healthy controls (HC), individuals with LTBI and ATB patients were collected for gut microbiome and metabolomics analyses. Compared to HC and LTBI subjects, participants with ATB showed a significant decrease in gut bacterial α-diversity. Additionally, there were significant differences in gut microbial communities and metabolism among the HC, LTBI, and ATB groups. PICRUSt2 analysis revealed that microbiota metabolic pathways involving the degradation of purine and pyrimidine metabolites were upregulated in LTBI and ATB individuals relative to HCs. Metabolomic profiling similarly revealed that purine and pyrimidine metabolite levels were decreased in LTBI and ATB samples relative to those from HCs. Further correlation analyses revealed that the levels of purine and pyrimidine metabolites were negatively correlated with those of gut microbial genera represented by Ruminococcus_gnavus_group (R. gnavus), and the levels of R. gnavus were also positively correlated with adenosine nucleotide degradation II, which is a purine degradation pathway. Moreover, a combined signature including hypoxanthine and xanthine was found to effectively distinguish between LTBI and HC samples (area under the curve [AUC] of training set = 0.796; AUC of testing set = 0.924). Therefore, through gut microbiome and metabolomic analyses, these findings provide valuable clues regarding how alterations in gut purine and pyrimidine metabolism are linked to the pathogenesis of LTBI.IMPORTANCEThis study provides valuable insight into alterations in the gut microbiome and metabolomic profiles in a cohort of adults with LTBI and ATB. Perturbed gut purine and pyrimidine metabolism in LTBI was associated with the compositional alterations of gut microbiota, which may be an impetus for developing novel diagnostic strategies and interventions targeting LTBI.

Predictive machine learning models for anticipating loss to follow-up in tuberculosis patients throughout anti-TB treatment journey

Loss to follow-up (LTFU) in tuberculosis (TB) management increases morbidity and mortality, challenging effective control strategies. This study aims to develop and evaluate machine learning models to predict loss to follow-up in TB patients, improving treatment adherence and outcomes. Retrospective data encompassing tuberculosis patients who underwent treatment or registration at the National Center for Clinical Medical Research on Infectious Diseases from January 2017 to December 2021 were compiled. Employing machine learning techniques, namely SVM, RF, XGBoost, and logistic regression, the study aimed to prognosticate LTFU. A comprehensive cohort of 24,265 tuberculosis patients underwent scrutiny, revealing a LTFU prevalence of 12.51% (n = 3036). Education level, history of hospitalization, alcohol consumption, outpatient admission, and prior tuberculosis history emerged as precursors for pre-treatment LTFU. Employment status, outpatient admission, presence of chronic hepatitis/cirrhosis, drug adverse reactions, alternative contact availability, and health insurance coverage exerted substantial influence on treatment-phase LTFU. XGBoost consistently surpassed alternative models, boasting superior discriminative ability with an average AUC of 0.921 for pre-treatment LTFU and 0.825 for in-treatment LTFU. Our study demonstrates that the XGBoost model provides superior predictive performance in identifying LTFU risk among tuberculosis patients. The identification of key risk factors highlights the importance of targeted interventions, which could lead to significant improvements in treatment adherence and patient outcomes.

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.

Factors associated with unfavourable treatment outcomes among tuberculosis patients at health facilities of Maseru, Lesotho

Tuberculosis (TB) treatment success rates (TSR) remain low in Lesotho. The country achieved TSR of 76% in 2020, which is far below the World Health Organization’s 95% target set for 2030. This study determined the level of treatment success and factors associated with unfavourable treatment outcomes. This descriptive cross-sectional study used patient records to perform descriptive and logistic regression analyses. Sixty-one per cent of the 336 TB patients were male. Two hundred and eighty-nine had favourable outcomes, of which 10% died in the course of treatment. Patients ≤ 44 years old, and those with supported treatment, had lower odds of unfavourable treatment outcomes, respectively, adjusted odds ration [aOR] = 0.39 (95% CI: 0.19–0.78) and aOR = 0.22 (95% CI: 0.08–0.62), p 0.05.Contribution: The death of patients while on TB treatment needs to be addressed, including heightened advocacy for supported treatment.

The progress of Mycobacterium tuberculosis drug targets

Tuberculosis (TB) has been troubling humans for hundreds of years, is a highly infectious disease caused by Mycobacterium tuberculosis (Mtb) infection, Mtb can infect almost all organs of the body and is one of the deadly infectious diseases in the world. At present, the first-line treatment regimen has a long treatment cycle and is prone to multiple drug resistance. Anti-tuberculosis drugs and latent tuberculosis infection (LTBI) resistance are increasing year by year, and new targets and new bioactive compounds are urgently needed to treat this disease. This review focuses on the latest reported anti-TB drug targets and related compounds in recent years, reviews the current TB drug regimen and major defects, outlines the key drug targets developed to date in Mtb, and the current situation of newly discovered anti-TB resistant forms of drugs. To provide a reference for the research and development of new anti-TB drugs and bring new treatment strategies for TB patients.

Formation of treatment regimens in newly diagnosed patients before the diagnosis of pulmonary tuberculosis verification

Abstract. One of the basic principles of treatment of tuberculosis patients is the appointment of treatment taking into account the drug resistance of Mycobacterium tuberculosis (MBT). However, during treatment, it may be necessary to change the intake regimen when new data on drug resistance become available. The search for ways to choose the optimal treatment method seems relevant.Aim: To analyze the prescribed regimens and the reason for their correction in newly identified patients before verifying the diagnosis of tuberculosis.Material and Methods. The following methods were used to detect MBT: luminescent microscopy, molecular genetic methods and seeding on liquid and solid media. Tests for drug sensitivity were conducted in parallel. The study group consisted of patients with established bacterial excretion (n = 79), whose diagnosis was confirmed by cultural methods. A retrospective method was used in the analysis.Results. At the beginning of treatment with bacterioscopy and polymerase chain reaction methods MBT was detected in 65/79 (82.2%) cases, the remaining 14 cases were detected only by culture methods. Forced change of the therapy regimen during treatment after receiving the results was in 25/79 (31.6%) cases, of which 1/25 (4%) with isoniazid resistance, 7/25 (28%) with multidrug-resistant tuberculosis, 17/25 (68%) with the pre-extensive drug resistance regimen. The latter was prescribed only after receiving results of tests for drug sensitivity on liquid and solid media after 1–3 months. The multidrug-resistant tuberculosis treatment regimen decreased after receiving data on resistance to fluoroquinolones in accordance with the seeding data, but the largest number of patients still remained on this regimen – 41/79 (51.9%). Among these patients a change in chemotherapy regimen from multidrug-resistant tuberculosis to pre-extensive drug resistance during the intensive phase of treatment occurred in 17/25 (68%).Conclusion. When prescribing a regimen, it is recommended to assess the risk of changing the regimen and, if there are predictors, apply a chemotherapy regimen before treatment.

Time Motion Study of Tuberculosis Patients Attending a Hospital in an Indian State

Abstract Objectives: To analyse the time taken in availing various services by a patient of cardinal symptoms of Tuberculosis in TB Hospital, Bhopal, India and to determine the satisfaction of patients regarding care. Methods: This is a time–motion observational study of patients who came with symptoms of TB. A sample of 210 was calculated using Cochran’s formula. Results: Amongst the 210 patients studied, the majority were males, i.e. 123 (58.6%). A striking feature was found during this study that reports of sputum were given 2–5 days after collection. Conclusion: This busy hospital dedicated to providing comprehensive healthcare pertaining to TB had multiple patient queues, long clinical visits and short clinical encounters. Although the patients were satisfied with the clinical consultations from the doctors, they found difficulty in availing laboratory and X-ray services.

Indole Propionic Acid (IPA), A Gut Microbiota-Derived Metabolite, in Active Pulmonary Tuberculosis (TB) Infection: A Case Control Study

Introduction: A metabolomics study revealed that the tryptophan (Trp) pathway is upregulated in tuberculosis (TB) infection. Indole propionic acid (IPA) is a gut microbiota-derived tryptophan metabolite with antimycobacterial properties through TrpE inhibition and as ligand for AhR in in vitro and in vivo studies. TB infection is associated with gut dysbiosis. However, plasma IPA levels and related factors in active TB patients have not yet been explored. This study aimed to determine the differences and correlations between plasma IPA levels and patient characteristics (age, gender, BMI and GeneXpert result), IPA-producing gut microbiota (Clostridium sporogenes, Lactobacillus sp., and Peptostreptococcus anaerobius), and IFN-γ concentrations in active TB patients and healthy subjects. Materials and methods: A case-control study was performed in 29 active TB patients and 30 healthy controls (HCs) in Aceh, Indonesia. The plasma IPA and IFN-γ levels were measured by ELISA, and the relative abundance of gut microbiota was determined by quantitative PCR (qPCR). The results and discussion: Increased plasma IPA levels (median (IQR) of 22.2 pmol/L (21.3 - 23.9) vs. 18.9 pmol/L (17 - 22.8), p 0.000) were associated with active TB according to the adjusted model (AOR 1.36 (95 % CI 0.37 - 5.1)). Increase of plasma IPA level in higher mycobacterial load patients was found. Higher plasma IPA was positively associated with female, normo- and overweight status, and higher relative abundance of C. sporogenes. The metabolite could be used to discriminate active TB disease at a cutoff of 21.40 pmol/L (72 % sensitivity, 70 % specificity and AUC 0.77). Dysbiosis in IPA-producing bacteria was showed in active TB patients. Conclusion: Plasma IPA could be considered as TB biomarker, and it may also influence disease progression. Future works are needed to validate plasma IPA as biomarker in LTBI and other respiratory infection, as well as its role as biomarker of treatment monitoring response. HIGHLIGHTS The upregulation of the tryptophan (Trp) pathway in tuberculosis infection. Indole propionic acid (IPA) is a Trp metabolite with antimycobacterial properties Higher plasma IPA levels were found in TB patients than in healthy subjects. Dysbiosis of several IPA-producing gut microbiota was revealed in this study. GRAPHICAL ABSTRACT

Hubungan Komunikasi Interpersonal Perawat Dengan Kepatuhan Pasien Menjalankan Pengobatan Tuberkulosis di UPTD Puskesmas Kali Baru Bekasi

Background: Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis, or acid-fast bacilli (AFB), which can survive in low-oxygen environments. Factors influencing TB patient adherence include motivation, knowledge, attitude, and family support. Research Objective: To determine the relationship between nurse-patient interpersonal communication and patient adherence to TB treatment at UPTD Puskesmas Kalibaru, Bekasi. Research Method: This study used a quantitative method with an observational analytic design and a cross-sectional approach, involving 30 patients. The sampling technique used was total sampling. Results: The Chi-Square test yielded a p-value of 0.000 &lt; α (0.05), indicating that H0 is rejected.Conclusion: There is a significant relationship between nurse-patient interpersonal communication and patient adherence to TB treatment at UPTD Puskesmas Kalibaru, Bekasi.

Silicosis predicts drug resistance and retreatment among tuberculosis patients in India: a secondary data analysis from Khambhat, Gujarat (2006–2022)

BackgroundIndia, with the highest global burden of tuberculosis (TB) and drug-resistant TB, aims to eliminate TB by 2025. Yet, limited evidence exists on drug resistance patterns and retreatment among patients with silico-tuberculosis. This study explores these patterns and assesses the impact of silicosis on TB retreatment in India.MethodsThis secondary data analysis stems from a larger retrospective cohort study conducted in Khambhat, Gujarat, between January 2006 and February 2022. It included 138 patients with silico-tuberculosis and 2,610 TB patients without silicosis. Data from the Nikshay TB information portal were linked with silicosis diagnosis reports from the Pneumoconiosis Board using the unique Nikshay ID as the linking variable. Drug-resistant TB was defined as resistance to any anti-TB drug recorded in Nikshay. Retreatment refers to TB patients who have previously undergone anti-TB treatment for one month or more and need further treatment. Recurrent TB denotes patients who were previously declared cured or had completed treatment but later tested positive for microbiologically confirmed TB. Multivariable logistic regression was used to determine the impact of co-prevalent silicosis on drug resistance and retreatment.ResultsPatients with silico-tuberculosis showed a higher proportion of retreatment compared to those without silicosis (55% vs. 23%, p < 0.001). Notably, 28% of patients with silico-tuberculosis were recurrent TB cases, compared to 11% among those without silicosis. Regarding drug resistance, the silico-tuberculosis group exhibited a higher rate (6% vs. 3%), largely due to rifampicin resistance (5% vs. 2%, p = 0.022). Co-prevalent silicosis was associated with a 2.5 times greater risk of drug-resistant TB (adjusted OR 2.5, 95% CI, 1.1–5.3; p = 0.021). Additionally, patients with silico-tuberculosis had a fourfold increased risk of retreatment for TB (adjusted OR 4, 95% CI, 3–6; p < 0.001).ConclusionsCo-prevalent silicosis significantly elevates the risk of drug resistance, recurrence, and retreatment among TB patients in India. This study indicates a need for improved treatment protocols and suggests that future research should focus on randomized controlled trials to evaluate appropriate anti-TB regimen and duration of therapy for this high-risk group. Given India’s goal to eliminate TB by 2025, addressing the challenges posed by silico-tuberculosis is critical.

Factors Associated with Poor Treatment Outcomes in Newly Diagnosed Tuberculosis Patients in Sub-Sahara Africa: A Systematic Review

Introduction: The burden of Tuberculosis (TB) in Africa continues to rise despite numerous interventions to stop the spread. Addressing factors associated requires a robust model that addresses cross-cutting issues in the continuum of TB care and management. The objective of this systematic review is to determine factors associated with poor treatment outcomes in newly diagnosed TB patients in sub-Saharan Africa. Method: The literature search identified 234 studies that were written in English. All the articles were identified via database search and imported into Mendeley for analysis. A total of 95 duplicates were removed and the abstracts of remaining studies were reviewed. A total of 139 abstracts were screened with misleading and non-open access journal articles removed. A full reading of the remaining 104 potentially relevant studies was done, in order to ascertain compliance with the inclusion/exclusion criteria and 24 studies were found to be eligible and were included in this review. Results: HIV co-infection, type of TB infection and gender were observed as most common factors associated with poor treatment outcomes in newly diagnosed patients. Several studies emphasized the impact of male gender on poor treatment outcomes stating a higher likelihood to developing unfavorable outcomes. Other factors identified included social factors namely employment, location, nutrition, failure to gain weight, failure to present at facility, delay to be treated at the facility and the type of facilities where one was treated. Conclusion: The common factors associated with poor treatment outcomes were HIV co-infection, type of TB infection and gender and these were notably underscored by social factors. Addressing these challenges will significantly improve the health outcomes of TB patients in the region.