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The Use of Sputum Dashboard and Dispatch Riders in Mitigating Delay in Sputum Samples’ Processing—Evidence from an Intervention in Lagos State, Nigeria

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Journal of Tuberculosis Research 2021年第3期9卷 146-159页

作者： Muse Olatunbosun Fadeyi Akinwumi Akindele Adebayo Bakare Bolaji Ahmed Osman El-Tayeb Taofeekat Ali Yasir Othman Obioha Udunze Gbolahan Dairo Aderonke Agbaje damien foundation Belgium (Nigeria Project) Ibadan Oyo State Nigeria Institute of Human Virology Nigeria (IHVN) Abuja Nigeria Hull University Teaching Hospitals NHS Trust Hull United Kingdom

The act of referring TB presumptive individuals after verbal screening to another health facility/diagnostic centres for testing often results in large loss to follow-up, owing to the many barriers people face in accessing care. The transportation of sputum samples is an efficient method of increasing access to tuberculosis (TB) diagnostics in areas where testing is not currently available. One of the major reasons for the low yield of TB cases in the field was delay in sputum sample transportation to diagnostic laboratories among other factors. Damien Foundation Belgium, carried out a unique sputum riders initiatives in 20 LGAs of Lagos state between Q3-2019 and Q4-2020. A total of 25 sputum dispatch riders across the 20 LGAs in the State who are monitored routinely on an electronic dashboard were engaged for sputum logistics. Therefore, this report highlights how the initiatives have contributed to increased TB case notification in a densely populated metropolitan city in Nigeria. Overall, 48,265 units of sputum samples were transported to the laboratory from the facilities 99.9% of results which were received from the laboratory by the dispatch riders. The contribution of sputum riders to the overall TB case detection by the project progressively increased from 9% when the intervention began to 57% as at Q4 2020. The transportation of sputum samples by motorcycle dispatch riders is an efficient method of increasing access to TB diagnostic services in communities where testing is not currently available.

关键词： Sputum Samples Dispatch Rider Electronic Dashboard Sputum Logistics Tuberculosis

Assessment of the Contributions of Private Provider Engagement in Tuberculosis Case Finding and Notification in South West Nigeria

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Journal of Tuberculosis Research 2021年第3期9卷 160-171页

作者： Muse O. Fadeyi Bolaji Ahmed Akinwumi Akindele Adebayo Bakare Modupe Ariyo Olalekan Onitiju Osman El-Tayeb Taofeekat Ali Yasir Othman Aderonke Agbaje damien foundation Belgium (Nigeria Project) Ibadan Oyo State Nigeria Institute of Human Virology Nigeria (IHVN) Abuja Nigeria Hull University Teaching Hospitals NHS Trust Hull United Kingdom

Introduction: Tuberculosis is one of the leading causes of mortalities attributable to an infectious disease. In a private sector-driven health system such as Nigeria, the private health providers are very important stakeholders in tuberculosis diagnosis and management. Unfortunately, there are few data on the level of contribution of these private health providers to the case finding and notification of tuberculosis in Nigeria. Consequently, this study assessed the contribution of the private providers to the diagnosis and treatment of tuberculosis under the Global Fund Private Public Mix New Funding Model (2nd phase) grant (GF PPM NFM2) in the four implementing states of south west Nigeria. Materials and Methods: This is a retrospective, cross-sectional analysis of the NFM2 programme implementation data collected between January 1, 2019 and December 31, 2020. Data was extracted from the routine registers such as the presumptive TB registers;treatment register of the private health facilities engaged for PPM activities between 2019 and 2020. The data was entered and analyzed using Microsoft excel package. The variables were summarized using appropriate charts and table. Results: Concerning the percentage contribution of the Global Fund Private Public Mix (GF PPM) grant to the total sta

关键词： Private Provider Tuberculosis Diagnosis Notification

现场条件下痰涂片查抗酸杆菌石炭酸复红染色方法的差异

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国际结核病与肺部疾病杂志 2006年第3期1卷 121-127页

作者： A. Van Deun A. Hamid Salim K. J. M. Aung Md. A. Hossain N. Chambugonj Md. A. Hye A. Kawria E. Declercq 张宗德（译）屠德华（校）张立兴（审） Mycobacteriology Unit Institute of Tropical Medicine Antwerpen Belgium International Union against Tuberculosis and Lung Disease Paris France damien foundation Bangladesh Dhaka Bangladesh damien foundation Belgium Brussels Belgium 不详

地点:孟加拉国现场项目。目的:比较常规使用的石炭酸复红染色法改变的有效性。设计:75个现场临床检查地点,使用常规1％碱性复红加热15分钟的萋-尼氏染色法(ZN)。盲法对照检查ZN 1％与ZN 0．3％碱性复红染色5分钟,或ZN 1％5分钟与Kinyou... 详细信息

地点:孟加拉国现场项目。目的:比较常规使用的石炭酸复红染色法改变的有效性。设计:75个现场临床检查地点,使用常规1％碱性复红加热15分钟的萋-尼氏染色法(ZN)。盲法对照检查ZN 1％与ZN 0．3％碱性复红染色5分钟,或ZN 1％5分钟与Kinyoun冷染色法的双份涂片的结果。结果不符时进行复检。结果:假阳性的数目可对照时,Kinyoun氏法的敏感性比ZN 1％5分钟低的多(85．6％对93．0％, P<0．001)。ZN 1％5分钟的敏感性不比0．3％5分钟染色高(89．9％对86．5％)。常规使用的1％15分钟的ZN检查法比本研究中的其它方法查出的阳性教都要高。结论:Kinyoun氏冷染色法在现场临床条件下的敏感性不令人满意。WHO/IUATLD推荐的0．3％复红5分钟的敏感性和原来的1％ZN法5分钟没明显区别,但1％15分钟加热染色法更好。降低复红浓度、减少染色时间可能会增加出错的机会。结核项目中使用的较高浓度和较长时间的热ZN法不应当鼓励去改变。

关键词：萋-尼氏石炭酸复红显微镜染色

发光二极管荧光显微镜结核分枝杆菌染色:美蓝是一种良好的背景染料

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国际结核病与肺部疾病杂志 2011年第4期6卷 169-173页

作者： A.Van Deun K.J.M.Aung A.Hamid Salim M.Gumusboga P.Nandi Md.A.Hossain 逄宇 International Union Against Tuberculosis and Lung Disease Paris France Mycobacteriology Unit Institute of Tropical Medicine Antwerp Belgium damien foundation Dhaka Bangladesh damien foundation Dhaka Bangladesh

背景:达米恩基金会孟加拉国结核病(TB)控制项目。目的:比较蓝墨水、高锰酸钾和美蓝用于透射发光二极管(LED)TB荧光显微镜(FM)的背景染色。设计:将萋-尼染色(Z-N)抗酸杆菌阳性或阴性的痰标本制成一式三份的金胺染色涂片,使用上述一种背... 详细信息

背景:达米恩基金会孟加拉国结核病(TB)控制项目。目的:比较蓝墨水、高锰酸钾和美蓝用于透射发光二极管(LED)TB荧光显微镜(FM)的背景染色。设计:将萋-尼染色(Z-N)抗酸杆菌阳性或阴性的痰标本制成一式三份的金胺染色涂片,使用上述一种背景染液染色,而后选用LEDFM进行盲法镜检。对与萋-尼染色结果不一致的涂片,由参比实验室在金胺复染前后进行复检,金胺复染结果作为金标准。结果:在评价的1977份涂片中,991(50.1%)来自Z-N阳性标本。其中用蓝墨水、高锰酸钾和美蓝进行背景染色的真阳性分别为919、942和958张涂片,而假阳性数分别为12、12和16张涂片。美蓝复染的敏感性(95.6%,95%CI:94.2～96.8)要高于蓝墨水(92.7%,95%CI:90.9～94.3,P<0.01)或高锰酸钾(93.6%,95%CI:91.9～95.0,P<0.05)。在180例不一致涂片中,经过或未经复染,85%的涂片未找到抗酸杆菌,15%的涂片未找到抗酸杆菌。结论:在使用透射蓝光激发的LED荧光显微镜观察时,美蓝复染至少与高锰酸钾效果相当,而比蓝墨水更便宜。对金胺染色涂片进行室间质量评估盲法复检时,需要在第一次复检前对所有涂片进行复染。

关键词：结核发光二极管荧光显微镜检查美蓝抗酸杆菌

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涂片抗酸染杆菌可疑阳性的意义

结核与肺部疾病杂志 2005年第3期8卷 121-126页

作者： A. Van Deun A. Hamid Salim E. Cooreman P. Dam A. P. K. Das K. J. M. Aung H. L. Rieder 张宗德 Mycobacteriblogy Unit Institute of Tropical Medicine Antwerp Belgium International Union Against Tuberculosis and Lung Disease Paris France damien foundation Bangladesh Dhaka Bangladesh

背景:孟加拉国结核控制项目。目的:评价抗酸染色涂片可疑阳性(IUATLD/WHO,高倍视野<10/100)的频度及诊断价值,评估现行阳性标准的适用性。设计:分析实验室登记数据库,病人记录和痰标本收集策略的诊断结果结果:可疑涂片阳性在可疑患者检... 详细信息

背景:孟加拉国结核控制项目。目的:评价抗酸染色涂片可疑阳性(IUATLD/WHO,高倍视野<10/100)的频度及诊断价值,评估现行阳性标准的适用性。设计:分析实验室登记数据库,病人记录和痰标本收集策略的诊断结果结果:可疑涂片阳性在可疑患者检查中约占10%,在随访涂片中约占50%。在可疑患者中,若以1-9AFB/100HPF 为标准,约10%的可疑涂片不能被平行标本的抗酸染色可疑涂片阳性所证实,而采用10AFB/100HPF 的阈值时该比例为则7.5%。如果采用ATS 推荐的1AFB/100HPF 的阳性阈值,只增加1.5%的假阳性率,但可增加10%的确诊阳性病例,阳性结果增加超过了增加第3 次痰检的结果。由于强化治疗后期进行的随访痰涂片总是和治疗失败及部理想的转归联系在一起而显示其重要性。结论:涂片可疑阳性结果并不罕见,不应被忽视。在结核控制项目地区具有可靠的抗酸染色镜检及质控的情况下应采用更低的阳性阈值。

关键词：抗酸菌镜检定量抗酸染色涂片可疑阳性结核控制项目杆菌阳性阈值阳性标准可疑患者涂片阳性标本收集

Implementing a Short Regimen for Multidrug-Resistant Tuberculosis in Kinshasa, Democratic Republic of Congo: A Cohort Study 2014-2017

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Journal of Tuberculosis Research 2020年第3期8卷 111-126页

作者： Innocent Murhula Kashongwe Leopoldine Mbulula Fina Mawete Nicole Anshambi Nadine Maingowa Michel Kaswa Jean Marie Ntumba Kayembe Francois Bompeka Lepira Zacharie Munogolo Kashongwe Pulmonology Unit Internal Medicine Kinshasa University Hospital Kinshasa Democratic Republic of the Congo Drug Resistant Tuberculosis Unit “Centre Excellence damien” Damian Foundation Kinshasa Democratic Republic of the Congo National Tuberculosis Program of the Democratic Republic of the Congo Kinshasa Democratic Republic of the Congo Provincial Coordination for Tuberculosis Control Kinshasa Democratic Republic of the Congo

Setting: Kinshasa, capital of Democratic Republic of Congo, has the high rate of multidrug resistant tuberculosis (MDR-TB) which is associated with poor treatment outcomes until 2013. A new approach was needed. Objectives: To implement a new strategy in order to improve treatment outcomes. Design: A retrospective cohort study reviewing all the patients diagnosed MDR Tuberculosis between 2014 and 2017. The study was conducted in the National Tuberculosis Program (NTP) framework comparing the short regimen and the WHO standard regimen. Results: From 1246 patients diagnosed RR/TB, 1073 were included in the analysis: 948 on shorter regimen, and 125 on WHO standard regimen. The strategy was based on patient-centered care. In the short regimen group, 62.7% were male, 61.4% were age 25 - 44 years, 52.6% had previous history of TB, 39.3% underweight, 12.5% HIV positive. The median time from diagnosis to treatment was 19 days (0 - 163). In the long regimen group, 75% were male, 37.6% were age 14 - 44 years, 61.6% underweight, 18.4% HIV positive. The median time from diagnosis to treatment was 19 days (0 - 114). Favorable outcomes represented 81.9% in the short regimen group versus 72% in the long regimen group. Death and loss to follow-up were more observed in long regimen group (27.2% versus 15.4%). Factors associated with unfavorable outcomes in the short regimen group included sex, age ≥ 45 years, previous TB history, HIV status, delay to begin treatment. For the long regimen, the factors age and delay emerged, underweight and HIV were borderline. Drug adverse events were reported respectively in 43.5% and 42.4% for short and long regimen;with gastrointestinal disturbances, vestibular troubles, ototoxicity, arthralgia and anemia as the most common in the 2 groups. Conclusion: The new approach improved favorable outcomes. Both short and long regimens reached a high level of favorable outcome compared to the previous study. The short regim

关键词： MDR-TB Short Regimen Patient Centered Card

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萋尼氏染色:理论与实践

国际结核病与肺部疾病杂志 2008年第2期3卷 90-92页

作者： A. Van Deun M. A. Hossain M. Gumusboga H.L. Rieder 姜广路（译）黄海荣（校）何广学（审） Mycobacteriology Unit Institute of Tropical Medicine Antwerp Belgium International Union AgainstTuberculosis and Lung Disease Paris France damien foundation Bangladesh Dhaka Bangladesh 不详

世界卫生组织、国际防痨与肺病联盟的指南所提供的萋尼氏染色内容,在某些方面缺乏实用性,本文给出的建议意在对指南加以补充。这些建议是建立在有关碱性复红染色和染色液的试验以及实际经验基础之上的。

关键词：显微镜萋尼氏染色碱性复红

Prevalence of Adverse Drug Reactions to Second Line Anti Tuberculosis Drugs in Nigeria: A Cross-Sectional Study

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Journal of Tuberculosis Research 2021年第2期9卷 90-102页

作者： Abideen Adedayo Ganiyu Yohanna Kambai Avong Akinwumi Akinyede Olusoji Mayowa Ige Osman El tayeb Fatai Taleatu Ayobami Omayeka Victor Babawale Ibrahim Oreagba Department of Pharmacology Therapeutics and Toxicology College of Medicine University of Lagos Lagos Nigeria Government Chest Hospital Ibadan Nigeria Institute of Human Virology of Nigeria (IHVN) Abuja Nigeria University of Technology Sydney Ultimo Australia University College Hospital Ibadan Nigeria damien foundation Belgium Nigeria Office Ibadan Nigeria National Tuberculosis and Leprosy Control Programme (NTBLCP) Abuja Nigeria

Introduction: Multidrug resistant tuberculosis (MDR-TB) is treated with second line antituberculosis drugs. These drugs are notorious for inflicting serious adverse drug reactions (ADRs), which many studies have shown causes a wide range of economic and health problems including death. Aim: The study examined the prevalence of ADRs, associated risk factors, socio-demographic association and outcomes among patients treated for MDR-TB at a comprehensive tuberculosis treatment center in Nigeria. Method: The study was conducted at the Government Chest Hospital, Jericho, Ibadan. We applied a retrospective assessment of patient treatment data and ADRs reports stored at the study site from March 2013 and February 2016. Subsequently, a prospective study of ADRs was conducted on patients admitted into the same hospital. Causality relationship between the drugs and the reported ADRs was determined with a specially validated tool. The outcomes assessed include recovery from the ADRs, death and permanent deafness from the ADRs. Extracted data were analyzed using SPSS version 22.0. Risk Ratio was calculated for the influence of risk factors for adverse drug reactions. Logist

关键词： Multidrug Resistant Tuberculosis ADR Risk Factors Prevalence

Sensorineural Hearing Loss in Multidrug-Resistant Tuberculosis Patients in Kinshasa (Democratic Republic of Congo): Prospective Cohort Study of Therapeutic Regimen with Aminoglycoside versus Bedaquiline

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Journal of Tuberculosis Research 2023年第3期11卷 109-119页

作者： Mireille A. Mpwate Eddy M. Mbambu Christian N. Matanda Gabriel M. Lema Michel K. Kaswa Murielle L. Aloni Nicole M. Anshambi Fabrice M. Matuta Luc L. Lukasu Dominique M. Mupepe Serge K. Mpwate Pierre Z. Akilimali Zacharie M. Kashongwe Richard N. Matanda Department of Otorhinolaryngology University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo National Tuberculosis Control Program in the Democratic Republic of Congo Kinshasa Democratic Republic of Congo Provincial Coordination for the Fight against Tuberculosis Kinshasa Democratic Republic of Congo Multidrug-Resistant Tuberculosis Unit “Centre d’Excellence Damien” Damien Foundation Kinshasa Democratic Republic of Congo Division of Cardiology Department of Internal Medicine University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo Department of Anatomy-Pathology University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo Kinshasa School of Public Health Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of Congo Pneumology Unit Department of Internal Medicine University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo

Context: Multidrug-resistant tuberculosis (MDR-TB) remains a major public health problem in developing countries such as the Democratic Republic of Congo (DRC), which continues to face the emergence of MDR-TB cases. Because of the ototoxic effects of AGs, the World Health Organization (WHO) has recommended the introduction of the bedaquiline regimen. However, very few data are available regarding the susceptibility of bedaquiline to induce hearing loss, hence the present study set out to compare the AG-based regimen and the bedaquiline-based regimen in the occurrence of hearing loss in MDR-TB patients. Methods: This is a prospective multicenter cohort study that included 335 MDR-TB patients, performed in Kinshasa (DRC) during the period from January 2020 to January 2021. Sociodemographic, clinical, biological and audiometric data were analyzed using Stata 17. Repeated-measures analysis of variance was used to compare changes in the degree of hearing loss over time between the two groups of patients on AG and bedaquiline regimens. The double-difference method was estimated using regression with fixed-effects. A p value < 0.05 was considered the threshold for statistical significance. Results: The degree of hearing loss was similar between the two groups at the first month [AGs (28 dB) vs BDQ (30 dB);p = 0.298]. At six months, the mean degree of hearing loss was significantly greater in the aminoglycoside regimen group [AGs (60.5 dB) vs BDQ (44 dB);p < 0.001]. The double difference was significant, with a greater increase in hearing loss in the AGs group (diff-in-diff 18.3;p < 0.001). After adjustment for age and serum albumin, the group receiving the AG-based regimen had a 2-point greater worsening than those with bedaquiline at the sixth month (diff-in-diff 19.8;p Conclusion: Hearing loss is frequent with both treatment regimens, but more marked with the Aminoglycoside-based regimen. Thus, bedaquiline should also benefit for audiometric monitoring in future MDR-TB p

关键词： Multidrug-Resistant Tuberculosis Aminoglycosides Bedaquiline Hearing Loss