Pub Date : 2024-05-01DOI: 10.5588/ijtldopen.23.0624
N.J. Henry, S. Zawedde-Muyanja, R.K. Majwala, S. Turyahabwe, R.V. Barnabas, R.C. Reiner, Jr, C.E. Moore, J.M. Ross
BACKGROUNDIdentifying spatial variation in TB burden can help national TB programs effectively allocate resources to reach and treat all people with TB. However, data limitations pose challenges for subnational TB burden estimation.METHODSWe developed a small-area modeling approach using geo-positioned prevalence survey data, case notifications, and geospatial covariates to simultaneously estimate spatial variation in TB incidence and case notification completeness across districts in Uganda from 2016–2019. TB incidence was estimated using 1) cluster-level data from the national 2014–2015 TB prevalence survey transformed to incidence, and 2) case notifications adjusted for geospatial covariates of health system access. The case notification completeness surface was fit jointly using observed case notifications and estimated incidence.RESULTSEstimated pulmonary TB incidence among adults varied >10-fold across Ugandan districts in 2019. Case detection increased nationwide from 2016 to 2019, and the number of districts with case detection rates >70% quadrupled. District-level estimates of TB incidence were five times more precise than a model using TB prevalence survey data alone.CONCLUSIONA joint spatial modeling approach provides useful insights for TB program operation, outlining areas where TB incidence estimates are highest and health programs should concentrate their efforts. This approach can be applied in many countries with high TB burden.
{"title":"Mapping TB incidence across districts in Uganda to inform health program activities","authors":"N.J. Henry, S. Zawedde-Muyanja, R.K. Majwala, S. Turyahabwe, R.V. Barnabas, R.C. Reiner, Jr, C.E. Moore, J.M. Ross","doi":"10.5588/ijtldopen.23.0624","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0624","url":null,"abstract":"BACKGROUNDIdentifying spatial variation in TB burden can help national TB programs effectively allocate resources to reach and treat all people with TB. However, data limitations pose challenges for subnational TB burden estimation.METHODSWe\u0000 developed a small-area modeling approach using geo-positioned prevalence survey data, case notifications, and geospatial covariates to simultaneously estimate spatial variation in TB incidence and case notification completeness across districts in Uganda from 2016–2019. TB incidence\u0000 was estimated using 1) cluster-level data from the national 2014–2015 TB prevalence survey transformed to incidence, and 2) case notifications adjusted for geospatial covariates of health system access. The case notification completeness surface was fit jointly using observed case notifications\u0000 and estimated incidence.RESULTSEstimated pulmonary TB incidence among adults varied >10-fold across Ugandan districts in 2019. Case detection increased nationwide from 2016 to 2019, and the number of districts with case detection\u0000 rates >70% quadrupled. District-level estimates of TB incidence were five times more precise than a model using TB prevalence survey data alone.CONCLUSIONA joint spatial modeling approach provides useful insights for TB program operation,\u0000 outlining areas where TB incidence estimates are highest and health programs should concentrate their efforts. This approach can be applied in many countries with high TB burden.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.5588/ijtldopen.24.0167
M. Calvi, D. Boccia, E. Jaramillo, F. Mavhunga, J. Reeder, T. Kasaeva
{"title":"Comprehensive care for people affected by TB: addressing TB-associated disabilities","authors":"M. Calvi, D. Boccia, E. Jaramillo, F. Mavhunga, J. Reeder, T. Kasaeva","doi":"10.5588/ijtldopen.24.0167","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0167","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141048813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.5588/ijtldopen.24.0082
S.A. Adakun, F.M. Banda, A. Bloom, M. Bochnowicz, J. Chakaya, A. Chansa, H. Chiguvare, R. Chimzizi, C. Colvin, J. Dongo, A. Durena, C. Duri, R. Edmund, A. Harries, I. Kathure, F. Kavenga, Y. Lin, H. Luzze, I. Mbithi, M. Mputu, A. Mubanga, D. Nair, M. Ngwenya, B. Okotu, P. Owiti, A. Owuor, P. Thekkur, C. Timire, S. Turyahabwe, E. Tweyongyere, M. YaDiul, R. Zachariah, K. Zimba
BACKGROUNDWe examined the feasibility of assessing and referring adults successfully completing TB treatment for comorbidities, risk determinants and disability in health facilities in Kenya, Uganda, Zambia and Zimbabwe.METHODSThis was a cross-sectional study within national TB programmes.RESULTSHealth workers assessed 1,063 patients (78% of eligible) in a median of 22 min [IQR 16–35] and found it useful and feasible to accomplish in addition to other responsibilities. For comorbidities, 476 (44%) had HIV co-infection, 172 (16%) had high blood pressure (newly detected in 124), 43 (4%) had mental health disorders (newly detected in 33) and 36 (3%) had diabetes mellitus. The most common risk determinants were ‘probable alcohol dependence’ (15%) and malnutrition (14%). Disability, defined as walking <400 m in 6 min, was found in 151/882 (17%). Overall, 763 (72%) patients had at least one comorbidity, risk determinant and/or disability. At least two-thirds of eligible patients were referred for care, although 80% of those with disability needed referral outside their original health facility.CONCLUSIONSSeven in 10 patients completing TB treatment had at least one comorbidity, risk determinant and/or disability. This emphasises the need for offering early patient-centred care, including pulmonary rehabilitation, to improve quality of life, reduce TB recurrence and increase long-term survival.
{"title":"Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe","authors":"S.A. Adakun, F.M. Banda, A. Bloom, M. Bochnowicz, J. Chakaya, A. Chansa, H. Chiguvare, R. Chimzizi, C. Colvin, J. Dongo, A. Durena, C. Duri, R. Edmund, A. Harries, I. Kathure, F. Kavenga, Y. Lin, H. Luzze, I. Mbithi, M. Mputu, A. Mubanga, D. Nair, M. Ngwenya, B. Okotu, P. Owiti, A. Owuor, P. Thekkur, C. Timire, S. Turyahabwe, E. Tweyongyere, M. YaDiul, R. Zachariah, K. Zimba","doi":"10.5588/ijtldopen.24.0082","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0082","url":null,"abstract":"BACKGROUNDWe examined the feasibility of assessing and referring adults successfully completing TB treatment for comorbidities, risk determinants and disability in health facilities in Kenya, Uganda, Zambia and Zimbabwe.METHODSThis\u0000 was a cross-sectional study within national TB programmes.RESULTSHealth workers assessed 1,063 patients (78% of eligible) in a median of 22 min [IQR 16–35] and found it useful and feasible to accomplish in addition to other responsibilities.\u0000 For comorbidities, 476 (44%) had HIV co-infection, 172 (16%) had high blood pressure (newly detected in 124), 43 (4%) had mental health disorders (newly detected in 33) and 36 (3%) had diabetes mellitus. The most common risk determinants were ‘probable alcohol dependence’ (15%)\u0000 and malnutrition (14%). Disability, defined as walking <400 m in 6 min, was found in 151/882 (17%). Overall, 763 (72%) patients had at least one comorbidity, risk determinant and/or disability. At least two-thirds of eligible patients were referred for care, although 80% of those with disability\u0000 needed referral outside their original health facility.CONCLUSIONSSeven in 10 patients completing TB treatment had at least one comorbidity, risk determinant and/or disability. This emphasises the need for offering early patient-centred\u0000 care, including pulmonary rehabilitation, to improve quality of life, reduce TB recurrence and increase long-term survival.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.5588/ijtldopen.23.0490
B. Awokola, H. Lawin, O. Johnson, A. Humphrey, D. Nzogo, L. Zubar, G. Okello, S. Semple, E. Awokola, G. Amusa, N. Mohammed, C. Jewell, A. Erhart, K. Mortimer, G. Devereux, B. H. Mbatchou-Ngahane
BACKGROUNDAir pollution exposure can increase the risk of development and exacerbation of chronic airway disease (CAD). We set out to assess CAD patients in Benin, Cameroon and The Gambia and to compare their measured exposures to air pollution.METHODOLOGYWe recruited patients with a diagnosis of CAD from four clinics in the three countries. We collected epidemiological, spirometric and home air pollution data.RESULTSOf the 98 adults recruited, 56 were men; the mean age was 51.6 years (standard deviation ±17.5). Most (69%) patients resided in cities and ever smoking was highest in Cameroon (23.0%). Cough, wheeze and shortness of breath were reported across the countries. A diagnosis of asthma was present in 74.0%; 16.3% had chronic obstructive pulmonary disease and 4.1% had chronic bronchitis. Prevalence of airflow obstruction was respectively 77.1%, 54.0% and 64.0% in Benin, Cameroon, and Gambia. Across the sites, 18.0% reported >5 exacerbations. The median home particulate matter less than 2.5 μm in diameter (PM2.5) was respectively 13.0 μg/m3, 5.0 μg/m3 and 4.4 μg/m3. The median home carbon monoxide (CO) exposures were respectively 1.6 parts per million (ppm), 0.3 ppm and 0.4 ppm. Home PM2.5 differed significantly between the three countries (P < 0.001) while home CO did not.CONCLUSIONBased on these results, preventive programmes should focus on ensuring proper spirometric diagnosis, good disease control and reduction in air pollution exposure.
{"title":"Non-communicable airway disease and air pollution in three African Countries: Benin, Cameroon and The Gambia","authors":"B. Awokola, H. Lawin, O. Johnson, A. Humphrey, D. Nzogo, L. Zubar, G. Okello, S. Semple, E. Awokola, G. Amusa, N. Mohammed, C. Jewell, A. Erhart, K. Mortimer, G. Devereux, B. H. Mbatchou-Ngahane","doi":"10.5588/ijtldopen.23.0490","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0490","url":null,"abstract":"BACKGROUNDAir pollution exposure can increase the risk of development and exacerbation of chronic airway disease (CAD). We set out to assess CAD patients in Benin, Cameroon and The Gambia and to compare their measured exposures to air\u0000 pollution.METHODOLOGYWe recruited patients with a diagnosis of CAD from four clinics in the three countries. We collected epidemiological, spirometric and home air pollution data.RESULTSOf\u0000 the 98 adults recruited, 56 were men; the mean age was 51.6 years (standard deviation ±17.5). Most (69%) patients resided in cities and ever smoking was highest in Cameroon (23.0%). Cough, wheeze and shortness of breath were reported across the countries. A diagnosis of asthma was present\u0000 in 74.0%; 16.3% had chronic obstructive pulmonary disease and 4.1% had chronic bronchitis. Prevalence of airflow obstruction was respectively 77.1%, 54.0% and 64.0% in Benin, Cameroon, and Gambia. Across the sites, 18.0% reported >5 exacerbations. The median home particulate matter less\u0000 than 2.5 μm in diameter (PM2.5) was respectively 13.0 μg/m3, 5.0 μg/m3 and 4.4 μg/m3. The median home carbon monoxide (CO) exposures were respectively 1.6 parts per million (ppm), 0.3 ppm and 0.4 ppm. Home PM2.5 differed significantly\u0000 between the three countries (P < 0.001) while home CO did not.CONCLUSIONBased on these results, preventive programmes should focus on ensuring proper spirometric diagnosis, good disease control and reduction in air pollution\u0000 exposure.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.5588/ijtldopen.23.0579
Y. Hamada, A. Lugendo, T. Ntshiqa, G. Kubeka, J.M. Lalashowi, S. Mwastaula, K. Ntshamane, I. Sabi, S. Wilson, A. Copas, K. Velen, N. Ntinginya, L. T. Minja, I. Abubakar, S. Charalambous, M.X. Rangaka
BACKGROUNDData on the prevalence of non-communicable diseases (NCDs) in TB household contacts (HHCs) are limited, yet important to inform integrated screening and care for NCD within contact investigations. It is also unclear if screening these contacts reveals more people with NCDs than individuals in the same neighbourhood.METHODWe conducted a pilot cross-sectional study in South Africa and Tanzania, enrolling adult HHCs of TB and individuals in neighbourhood households (controls). We inquired about known NCD and systematically measured blood pressure, and tested for spot blood glucose and haemoglobin A1c.RESULTSWe enrolled 203 adult contacts of 111 persons with TB and 160 controls. Among contacts, respectively 12.2% (95% CI 8.3–17.6) and 39.7% (95% CI 33.1–46.7) had diabetes and hypertension, compared to 14.1% (95% CI 9.2–21.0) and 44.7% (95% CI 36.9–52.7) among controls. More than half of NCDs were newly identified. We did not find a significant difference in the prevalence of at least one NCD between the two groups (OR 0.85, 95% CI 0.50–1.45, adjusted for age and sex).CONCLUSIONSWe found a high prevalence of undiagnosed NCDs among contacts, suggesting a potential benefit of integrating NCD screening and care within contact investigations. Screening in the same community might similarly find undiagnosed NCDs.
背景有关肺结核家庭接触者（HHC）中非传染性疾病（NCD）患病率的数据非常有限，但这些数据对于在接触者调查中进行 NCD 综合筛查和护理非常重要。我们在南非和坦桑尼亚开展了一项试验性横断面研究，招募了成年肺结核家庭接触者和邻近家庭的个人（对照组）。我们询问了已知的非传染性疾病，系统地测量了血压，并检测了定点血糖和血红蛋白 A1c。结果 我们招募了 111 名肺结核患者的 203 名成年接触者和 160 名对照者。在接触者中，分别有 12.2% (95% CI 8.3-17.6) 和 39.7% (95% CI 33.1-46.7)患有糖尿病和高血压，而在对照者中，分别有 14.1% (95% CI 9.2-21.0) 和 44.7% (95% CI 36.9-52.7)患有糖尿病和高血压。超过一半的非传染性疾病是新发现的。我们发现接触者中未确诊的 NCD 发病率很高，这表明将 NCD 筛查和护理整合到接触者调查中具有潜在的益处。在同一社区进行筛查也可能发现未确诊的非传染性疾病。
{"title":"A pilot cross-sectional study of non-communicable diseases in TB household contacts","authors":"Y. Hamada, A. Lugendo, T. Ntshiqa, G. Kubeka, J.M. Lalashowi, S. Mwastaula, K. Ntshamane, I. Sabi, S. Wilson, A. Copas, K. Velen, N. Ntinginya, L. T. Minja, I. Abubakar, S. Charalambous, M.X. Rangaka","doi":"10.5588/ijtldopen.23.0579","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0579","url":null,"abstract":"BACKGROUNDData on the prevalence of non-communicable diseases (NCDs) in TB household contacts (HHCs) are limited, yet important to inform integrated screening and care for NCD within contact investigations. It is also unclear if screening\u0000 these contacts reveals more people with NCDs than individuals in the same neighbourhood.METHODWe conducted a pilot cross-sectional study in South Africa and Tanzania, enrolling adult HHCs of TB and individuals in neighbourhood\u0000 households (controls). We inquired about known NCD and systematically measured blood pressure, and tested for spot blood glucose and haemoglobin A1c.RESULTSWe enrolled 203 adult contacts of 111 persons with TB and 160 controls.\u0000 Among contacts, respectively 12.2% (95% CI 8.3–17.6) and 39.7% (95% CI 33.1–46.7) had diabetes and hypertension, compared to 14.1% (95% CI 9.2–21.0) and 44.7% (95% CI 36.9–52.7) among controls. More than half of NCDs were newly identified. We did not find a significant\u0000 difference in the prevalence of at least one NCD between the two groups (OR 0.85, 95% CI 0.50–1.45, adjusted for age and sex).CONCLUSIONSWe found a high prevalence of undiagnosed NCDs among contacts, suggesting a potential\u0000 benefit of integrating NCD screening and care within contact investigations. Screening in the same community might similarly find undiagnosed NCDs.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.5588/ijtldopen.23.0623
M. Mbenga, A. Slyzkyi, V. Mirtskhulava, S. Pak, A. Gebhard, G. Utepkalieva, A. Sagimbekova, M. Adenov, G. Ryskulov
{"title":"Decentralised ECG monitoring for drug-resistant TB patients in ambulatory settings","authors":"M. Mbenga, A. Slyzkyi, V. Mirtskhulava, S. Pak, A. Gebhard, G. Utepkalieva, A. Sagimbekova, M. Adenov, G. Ryskulov","doi":"10.5588/ijtldopen.23.0623","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0623","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140757066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.5588/ijtldopen.23.0607
A. Ciobanu, V. Plesca, S. Doltu, M. Manea, L. Domente, A. Dadu
SETTINGThe Republic of Moldova, one of Europe's poorest countries, also bears one of the highest burdens of rifampicin-resistant TB (RR-TB).OBJECTIVESTo trace the patients’ journey through TB in terms of the relationship with poverty and assess its determinants.DESIGNThis cross-sectional study used secondary data from a survey assessing catastrophic costs in RR-TB-affected households.RESULTSData were obtained from 430 RR-TB patients. The percentage of poor TB-affected households rose from 65% prior to TB to 86% after TB treatment completion (P < 0.001). Social factors leading to poverty were identified for each stage: diagnostic period (history of incarceration: cOR 2.3, 95% CI 1.1–5.2); treatment period (being unemployed or unofficially employed: cOR 6.7, 95% CI 4.3–10.0); and post-treatment (being married or cohabiting: cOR 5.7, 95% CI 2.9–11.0). Participants who had ≥3 members in their households were more likely to be poor at all TB stages: diagnostic period (cOR 5.7, 95% CI 3.7–8.8), treatment period (cOR 3.8, 95% CI 2.5–5.6) and post-treatment (cOR 7.2, 95% CI 3.6–14.3).CONCLUSIONThe study identified risk factors associated with poverty at each stage of TB. These findings outline that innovative social protection policies are required to protect TB patients against poverty.
背景摩尔多瓦共和国是欧洲最贫穷的国家之一，同时也是耐利福平肺结核（RR-TB）负担最重的国家之一。目的追踪肺结核患者的治疗过程与贫困的关系，并评估其决定因素。受肺结核影响的贫困家庭比例从肺结核前的 65% 上升到肺结核治疗结束后的 86%（P < 0.001）。导致贫困的社会因素在每个阶段都有所体现：诊断期（监禁史：cOR 2.3，95% CI 1.1-5.2）；治疗期（失业或非正式就业：cOR 6.7，95% CI 4.3-10.0）；治疗后（已婚或同居：cOR 5.7，95% CI 2.9-11.0）。在所有肺结核阶段：诊断期（cOR 5.7，95% CI 3.7-8.8）、治疗期（cOR 3.8，95% CI 2.5-5.6）和治疗后（cOR 7.2，95% CI 3.6-14.3），家庭成员≥3 人的参与者更有可能处于贫困状态。这些发现表明，需要创新的社会保护政策来保护结核病患者免受贫困的困扰。
{"title":"TB and poverty: the effect of rifampicin-resistant TB on household income","authors":"A. Ciobanu, V. Plesca, S. Doltu, M. Manea, L. Domente, A. Dadu","doi":"10.5588/ijtldopen.23.0607","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0607","url":null,"abstract":"<sec id=\"st1\"><title>SETTING</title>The Republic of Moldova, one of Europe's poorest countries, also bears one of the highest burdens of rifampicin-resistant TB (RR-TB).</sec><sec id=\"st2\"><title>OBJECTIVES</title>To trace the patients’\u0000 journey through TB in terms of the relationship with poverty and assess its determinants.</sec><sec id=\"st3\"><title>DESIGN</title>This cross-sectional study used secondary data from a survey assessing catastrophic costs in RR-TB-affected households.</sec><sec\u0000 id=\"st4\"><title>RESULTS</title>Data were obtained from 430 RR-TB patients. The percentage of poor TB-affected households rose from 65% prior to TB to 86% after TB treatment completion (P < 0.001). Social factors leading to poverty were identified for each stage:\u0000 diagnostic period (history of incarceration: cOR 2.3, 95% CI 1.1–5.2); treatment period (being unemployed or unofficially employed: cOR 6.7, 95% CI 4.3–10.0); and post-treatment (being married or cohabiting: cOR 5.7, 95% CI 2.9–11.0). Participants who had ≥3 members in\u0000 their households were more likely to be poor at all TB stages: diagnostic period (cOR 5.7, 95% CI 3.7–8.8), treatment period (cOR 3.8, 95% CI 2.5–5.6) and post-treatment (cOR 7.2, 95% CI 3.6–14.3).</sec><sec id=\"st5\"><title>CONCLUSION</title>The\u0000 study identified risk factors associated with poverty at each stage of TB. These findings outline that innovative social protection policies are required to protect TB patients against poverty.</sec>","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.5588/ijtldopen.23.0466
R. Mangat, S.K. Brode, H.K. Mah, M.S. Brar, N.F. Sabur
BACKGROUNDRifampicin (RIF) is considered the backbone of TB treatment, but adverse effects often limit its use.METHODSThis retrospective cohort study examined patients treated for TB disease at our institution, and compared those who received RIF to those who were intolerant to RIF.RESULTSA total of 829 patients were included. Seventy-six patients (9%) were intolerant to RIF. Patients with RIF intolerance were significantly older (median age: 67 years, IQR 50–78 vs. 48 years, IQR 31–70; P < 0.0001), and were more likely to be female (57% vs. 41%; P = 0.01) and have concurrent diabetes mellitus (37.3% vs. 19%; P < 0.0001) compared to those who tolerated RIF. RIF intolerance was most commonly due to transaminitis (25%), cytopenia (14.5%), rash (17.1%) and gastro-intestinal intolerance (7.8%). Twenty patients were subsequently challenged with rifabutin, and this was successful in 70%. The mean treatment duration was significantly longer in patients who were intolerant to RIF (335 vs. 270 days; P < 0.001). There was no significant difference in treatment outcomes.CONCLUSIONRIF intolerance is more common in older patients, females, and those with concurrent diabetes mellitus. Patients who could not tolerate RIF had a longer duration of therapy, but no difference in treatment outcomes. When attempted, rifabutin was well tolerated in most patients with a previous RIF-related adverse event.
{"title":"Characteristics of and treatment outcomes in rifampicin-intolerant patients","authors":"R. Mangat, S.K. Brode, H.K. Mah, M.S. Brar, N.F. Sabur","doi":"10.5588/ijtldopen.23.0466","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0466","url":null,"abstract":"BACKGROUNDRifampicin (RIF) is considered the backbone of TB treatment, but adverse effects often limit its use.METHODSThis retrospective cohort study examined patients treated\u0000 for TB disease at our institution, and compared those who received RIF to those who were intolerant to RIF.RESULTSA total of 829 patients were included. Seventy-six patients (9%) were intolerant to RIF. Patients with RIF intolerance\u0000 were significantly older (median age: 67 years, IQR 50–78 vs. 48 years, IQR 31–70; P < 0.0001), and were more likely to be female (57% vs. 41%; P = 0.01) and have concurrent diabetes mellitus (37.3% vs. 19%; P < 0.0001) compared to those who tolerated\u0000 RIF. RIF intolerance was most commonly due to transaminitis (25%), cytopenia (14.5%), rash (17.1%) and gastro-intestinal intolerance (7.8%). Twenty patients were subsequently challenged with rifabutin, and this was successful in 70%. The mean treatment duration was significantly longer in\u0000 patients who were intolerant to RIF (335 vs. 270 days; P < 0.001). There was no significant difference in treatment outcomes.CONCLUSIONRIF intolerance is more common in older patients, females, and those with concurrent\u0000 diabetes mellitus. Patients who could not tolerate RIF had a longer duration of therapy, but no difference in treatment outcomes. When attempted, rifabutin was well tolerated in most patients with a previous RIF-related adverse event.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.5588/ijtldopen.24.0101
A. Harries, D. Nair, P. Thekkur, R. Ananthakrishnan, R. Thiagesan, J. M. Chakaya, I. Mbithi, B. Jamil, R. Fatima, M. Khogali, R. Zachariah, S.D. Berger, S. Satyanarayana, A.M.V. Kumar, A. Bochner, A. McClelland
{"title":"TB preventive therapy: uptake and time to initiation during implementation of ‘7-1-7’","authors":"A. Harries, D. Nair, P. Thekkur, R. Ananthakrishnan, R. Thiagesan, J. M. Chakaya, I. Mbithi, B. Jamil, R. Fatima, M. Khogali, R. Zachariah, S.D. Berger, S. Satyanarayana, A.M.V. Kumar, A. Bochner, A. McClelland","doi":"10.5588/ijtldopen.24.0101","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0101","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.5588/ijtldopen.24.0131
R.L. Goodall, S.M. Fabiane, A. Hakiman, A.M. Crook, F. Mirzayev, S. Schumacher, M.X. Rangaka
{"title":"A publicly accessible global data repository – the WHO TB-IPD platform","authors":"R.L. Goodall, S.M. Fabiane, A. Hakiman, A.M. Crook, F. Mirzayev, S. Schumacher, M.X. Rangaka","doi":"10.5588/ijtldopen.24.0131","DOIUrl":"https://doi.org/10.5588/ijtldopen.24.0131","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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