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DOST Model’ for DR-tb Patients, New Delhi: Perspectives of Healthcare Providers

Journal of Tuberculosis Research 2022年第4期10卷 187-198页

作者： Vindhya Vatsyayan Theresa Pattery Khasim Sayyad Jason Williams Arnab Pal Vikas Panibatla Ashwani Khanna Clinton Health Access Initiative (CHAI) Delhi India Johnson & Johnson Global Public Health R & D Breese Belgium tb alert india Hyderabad India Delhi State tb Control Office Delhi India

Introduction: In india, tuberculosis continues to be a major public health problem and there is a growing concern about drug-resistant tuberculosis as most of the patients are from private sector. The National tb Elimination Programme (NTEP) in collaboration with tb alert, india (tbAI) and Clinton Health Association of india (CHAI) had implemented a collaborative project to strengthen the network between the private practitioners and public healthcare facilities in New Delhi during 2019 and 2020. Methods: A study was conducted to understand the enablers and challenges encountered by them during the implementation of the project. This is a qualitative exploration of the “healthcare providers” on a project linking DR-tb patients in private sector with government health facilities. The process of data collection involved face-to-face in-depth interviews of healthcare providers, the Doctors mainly from private and public health facilities, the paramedical workers from general health system and paramedical from the project using an interview guide administered through a trained researcher. Results: The study findings revealed that all healthcare providers were completely aware of the DOST project in the health system, the model led to early diagnosis and initiation of quality treatment. There were no major challenges to the implementation of the project. The healthcare providers wish to have this project implemented for a longer duration. Conclusion: The perspectives of healthcare providers towards the “DOST” project were optimistic and call for re-initiating the project in the area.

关键词： DOST Drug-Resistant Tuberculosis Patients india Health Care Providers

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Prevalence and Risk Factors of Adverse Drug Reactions Associated Multidrug Resistant Tuberculosis Treatments in Selected Treatment Centers in Addis Ababa Ethiopia

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Journal of Tuberculosis Research 2014年第3期2卷 144-154页

作者： Haregewoin Bezu Daniel Seifu Getnet Yimer Tesfamariam Mebrhatu All Africa Leprosy TB Rehabilitation and Training Center Armauer Hansen Research Institute (AHRI/ALERT) Addis Ababa Ethiopia Department of Medical Biochemistry College of Health Sciences Addis Ababa University Addis Ababa Ethiopia Research and Technology Transfer College of Health Sciences Addis Ababa University Addis Ababa Ethiopia

Introduction: The key to successful elimination of tuberculosis (tb) is treatment of cases with optimum chemotherapy. Irrational anti-tb drug use over time has led to drug-resistant tb. The treatment of MDR-tb with second line drugs is long, complex and costly, and has a considerable rate of adverse effects. The level of ADR reporting is low in Ethiopia due to different factors. This Study conducted in a selected treated area in Addis Ababa, Ethiopia and helped the health care centers to understand the prevalence of ADR related MDR-tb and be aware of those adverse effects in order to detect them early and be prepared to take proper steps when they occur. Aim of the Study: To determine the prevalence and risk factor of adverse drug reactions associated treatments of Multidrug Resistant tuberculosis. Method: This was a cross sectional study, which was conducted between March 2012 and February 2013 at St. Peter tb specialized hospital and AHRI/alert. 73 MDR tb patients, who were on MDR tb treatments, enrolled to the study. Adverse Drug Reactions associated MDR tb treatments were assessed by patient history review and questionnaire. Chemistry laboratory was used to test renal function, thyroid function, liver enzyme and potassium level. Result: In 72 patients, at least two ADRs were found. The mean age of the study population (Mean ± SD) was 28 ± 8.8. In this study the most commonly found adverse drug reactions (ADRs) were: Anorexia 83.3%, Nausea and vomiting 82%, Gastritis 64%, Arteralgia 47%, Skin rash and itching 45%, Headache 29.2%, Depression 22.2% and Blurred vision 19.4%. Using binary logistic regression model older age (COR 8.71, 95% [CI] 1.06 - 71.9), alcoholism (COR 4.05, 95% [CI] 1.05 - 15.6), smoking (COR 0.24, 95% [CI] 0.06 - 0.87) and concomitant drug intake (COR 0.14, 95% [CI] 0.03 - 0.76) were independent predictors for ADRs. Conclusion: The prevalence of ADRs related MDR tb treatments is high. To minimize ADR occurrence, ADR predictors should be integra

关键词： MDR tb ADR Second Line Anti-tb Treatment

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Prevalence of Mycobacterium tuberculosis Strains Isolated from Both Pulmonary and Extra Pulmonary Samples and Their Resistance to Rifampicin: A Study from Kolkata and Surrounding Suburbs

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Journal of Tuberculosis Research 2016年第2期4卷 61-71页

作者： Soma Chakraborty Arindam Chakraborty Tathagata Talukder Mita Mukherjee Tridip Chatterjee Department of Microbiology Suraksha Diagnostics DD-18/1 Kolkata India Suraksha Genomics (R & D Division of Suraksha Diagnostics) DD-18/1 Kolkata India

Tuberculosis (tb) is one of the major causes of morbidity and mortality worldwide. In india, nearly 1.8 million new cases of tb are reported annually, which accounts for a fifth of new cases in the world—greater than in any other country. Anti-tubercular drugs (ATDs) have been used for decades, and widespread resistance to them is a very serious public health concern in any part of the world. Aim of this study was to determine the prevalence of Rifampicin (the first line Anti-tb drug) resistance among both pulmonary and extra-pulmonary samples tested positive for Mycobacterium tuberculosis and thereby predict the prevalence of Multi-drug resistant (MDR) tuberculosis in Kolkata and its Suburban regions. All 331 randomly collected clinical samples (both Pulmonary and Extra Pulmonary) were initially screened by Zeihl-Neelsen AFB staining followed by culture on BacT/alert 3D system and on Lowenstein-Jensen medium and the positive samples were subjected to detection of Mycobacterium tuberculosis complex (MtbC) and simultaneous analysis of Rifampicin resistance by Xpert Mtb/RIF assay. Out of the 51 (15.40%) culture positive samples, 13.7% of pulmonary samples and 9.09% of extra-pulmonary samples were Rifampicin resistant. The prevalence of Rifampicin resistant tb in our study is high and the possible reasons can be mixing of new as well as retreatment cases and smaller sample size but, yet it can help Government and public health regulatory bodies to formulate adequate strategies to fight against drug resistant tuberculosis, especially in this part of the world.

关键词： Tuberculosis (tb) Multi Drug Resistant tb (MDR-tb) Rifampicin Resistant tb GeneXpert

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