首页 > 最新文献

Public Health Action最新文献

英文 中文
Using digital chatbots to close gaps in healthcare access during the COVID-19 pandemic. 在2019冠状病毒病大流行期间,使用数字聊天机器人弥合医疗保健获取方面的差距。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2022-12-21 DOI: 10.5588/pha.22.0046
C Tzelios, C Contreras, B Istenes, A Astupillo, L Lecca, K Ramos, L Ramos, K Roca, J T Galea, M Tovar, C D Mitnick, J Peinado

Introduction: Chatbots have emerged as a first link to care in recent years. The COVID-19 pandemic, and consequent health system disruptions, expanded their use. Socios En Salud (SES) introduced chatbots in Peru, which experienced one of the highest excess COVID mortalities in the world.

Methods: SES and the government identified unmet population health needs, which could be amenable to virtual interventions. Chatbots were developed to screen individuals for these conditions; we describe the period of deployment, number of screenings, and number of people who received services.

Results: Between April 2020 and May 2021, SES deployed nine ChatBots: four for mental health, two for maternal and child health, and three for chronic diseases: breast cancer, hypertension, diabetes mellitus, and obesity. Mental health services were provided to 42,932 people, 99.99% of those offered services. The other ChatBots reached fewer people. Overall, more than 50% of eligible people accepted chatbot-based services.

Discussion: ChatBot use was highest for mental health. Chatbots may increase connections between a vulnerable population and health services; this is likely dependent on several factors, including condition, population, and penetration of smart phones. Future research will be critical to understand user experience and preferences and to ensure that chatbots link vulnerable populations to appropriate, high-quality care.

导语:近年来,聊天机器人已经成为护理的第一环节。COVID-19大流行及其造成的卫生系统中断扩大了它们的使用。秘鲁是世界上新冠肺炎死亡率最高的国家之一,社会服务公司(SES)在秘鲁推出了聊天机器人。方法:社会服务系统和政府确定了未满足的人口健康需求,这些需求可以通过虚拟干预来满足。开发聊天机器人是为了筛查这些疾病的个体;我们描述了部署的时间、筛选的次数和接受服务的人数。结果:在2020年4月至2021年5月期间,SES部署了9个聊天机器人:4个用于心理健康,2个用于孕产妇和儿童健康,3个用于慢性疾病:乳腺癌、高血压、糖尿病和肥胖症。向42,932人提供了心理健康服务,占提供服务人数的99.99%。其他聊天机器人接触到的人更少。总体而言,超过50%的符合条件的人接受了聊天机器人服务。讨论:聊天机器人在心理健康方面的使用率最高。聊天机器人可能会增加弱势群体与医疗服务之间的联系;这可能取决于几个因素,包括条件、人口和智能手机的普及率。未来的研究对于了解用户体验和偏好以及确保聊天机器人将弱势群体与适当的高质量护理联系起来至关重要。
{"title":"Using digital chatbots to close gaps in healthcare access during the COVID-19 pandemic.","authors":"C Tzelios,&nbsp;C Contreras,&nbsp;B Istenes,&nbsp;A Astupillo,&nbsp;L Lecca,&nbsp;K Ramos,&nbsp;L Ramos,&nbsp;K Roca,&nbsp;J T Galea,&nbsp;M Tovar,&nbsp;C D Mitnick,&nbsp;J Peinado","doi":"10.5588/pha.22.0046","DOIUrl":"https://doi.org/10.5588/pha.22.0046","url":null,"abstract":"<p><strong>Introduction: </strong>Chatbots have emerged as a first link to care in recent years. The COVID-19 pandemic, and consequent health system disruptions, expanded their use. Socios En Salud (SES) introduced chatbots in Peru, which experienced one of the highest excess COVID mortalities in the world.</p><p><strong>Methods: </strong>SES and the government identified unmet population health needs, which could be amenable to virtual interventions. Chatbots were developed to screen individuals for these conditions; we describe the period of deployment, number of screenings, and number of people who received services.</p><p><strong>Results: </strong>Between April 2020 and May 2021, SES deployed nine ChatBots: four for mental health, two for maternal and child health, and three for chronic diseases: breast cancer, hypertension, diabetes mellitus, and obesity. Mental health services were provided to 42,932 people, 99.99% of those offered services. The other ChatBots reached fewer people. Overall, more than 50% of eligible people accepted chatbot-based services.</p><p><strong>Discussion: </strong>ChatBot use was highest for mental health. Chatbots may increase connections between a vulnerable population and health services; this is likely dependent on several factors, including condition, population, and penetration of smart phones. Future research will be critical to understand user experience and preferences and to ensure that chatbots link vulnerable populations to appropriate, high-quality care.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 4","pages":"180-185"},"PeriodicalIF":1.4,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716819/pdf/i2220-8372-12-4-180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10422057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Strategic response to COVID-19 in Ethiopia. 埃塞俄比亚 COVID-19 的战略对策。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2022-12-21 DOI: 10.5588/pha.22.0007
D K Huluka, A W Ashagrie, T H Gebremariam, H Y Ahmed, R A Kebede, A B Binegdie, K G Gebrehiwot, M Tadesse, M Sultan, W W Dode, A A Tumebo, A Abayneh, Y Seman, T Firew, C B Sherman, N W Schluger, D A Haisch

COVID-19, the novel coronavirus, has posed a major threat to low- and middle-income countries (LMICs) due to inadequate health infrastructure and human resources. Ethiopia, a low-income country with the second largest population in Africa, has coordinated a strategic response, leveraging existing infrastructure and health systems and mobilizing public health professionals and specialist expert physicians for a multifaceted, unified government approach and adaptive response. Resource limitations, particularly in critical care, have still posed challenges, but the public health and clinical interventions thus far have prevented the catastrophic toll that many predicted. As the pandemic continues, Ethiopia expects to use a triple care model integrated at all levels, consisting of COVID-19 care, isolation care for suspected cases, and essential health services, and urges intensified non-pharmaceutical interventions alongside equitable global vaccine distribution as the ultimate answers to pandemic control. This paper draws on existing data, national planning and guidelines, and expertise from health leadership to describe this response in hopes of providing an example of how future large-scale health challenges might be faced in LMICs, using Ethiopia's successes and challenges in facing the pandemic.

由于卫生基础设施和人力资源不足,新型冠状病毒 COVID-19 已对中低收入国家(LMIC)构成重大威胁。埃塞俄比亚是非洲第二大人口众多的低收入国家,该国利用现有的基础设施和卫生系统,动员公共卫生专业人员和专科专家医生,采取多方面、统一的政府方法和适应性应对措施,协调采取了战略应对措施。资源限制,尤其是重症护理方面的资源限制,仍然构成了挑战,但迄今为止的公共卫生和临床干预措施避免了许多人预测的灾难性伤亡。随着疫情的持续,埃塞俄比亚预计将在各个层面采用三重护理模式,包括 COVID-19 护理、疑似病例隔离护理和基本医疗服务,并敦促加强非药物干预措施,同时在全球范围内公平分配疫苗,以此作为控制疫情的最终解决方案。本文借鉴了现有数据、国家规划和指导方针以及卫生领导层的专业知识,描述了这一应对措施,希望通过埃塞俄比亚在面对大流行病时取得的成功和面临的挑战,为低收入与中等收入国家未来如何应对大规模卫生挑战提供一个范例。
{"title":"Strategic response to COVID-19 in Ethiopia.","authors":"D K Huluka, A W Ashagrie, T H Gebremariam, H Y Ahmed, R A Kebede, A B Binegdie, K G Gebrehiwot, M Tadesse, M Sultan, W W Dode, A A Tumebo, A Abayneh, Y Seman, T Firew, C B Sherman, N W Schluger, D A Haisch","doi":"10.5588/pha.22.0007","DOIUrl":"10.5588/pha.22.0007","url":null,"abstract":"<p><p>COVID-19, the novel coronavirus, has posed a major threat to low- and middle-income countries (LMICs) due to inadequate health infrastructure and human resources. Ethiopia, a low-income country with the second largest population in Africa, has coordinated a strategic response, leveraging existing infrastructure and health systems and mobilizing public health professionals and specialist expert physicians for a multifaceted, unified government approach and adaptive response. Resource limitations, particularly in critical care, have still posed challenges, but the public health and clinical interventions thus far have prevented the catastrophic toll that many predicted. As the pandemic continues, Ethiopia expects to use a triple care model integrated at all levels, consisting of COVID-19 care, isolation care for suspected cases, and essential health services, and urges intensified non-pharmaceutical interventions alongside equitable global vaccine distribution as the ultimate answers to pandemic control. This paper draws on existing data, national planning and guidelines, and expertise from health leadership to describe this response in hopes of providing an example of how future large-scale health challenges might be faced in LMICs, using Ethiopia's successes and challenges in facing the pandemic.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 4","pages":"191-194"},"PeriodicalIF":1.4,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716818/pdf/i2220-8372-12-4-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9991353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents. 对改善儿童和青少年艾滋病治疗效果的干预措施进行过程评估。
IF 1.3 Q4 RESPIRATORY SYSTEM Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0009
M Seguin, S Dringus, S Chiomvu, T Apollo, E Sibanda, V Simms, S Bernays, R Chikodzore, N Redzo, P Mlilo, L Ndlovu, P Nzombe, B Ncube, K Kranzer, R Abbas Ferrand, C D Chikwari

Setting: Children and adolescents with HIV encounter challenges in initiation and adherence to antiretroviral therapy (ART). A community-based support intervention of structured home visits, aimed at improving initiation, adherence and treatment, was delivered by community health workers (CHWs) to children and adolescents newly diagnosed with HIV.

Objectives: To 1) describe intervention delivery, 2) explore CHW, caregiver and adolescents' perceptions of the intervention, 3) identify barriers and facilitators to implementation, and 4) ascertain treatment outcomes at 12 months' post-HIV diagnosis.

Design: We drew upon: 1) semi-structured interviews (n = 22) with 5 adolescents, 11 caregivers and 6 CHWs, 2) 28 CHW field manuals, and 3) quantitative data for study participants (demographic information and HIV clinical outcomes).

Results: Forty-one children received at least a part of the intervention. Of those whose viral load was tested, 26 (n = 32, 81.3%) were virally suppressed. Interviewees felt that the intervention supported ART adherence and strengthened mental health. Facilitators to intervention delivery were convenience and rapport between CHWs and families. Stigma, challenges in locating participants and inadequate resources for CHWs were barriers.

Conclusion: This intervention was helpful in supporting HIV treatment adherence among adolescents and children. Facilitators and barriers may be useful in developing future interventions.

环境:感染艾滋病病毒的儿童和青少年在开始和坚持抗逆转录病毒疗法(ART)方面遇到了挑战。社区卫生工作者(CHWs)为新诊断出感染艾滋病病毒的儿童和青少年提供了一项基于社区的支持性干预措施,即有组织的家访,旨在改善启动、坚持和治疗情况:目的:1)描述干预措施的实施情况;2)探讨社区保健员、护理人员和青少年对干预措施的看法;3)确定实施的障碍和促进因素;4)确定艾滋病毒确诊后 12 个月的治疗结果:设计:我们采用了以下方法1) 对 5 名青少年、11 名照顾者和 6 名儿童保健工作者进行的半结构式访谈(n = 22);2) 28 份儿童保健工作者实地手册;3) 研究参与者的定量数据(人口统计学信息和 HIV 临床结果):结果:41 名儿童至少接受了部分干预。在接受病毒载量检测的儿童中,有 26 人(n = 32,81.3%)的病毒得到抑制。受访者认为,干预有助于坚持抗逆转录病毒疗法,并能增强心理健康。社区保健工作者和家庭之间的便利和融洽关系是实施干预的有利因素。而污名化、寻找参与者方面的挑战以及社区保健员资源不足则是障碍:这项干预措施有助于支持青少年和儿童坚持接受艾滋病治疗。促进因素和障碍可能有助于制定未来的干预措施。
{"title":"Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents.","authors":"M Seguin, S Dringus, S Chiomvu, T Apollo, E Sibanda, V Simms, S Bernays, R Chikodzore, N Redzo, P Mlilo, L Ndlovu, P Nzombe, B Ncube, K Kranzer, R Abbas Ferrand, C D Chikwari","doi":"10.5588/pha.22.0009","DOIUrl":"10.5588/pha.22.0009","url":null,"abstract":"<p><strong>Setting: </strong>Children and adolescents with HIV encounter challenges in initiation and adherence to antiretroviral therapy (ART). A community-based support intervention of structured home visits, aimed at improving initiation, adherence and treatment, was delivered by community health workers (CHWs) to children and adolescents newly diagnosed with HIV.</p><p><strong>Objectives: </strong>To 1) describe intervention delivery, 2) explore CHW, caregiver and adolescents' perceptions of the intervention, 3) identify barriers and facilitators to implementation, and 4) ascertain treatment outcomes at 12 months' post-HIV diagnosis.</p><p><strong>Design: </strong>We drew upon: 1) semi-structured interviews (<i>n</i> = 22) with 5 adolescents, 11 caregivers and 6 CHWs, 2) 28 CHW field manuals, and 3) quantitative data for study participants (demographic information and HIV clinical outcomes).</p><p><strong>Results: </strong>Forty-one children received at least a part of the intervention. Of those whose viral load was tested, 26 (<i>n</i> = 32, 81.3%) were virally suppressed. Interviewees felt that the intervention supported ART adherence and strengthened mental health. Facilitators to intervention delivery were convenience and rapport between CHWs and families. Stigma, challenges in locating participants and inadequate resources for CHWs were barriers.</p><p><strong>Conclusion: </strong>This intervention was helpful in supporting HIV treatment adherence among adolescents and children. Facilitators and barriers may be useful in developing future interventions.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 3","pages":"108-114"},"PeriodicalIF":1.3,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9461220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria. 便携式数字x射线在尼日利亚农村社区用于结核病诊断前筛查。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2022-06-21 DOI: 10.5588/pha.21.0079
B Odume, E Chukwu, T Fawole, N Nwokoye, C Ogbudebe, O Chukwuogo, S Useni, C Dim, E Ubochioma, D Nongo, R Eneogu, T Lagundoye Odusote, O Oyelaran, C Anyaike

Setting: This pilot project was conducted in hard-to-reach communities of two Niger Delta States in the South-South Region of Nigeria.

Objective: To assess the usefulness of portable digital X-ray, the Delft-Light Backpack (DLB) for TB active case-finding (ACF) in hard-to-reach Niger Delta communities using the WHO 3B TB screening/diagnosis algorithm.

Design: DLB X-ray was used to screen all consenting eligible participants during community TB screening out-reaches in all hard-to-reach communities of Akwa Ibom and Cross River States in the Niger Delta, Nigeria. Participants with a CAD4TB (computer-aided detection for TB score) ⩾60 had Xpert (sputum) and/or clinical (radiograph) assessment for TB diagnosis. Data from the project were analysed for this study.

Results: A total of 8,230 participants (males: 47.2%, females: 52.8%) underwent TB screening and 1,140 (13.9%) presumptive TB cases were identified. The TB prevalence among all participants and among those with presumptive TB were respectively 1.2% and 8.6%. The number needed to screen was 84. Among people with presumptive TB, the proportion of males and females with confirmed TB was respectively 12.0% and 5.6% (P < 0.001).

Conclusion: TB screening using DLB X-ray during community-based ACF in hard-to-reach Niger Delta communities of Nigeria showed a high TB prevalence among participants. Nationwide deployment of the instrument in hard-to-reach areas is recommended.

环境:该试点项目在尼日利亚南南地区两个尼日尔三角洲州难以到达的社区开展。目的:评估便携式数字x线,Delft-Light Backpack (DLB)在难以到达的尼日尔三角洲社区使用WHO 3B结核病筛查/诊断算法进行结核病活动性病例发现(ACF)的有效性。设计:DLB x射线用于在尼日利亚尼日尔三角洲阿夸伊博姆州和克罗斯河州所有难以到达的社区结核病筛查外展活动中筛查所有同意的合格参与者。CAD4TB(计算机辅助检测结核病评分)大于或等于60的参与者进行了结核病诊断的Xpert(痰液)和/或临床(x光片)评估。本研究分析了该项目的数据。结果:共有8230名参与者(男性:47.2%,女性:52.8%)接受了结核病筛查,鉴定出1140例(13.9%)推定结核病病例。所有参与者和推定结核病患者的结核病患病率分别为1.2%和8.6%。需要筛选的人数是84人。在推定结核病患者中,男性和女性确诊结核病的比例分别为12.0%和5.6% (P < 0.001)。结论:在尼日利亚难以到达的尼日尔三角洲社区,社区ACF期间使用DLB x射线进行结核病筛查显示参与者中结核病患病率很高。建议在难以到达的地区在全国范围内部署该仪器。
{"title":"Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria.","authors":"B Odume,&nbsp;E Chukwu,&nbsp;T Fawole,&nbsp;N Nwokoye,&nbsp;C Ogbudebe,&nbsp;O Chukwuogo,&nbsp;S Useni,&nbsp;C Dim,&nbsp;E Ubochioma,&nbsp;D Nongo,&nbsp;R Eneogu,&nbsp;T Lagundoye Odusote,&nbsp;O Oyelaran,&nbsp;C Anyaike","doi":"10.5588/pha.21.0079","DOIUrl":"https://doi.org/10.5588/pha.21.0079","url":null,"abstract":"<p><strong>Setting: </strong>This pilot project was conducted in hard-to-reach communities of two Niger Delta States in the South-South Region of Nigeria.</p><p><strong>Objective: </strong>To assess the usefulness of portable digital X-ray, the Delft-Light Backpack (DLB) for TB active case-finding (ACF) in hard-to-reach Niger Delta communities using the WHO 3B TB screening/diagnosis algorithm.</p><p><strong>Design: </strong>DLB X-ray was used to screen all consenting eligible participants during community TB screening out-reaches in all hard-to-reach communities of Akwa Ibom and Cross River States in the Niger Delta, Nigeria. Participants with a CAD4TB (computer-aided detection for TB score) ⩾60 had Xpert (sputum) and/or clinical (radiograph) assessment for TB diagnosis. Data from the project were analysed for this study.</p><p><strong>Results: </strong>A total of 8,230 participants (males: 47.2%, females: 52.8%) underwent TB screening and 1,140 (13.9%) presumptive TB cases were identified. The TB prevalence among all participants and among those with presumptive TB were respectively 1.2% and 8.6%. The number needed to screen was 84. Among people with presumptive TB, the proportion of males and females with confirmed TB was respectively 12.0% and 5.6% (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>TB screening using DLB X-ray during community-based ACF in hard-to-reach Niger Delta communities of Nigeria showed a high TB prevalence among participants. Nationwide deployment of the instrument in hard-to-reach areas is recommended.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 2","pages":"85-89"},"PeriodicalIF":1.4,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176193/pdf/i2220-8372-12-2-85.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Hearing aid support for patients with DR-TB in Ethiopia. 埃塞俄比亚为耐药结核病患者提供助听器支持。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2022-06-21 DOI: 10.5588/pha.21.0068
G Teferra, K Teklemariam, D F Wares, C Negeri, A Bedru

Setting: Previous and current patients with drug-resistant TB (DR-TB) who had documented treatment-related hearing impairment due to second-line injectable (SLI) use were identified from different DR-TB treatment initiation centres in Ethiopia.

Objective: To assess selected patients with DR-TB for eligibility for hearing aids and provide hearing aids to 10 eligible patients.

Design: This was an observational cohort study. Patients were followed up for 8 months, with hearing assessments conducted at 1, 3 and 8 months to objectively assess hearing capacity.

Results: Of 12 patients assessed for hearing aids eligibility, 10 were fitted with hearing aids (type XTM XP P4) and followed up for 8 months. "Formal" improvement was observed only in one patient. However, "general quality of life" appeared to be improved in nine patients.

Conclusion: Minimal "formal" improvement was observed. However, the study was too small to say whether hearing aids should, or should not, be recommended as a public health measure. This needs a larger better controlled follow-up study. The all-oral DR-TB treatment regimens should be used for all patients with DR-TB in Ethiopia. However, as a proportion of patients with DR-TB are likely to continue receiving SLIs in the foreseeable future, they will require close audiometry assessment and appropriate care.

背景:从埃塞俄比亚不同的耐药结核病开始治疗中心确定了以前和现在的耐药结核病患者,这些患者由于使用二线注射(SLI)而记录有治疗相关的听力障碍。目的:评估选定的耐药结核病患者是否符合配戴助听器的条件,并为10例符合条件的患者提供助听器。设计:这是一项观察性队列研究。随访8个月,分别于1、3、8个月进行听力评估,客观评价患者听力。结果:12例患者中,10例患者配戴助听器(XTM XP P4型),随访8个月。只有一名患者出现“正式”改善。然而,9名患者的“总体生活质量”似乎有所改善。结论:观察到最小的“正式”改善。然而,这项研究规模太小,无法说明助听器是否应该被推荐作为一项公共卫生措施。这需要更大规模、更好的对照随访研究。埃塞俄比亚的所有耐药结核病患者都应采用全口服耐药结核病治疗方案。然而,由于一部分耐药结核病患者可能在可预见的未来继续接受特殊语言抑制剂治疗,他们将需要密切的听力评估和适当的护理。
{"title":"Hearing aid support for patients with DR-TB in Ethiopia.","authors":"G Teferra,&nbsp;K Teklemariam,&nbsp;D F Wares,&nbsp;C Negeri,&nbsp;A Bedru","doi":"10.5588/pha.21.0068","DOIUrl":"https://doi.org/10.5588/pha.21.0068","url":null,"abstract":"<p><strong>Setting: </strong>Previous and current patients with drug-resistant TB (DR-TB) who had documented treatment-related hearing impairment due to second-line injectable (SLI) use were identified from different DR-TB treatment initiation centres in Ethiopia.</p><p><strong>Objective: </strong>To assess selected patients with DR-TB for eligibility for hearing aids and provide hearing aids to 10 eligible patients.</p><p><strong>Design: </strong>This was an observational cohort study. Patients were followed up for 8 months, with hearing assessments conducted at 1, 3 and 8 months to objectively assess hearing capacity.</p><p><strong>Results: </strong>Of 12 patients assessed for hearing aids eligibility, 10 were fitted with hearing aids (type XTM XP P4) and followed up for 8 months. \"Formal\" improvement was observed only in one patient. However, \"general quality of life\" appeared to be improved in nine patients.</p><p><strong>Conclusion: </strong>Minimal \"formal\" improvement was observed. However, the study was too small to say whether hearing aids should, or should not, be recommended as a public health measure. This needs a larger better controlled follow-up study. The all-oral DR-TB treatment regimens should be used for all patients with DR-TB in Ethiopia. However, as a proportion of patients with DR-TB are likely to continue receiving SLIs in the foreseeable future, they will require close audiometry assessment and appropriate care.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 2","pages":"74-78"},"PeriodicalIF":1.4,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176189/pdf/i2220-8372-12-2-74.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
A structured community engagement strategy to support uptake of TB active case-finding. 有组织的社区参与战略,支持开展结核病主动病例发现工作。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2022-03-21 DOI: 10.5588/pha.21.0059
J T Galea, D Puma, C Tzelios, H Valdivia, A K Millones, J Jiménez, M B Brooks, C M Yuen, L Lecca, M C Becerra, S Keshavjee

Background: In Lima, Peru, a mobile TB screening program ("TB Móvil") was implemented in high TB prevalence districts to increase TB screening. Community engagement activities to promote TB Móvil were simultaneously conducted.

Objective: To describe a structured, theory-driven community engagement strategy to support the uptake of TB Móvil.

Methods: We adapted Popular Opinion Leader (POL), an evidence-based social networking intervention previously used in Peru to promote HIV testing, for TB Móvil. Community health workers, women who run soup kitchens, and motorcycle taxi drivers served as "popular opinion leaders" who disseminated information about TB Móvil in everyday conversations, aided by a multi-media campaign. Performance indicators of POL included the number/characteristics of persons screened; number of multimedia elements; and proportion of persons with abnormal radiographs hearing about TB Móvil before attending.

Results: Between February 2019 and January 2020, 63,899 people attended the TB Móvil program at 210 sites; 60.1% were female. The multimedia campaign included 36 videos, 16 audio vignettes, flyers, posters, community murals and "jingles." Among attendees receiving an abnormal chest X-ray suggestive of TB, 48% (6,935/14,563) reported hearing about TB Móvil before attending.

Conclusions: POL promotes the uptake of TB Móvil and should be considered as a strategy for increasing TB screening uptake.

背景:在秘鲁利马,在结核病高发地区实施了一项流动结核病筛查计划(“TB Móvil”),以增加结核病筛查。同时开展社区参与活动,推广结核病Móvil。目的:描述一个结构化的,理论驱动的社区参与战略,以支持结核病Móvil的吸收。方法:我们改编了民意领袖(POL),这是一种基于证据的社会网络干预措施,以前在秘鲁用于促进艾滋病毒检测,用于结核病Móvil。社区卫生工作者、经营施粥所的妇女和摩托车出租车司机成为“大众意见领袖”,在多媒体运动的帮助下,在日常对话中传播有关结核病Móvil的信息。POL的绩效指标包括筛选人员的数量/特征;多媒体元素的数量;x线片异常者在就诊前了解结核病Móvil的比例。结果:2019年2月至2020年1月期间,210个地点的63899人参加了结核病Móvil项目;60.1%为女性。这次多媒体宣传活动包括36个视频、16个音频短片、传单、海报、社区壁画和“广告歌”。在接受提示结核病的异常胸部x线检查的参与者中,48%(6,935/14,563)报告在参加之前听说过结核病Móvil。结论:POL促进结核病的吸收Móvil,应考虑作为增加结核病筛查吸收的策略。
{"title":"A structured community engagement strategy to support uptake of TB active case-finding.","authors":"J T Galea,&nbsp;D Puma,&nbsp;C Tzelios,&nbsp;H Valdivia,&nbsp;A K Millones,&nbsp;J Jiménez,&nbsp;M B Brooks,&nbsp;C M Yuen,&nbsp;L Lecca,&nbsp;M C Becerra,&nbsp;S Keshavjee","doi":"10.5588/pha.21.0059","DOIUrl":"https://doi.org/10.5588/pha.21.0059","url":null,"abstract":"<p><strong>Background: </strong>In Lima, Peru, a mobile TB screening program (\"TB Móvil\") was implemented in high TB prevalence districts to increase TB screening. Community engagement activities to promote TB Móvil were simultaneously conducted.</p><p><strong>Objective: </strong>To describe a structured, theory-driven community engagement strategy to support the uptake of TB Móvil.</p><p><strong>Methods: </strong>We adapted Popular Opinion Leader (POL), an evidence-based social networking intervention previously used in Peru to promote HIV testing, for TB Móvil. Community health workers, women who run soup kitchens, and motorcycle taxi drivers served as \"popular opinion leaders\" who disseminated information about TB Móvil in everyday conversations, aided by a multi-media campaign. Performance indicators of POL included the number/characteristics of persons screened; number of multimedia elements; and proportion of persons with abnormal radiographs hearing about TB Móvil before attending.</p><p><strong>Results: </strong>Between February 2019 and January 2020, 63,899 people attended the TB Móvil program at 210 sites; 60.1% were female. The multimedia campaign included 36 videos, 16 audio vignettes, flyers, posters, community murals and \"jingles.\" Among attendees receiving an abnormal chest X-ray suggestive of TB, 48% (6,935/14,563) reported hearing about TB Móvil before attending.</p><p><strong>Conclusions: </strong>POL promotes the uptake of TB Móvil and should be considered as a strategy for increasing TB screening uptake.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 1","pages":"18-23"},"PeriodicalIF":1.4,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908875/pdf/i2220-8372-12-1-18.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9695614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali. 马里巴马科活动性肺结核成人的儿童家庭接触者的异烟肼预防疗法。
IF 1.3 Q4 RESPIRATORY SYSTEM Pub Date : 2021-12-21 DOI: 10.5588/pha.21.0061
M Tolofoudie, A Somboro, B Diarra, Y S Sarro, H B Drame, A C G Togo, M Sanogo, A Dembele, T Togun, E Nkereuwem, B Baya, B Konate, U Egere, M Traore, M Maiga, K Saliba-Shaw, B Kampmann, S Diallo, S Doumbia, M Sylla

Background and objective: Isoniazid preventive therapy (IPT) is known to reduce the risk of developing active TB in about 59% in children aged ⩽15 years. We assessed adherence, completion and adverse events among children who were household contacts of a newly diagnosed adult with smear-positive TB in Bamako, Mali.

Methods: Children aged <15 years living in the same house with an adult smear-positive index case were enrolled in the study in the Bamako Region after consent was obtained from the parent or legal guardian. Adherence was assessed based on the number of tablets consumed during 6 months.

Results: A total of 260 children aged <15 years were identified as household contacts of 207 adult patients with smear-positive TB during the study period. Among all child contacts, 130/260 (50.0%) were aged 0-4 years and were eligible for IPT; 128/130 (98.5%) were started on IPT and 83/128 (64.8%) completed with good adherence at the end of the 6 months, and without any significant adverse events.

Conclusion: We successfully implemented IPT with good acceptance, but low completion rate. The Mali National TB Program and partners should expand this strategy to reach more children in Bamako and the whole country and create greater awareness in the population.

背景和目的:据了解,异烟肼预防疗法(IPT)可将 15 岁以下儿童罹患活动性肺结核的风险降低约 59%。我们评估了马里巴马科新诊断为涂片阳性肺结核成人的家庭接触者中儿童的依从性、完成情况和不良事件:结果结果:共有 260 名儿童接受了治疗:我们成功实施了 IPT,接受度高,但完成率低。马里国家结核病计划及其合作伙伴应扩大这一策略的覆盖范围,使其惠及巴马科乃至全国更多的儿童,并提高民众的认识。
{"title":"Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali.","authors":"M Tolofoudie, A Somboro, B Diarra, Y S Sarro, H B Drame, A C G Togo, M Sanogo, A Dembele, T Togun, E Nkereuwem, B Baya, B Konate, U Egere, M Traore, M Maiga, K Saliba-Shaw, B Kampmann, S Diallo, S Doumbia, M Sylla","doi":"10.5588/pha.21.0061","DOIUrl":"10.5588/pha.21.0061","url":null,"abstract":"<p><strong>Background and objective: </strong>Isoniazid preventive therapy (IPT) is known to reduce the risk of developing active TB in about 59% in children aged ⩽15 years. We assessed adherence, completion and adverse events among children who were household contacts of a newly diagnosed adult with smear-positive TB in Bamako, Mali.</p><p><strong>Methods: </strong>Children aged <15 years living in the same house with an adult smear-positive index case were enrolled in the study in the Bamako Region after consent was obtained from the parent or legal guardian. Adherence was assessed based on the number of tablets consumed during 6 months.</p><p><strong>Results: </strong>A total of 260 children aged <15 years were identified as household contacts of 207 adult patients with smear-positive TB during the study period. Among all child contacts, 130/260 (50.0%) were aged 0-4 years and were eligible for IPT; 128/130 (98.5%) were started on IPT and 83/128 (64.8%) completed with good adherence at the end of the 6 months, and without any significant adverse events.</p><p><strong>Conclusion: </strong>We successfully implemented IPT with good acceptance, but low completion rate. The Mali National TB Program and partners should expand this strategy to reach more children in Bamako and the whole country and create greater awareness in the population.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 4","pages":"191-195"},"PeriodicalIF":1.3,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680184/pdf/i2220-8372-11-4-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal. 尼泊尔一家三级医院尿路感染的低产量但高水平的多药耐药性。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2021-11-01 DOI: 10.5588/pha.21.0044
R Baral, L B Shrestha, N Ortuño-Gutiérrez, P Pyakure, B Rai, S P Rimal, S Singh, S K Sharma, B Khanal, K Selvaraj, A M V Kumar

Setting: There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal.

Objective: To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal.

Design: This was a cross-sectional study using secondary laboratory data.

Results: Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August.

Conclusion: Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.

背景:尼泊尔尿路感染(UTI)患者中多药耐药(MDR)的发生令人担忧。目的:了解尼泊尔东部达兰市柯伊拉腊卫生科学研究所2014 - 2018年培养阳性尿路感染标本中大肠埃希菌和肺炎克雷伯菌耐多药感染的培养阳性、趋势和季节变化。设计:这是一项使用二级实验室数据的横断面研究。结果:检尿样116417份,培养阳性19671份(16.9%),检尿样数量和培养阳性呈上升趋势。最常见的细菌是大肠杆菌(54.3%),其次是肺炎克雷伯菌(8.8%)。大肠杆菌和肺炎克雷伯菌分离株中MDR检出率分别为42.5%和36.0%。MDR在男性和55岁以上人群中较高,但呈逐年下降趋势。分离株数逐年增加,7 - 8月为高峰。结论:低培养阳性令人担忧,需要进一步改进诊断方案。耐多药耐药性的下降趋势是一个可喜的迹象。关于7 - 8月达到高峰的季节变化的信息可以帮助实验室更好地为这一时期做好准备,并提供足够的缓冲库存,以确保培养和抗生素敏感性试验。
{"title":"Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal.","authors":"R Baral,&nbsp;L B Shrestha,&nbsp;N Ortuño-Gutiérrez,&nbsp;P Pyakure,&nbsp;B Rai,&nbsp;S P Rimal,&nbsp;S Singh,&nbsp;S K Sharma,&nbsp;B Khanal,&nbsp;K Selvaraj,&nbsp;A M V Kumar","doi":"10.5588/pha.21.0044","DOIUrl":"https://doi.org/10.5588/pha.21.0044","url":null,"abstract":"<p><strong>Setting: </strong>There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal.</p><p><strong>Objective: </strong>To determine culture positivity, trends in MDR among <i>Escherichia coli and Klebsiella pneumoniae</i> infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal.</p><p><strong>Design: </strong>This was a cross-sectional study using secondary laboratory data.</p><p><strong>Results: </strong>Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. <i>E. coli</i> was the most common bacteria (54.3%), followed by <i>K. pneumoniae</i> (8.8%). Among <i>E. coli</i> and <i>K. pneumoniae</i> isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August.</p><p><strong>Conclusion: </strong>Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"70-76"},"PeriodicalIF":1.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575377/pdf/i2220-8372-11-s1-70.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39624215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal. 尼泊尔加德满都一家三级医院尿路感染的高多药耐药性。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2021-11-01 DOI: 10.5588/pha.21.0035
S Shakya, J Edwards, H A Gupte, S Shrestha, B M Shakya, K Parajuli, H P Kattel, P S Shrestha, R Ghimire, P Thekkur

Setting: Tribhuvan University Teaching Tertiary Care Hospital, Kathmandu, Nepal, May-October 2019.

Objective: 1) To describe the bacteriological profile, 2) to identify the antimicrobial resistance (AMR) pattern, and 3) to find the demographic characteristics associated with the presence of bacterial growth and multidrug resistance (MDR) in adult urine samples undergoing culture and drug susceptibility testing.

Design: This was a hospital-based, cross-sectional study using routine laboratory records.

Results: Among 11,776 urine samples, 16% (1,865/11,776) were culture-positive, predominantly caused by Escherichia coli (1,159/1,865; 62%). We found a high prevalence of resistance to at least one antibiotic (1,573/1,865; 84%) and MDR (1,000/1,865; 54%). Resistance to commonly used antibiotics for urinary tract infections (UTIs) such as ceftazidime, levofloxacin, cefepime and ampicillin was high. Patients aged ⩾60 years (adjusted prevalence ratio [aPR] 1.6, 95% CI 1.4-1.7) were more likely to have culture positivity. Patients with age ⩾45 years (45-59 years: aPR 1.5, 95% CI 1.3-1.7; ⩾60 years: aPR 1.4, 95% CI 1.2-1.6), male sex (aPR 1.3, 95% CI 1.2-1.5) and from inpatient settings (aPR 1.4, 95% CI 1.2-1.7) had significantly higher prevalence of MDR.

Conclusion: Urine samples from a tertiary hospital showed high prevalence of E. coli and MDR to routinely used antibiotics, especially among inpatients. Regular surveillance and application of updated antibiograms are crucial to monitor the AMR situation in Nepal.

地点:2019年5月至10月,尼泊尔加德满都特里布万大学三级教学医院。目的:1)描述细菌学特征;2)鉴定抗微生物药物耐药性(AMR)模式;3)通过培养和药敏试验,发现成人尿液样本中细菌生长和多药耐药(MDR)相关的人口学特征。设计:这是一项基于医院的横断面研究,使用常规实验室记录。结果:11776份尿样中,培养阳性占16%(1865 / 11776),主要由大肠杆菌引起(1159 / 1865;62%)。我们发现对至少一种抗生素的耐药性很高(1,573/1,865;84%)和耐多药(1000 / 1865;54%)。对头孢他啶、左氧氟沙星、头孢吡肟、氨苄西林等尿路感染常用抗生素的耐药性较高。年龄大于或等于60岁的患者(调整患病率[aPR] 1.6, 95% CI 1.4-1.7)更有可能具有培养阳性。年龄大于或等于45岁的患者(45-59岁:aPR 1.5, 95% CI 1.3-1.7;小于或等于60年:aPR 1.4, 95% CI 1.2-1.6),男性(aPR 1.3, 95% CI 1.2-1.5)和住院环境(aPR 1.4, 95% CI 1.2-1.7)具有显着更高的MDR患病率。结论:某三级医院尿样中大肠杆菌和耐多药感染率较高,住院患者尤甚。定期监测和应用更新的抗生素图对于监测尼泊尔的抗生素耐药性情况至关重要。
{"title":"High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal.","authors":"S Shakya,&nbsp;J Edwards,&nbsp;H A Gupte,&nbsp;S Shrestha,&nbsp;B M Shakya,&nbsp;K Parajuli,&nbsp;H P Kattel,&nbsp;P S Shrestha,&nbsp;R Ghimire,&nbsp;P Thekkur","doi":"10.5588/pha.21.0035","DOIUrl":"https://doi.org/10.5588/pha.21.0035","url":null,"abstract":"<p><strong>Setting: </strong>Tribhuvan University Teaching Tertiary Care Hospital, Kathmandu, Nepal, May-October 2019.</p><p><strong>Objective: </strong>1) To describe the bacteriological profile, 2) to identify the antimicrobial resistance (AMR) pattern, and 3) to find the demographic characteristics associated with the presence of bacterial growth and multidrug resistance (MDR) in adult urine samples undergoing culture and drug susceptibility testing.</p><p><strong>Design: </strong>This was a hospital-based, cross-sectional study using routine laboratory records.</p><p><strong>Results: </strong>Among 11,776 urine samples, 16% (1,865/11,776) were culture-positive, predominantly caused by <i>Escherichia coli</i> (1,159/1,865; 62%). We found a high prevalence of resistance to at least one antibiotic (1,573/1,865; 84%) and MDR (1,000/1,865; 54%). Resistance to commonly used antibiotics for urinary tract infections (UTIs) such as ceftazidime, levofloxacin, cefepime and ampicillin was high. Patients aged ⩾60 years (adjusted prevalence ratio [aPR] 1.6, 95% CI 1.4-1.7) were more likely to have culture positivity. Patients with age ⩾45 years (45-59 years: aPR 1.5, 95% CI 1.3-1.7; ⩾60 years: aPR 1.4, 95% CI 1.2-1.6), male sex (aPR 1.3, 95% CI 1.2-1.5) and from inpatient settings (aPR 1.4, 95% CI 1.2-1.7) had significantly higher prevalence of MDR.</p><p><strong>Conclusion: </strong>Urine samples from a tertiary hospital showed high prevalence of <i>E. coli</i> and MDR to routinely used antibiotics, especially among inpatients. Regular surveillance and application of updated antibiograms are crucial to monitor the AMR situation in Nepal.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"24-31"},"PeriodicalIF":1.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Prevalence of methicillin-resistant Staphylococcus aureus in a tertiary hospital in Nepal. 尼泊尔一家三级医院耐甲氧西林金黄色葡萄球菌的流行情况。
IF 1.4 Q4 RESPIRATORY SYSTEM Pub Date : 2021-11-01 DOI: 10.5588/pha.21.0042
P Pradhan, P Rajbhandari, S B Nagaraja, P Shrestha, R Grigoryan, S Satyanarayana, H Davtyan

Setting: Patan Hospital, Lalitpur, Nepal.

Objectives: To describe 1) the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and its antibiotic sensitivity pattern; 2) the demographic and clinical characteristics associated with MRSA infections; and 3) the treatment outcomes of in-patients with MRSA infection among patients with S. aureus infection between January 2018 and December 2020.

Design: This was a cross-sectional study using electronic and paper-based hospital records of patients with S. aureus infection.

Results: Of the 1,804 patients with S. aureus infection, 1,027 patients (57%, 95% CI 55-59) had MRSA. The MRSA were susceptible to vancomycin (100%), linezolid (96%), doxycycline (96%), chloramphenicol (86%) and cotrimoxazole (70%), and resistant to erythromycin (68%), clindamycin (56%), gentamycin (58%), ciprofloxacin (92%) and ofloxacin (91%). The prevalence of MRSA was higher in 2019, among out-patients, and in respiratory samples, and lower in blood samples. Of the 142 in-patients with MRSA, 93% had a successful clinical outcome (cured/improved).

Conclusion: More than 50% of patients with S. aureus infection had MRSA that were resistant to commonly available antibiotics. This calls for strengthening surveil-lance and good infection control practices in this hospital.

地点:尼泊尔拉利特普尔帕坦医院。目的:了解1)耐甲氧西林金黄色葡萄球菌(MRSA)的流行情况及其抗生素敏感性;2)与MRSA感染相关的人口学和临床特征;3) 2018年1月至2020年12月金黄色葡萄球菌感染患者中MRSA感染住院患者的治疗结果。设计:这是一项横断面研究,使用了金黄色葡萄球菌感染患者的电子和纸质医院记录。结果:1804例金黄色葡萄球菌感染患者中,1027例(57%,95% CI 55-59)有MRSA。MRSA对万古霉素(100%)、利奈唑胺(96%)、多西环素(96%)、氯霉素(86%)、复方新诺明(70%)敏感,对红霉素(68%)、克林霉素(56%)、庆大霉素(58%)、环丙沙星(92%)、氧氟沙星(91%)耐药。2019年,MRSA在门诊患者和呼吸道样本中的患病率较高,而血液样本中的患病率较低。在142例MRSA住院患者中,93%有成功的临床结果(治愈/改善)。结论:50%以上的金黄色葡萄球菌感染患者存在对常用抗生素耐药的MRSA。这就要求在该医院加强监测和良好的感染控制措施。
{"title":"Prevalence of methicillin-resistant <i>Staphylococcus aureus</i> in a tertiary hospital in Nepal.","authors":"P Pradhan,&nbsp;P Rajbhandari,&nbsp;S B Nagaraja,&nbsp;P Shrestha,&nbsp;R Grigoryan,&nbsp;S Satyanarayana,&nbsp;H Davtyan","doi":"10.5588/pha.21.0042","DOIUrl":"https://doi.org/10.5588/pha.21.0042","url":null,"abstract":"<p><strong>Setting: </strong>Patan Hospital, Lalitpur, Nepal.</p><p><strong>Objectives: </strong>To describe 1) the prevalence of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and its antibiotic sensitivity pattern; 2) the demographic and clinical characteristics associated with MRSA infections; and 3) the treatment outcomes of in-patients with MRSA infection among patients with <i>S. aureus</i> infection between January 2018 and December 2020.</p><p><strong>Design: </strong>This was a cross-sectional study using electronic and paper-based hospital records of patients with <i>S. aureus</i> infection.</p><p><strong>Results: </strong>Of the 1,804 patients with <i>S. aureus</i> infection<i>,</i> 1,027 patients (57%, 95% CI 55-59) had MRSA. The MRSA were susceptible to vancomycin (100%), linezolid (96%), doxycycline (96%), chloramphenicol (86%) and cotrimoxazole (70%), and resistant to erythromycin (68%), clindamycin (56%), gentamycin (58%), ciprofloxacin (92%) and ofloxacin (91%). The prevalence of MRSA was higher in 2019, among out-patients, and in respiratory samples, and lower in blood samples. Of the 142 in-patients with MRSA, 93% had a successful clinical outcome (cured/improved).</p><p><strong>Conclusion: </strong>More than 50% of patients with <i>S. aureus</i> infection had MRSA that were resistant to commonly available antibiotics. This calls for strengthening surveil-lance and good infection control practices in this hospital.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"46-51"},"PeriodicalIF":1.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
期刊
Public Health Action
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1