Background: Tuberculosis remains a major heal- th problem affecting about a third of the world population despite a number of preventive and control measures taken in the past few decades. Eighty-five percent of all t...Background: Tuberculosis remains a major heal- th problem affecting about a third of the world population despite a number of preventive and control measures taken in the past few decades. Eighty-five percent of all tuberculosis cases are concentrated in Asia and Africa due to lack of education and health care infrastructure. Objective: To determine factors affecting low tuberculosis case detection in the Sissala East district in the Upper West Region of Ghana. Methods: This was a descriptive study where semi-structured questionnaire was administered to 61 respondents;six focus group discussions and 20 in-depth interviews were conducted to generate both qualitative and quantitative data for analysis. Results: Tuberculosis, known locally as Kesibine was identified as a major problem in the district. The two most frequently reported TB related dis-tresses were coughing (96.7%) and chest pains (95.0%). However, these distresses were reported more after probing for them. The most frequently spontaneously reported distress was reduced income (60.7%) for patients. The most prominent cause reported was sexual pollution (72.2%). Suspected tuberculosis patients are stigmatized and are denied sex by their partners as shown in the following narrative;I will not eat or have sex with her or eat any leftover from her plate (male local healer, In-depth interview). Case detection and treatment is hampered by lack of communication between sub-district facilities and the district hospital to aid laboratory diagnosis. Conclusion: There is therefore the need for vigorous health education to inform the people about the biomedical causes of TB and the availability of appropriate treatment for the disease at health facilities. However, the education should not aim at changing the “wrong beliefs” but focus on making people aware of the biomedical causes and see TB as treatable infection, which could be controlled.展开更多
Background: India is a high TB (tuberculosis) burden country. The advent of HIV (Human immunodeficiency virus) and DR-TB (drug resistant TB) has worsened the ongoing TB control efforts. A study was conducted to (a) to...Background: India is a high TB (tuberculosis) burden country. The advent of HIV (Human immunodeficiency virus) and DR-TB (drug resistant TB) has worsened the ongoing TB control efforts. A study was conducted to (a) to determine the duration for developing drug resistant TB after diagnosis of HIV (b) to ascertain the patients status after one year of DR-TB treatment in Karnataka, India. Methods: It is a retrospective cross-sectional study involving review of records and reports at ART (Anti-retroviral treatment) centres and DR-TB centres in Karnataka during the period 2013-2014. Results: The median time from being known as HIV positive to being diagnosed as DR-TB was 1168 days (IQR: 571 - 1955). At the end of 14 months, nearly 39% of patients had died and 49% of patients were on treatment. Conclusion: The National Health programmes should prioritize monitoring of the HIV/TB patients and develop appropriate novel strategies for community involvement.展开更多
The SSM （sputum smear microscopy） and five immunochromatographic tuberculosis antibody detection tests （DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB） were compared for diagnosis...The SSM （sputum smear microscopy） and five immunochromatographic tuberculosis antibody detection tests （DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB） were compared for diagnosis of active TB at the Leprosy and Tuberculosis Referral Hospital, Uzuakoli, Abia State, Nigeria. Sputum specimens from 150 study participants （male/female ratio, 0.81） were cultured on Lowenstein-Jensen slopes and direct smears were stained by Ziehl-Neelsen technique and examined by light microscopy. Sera were tested for anti-TB antibodies using the rapid TB tests. A total of 91 participants were culture positive, 79 （86.8%） for M. tuberculosis and 12 （13.2%） for nontuberculous mycobacteria. The sensitivity of SSM was 50% （95% CI： 39.0-61.0） and specificity was 92.3% （95% CI： 86.4-98.2） in those culture positive for M. tuberculosis. The sensitivity and specificity of the Rapid TB tests ranged from 24.1-39.2% and 78.4-87.8%, respectively. None of the five rapid TB tests had acceptable level of accuracy for diagnosis of active TB. The sensitivity of SSM though moderate is inadequate for long term TB control in this setting.展开更多
文摘Background: Tuberculosis remains a major heal- th problem affecting about a third of the world population despite a number of preventive and control measures taken in the past few decades. Eighty-five percent of all tuberculosis cases are concentrated in Asia and Africa due to lack of education and health care infrastructure. Objective: To determine factors affecting low tuberculosis case detection in the Sissala East district in the Upper West Region of Ghana. Methods: This was a descriptive study where semi-structured questionnaire was administered to 61 respondents;six focus group discussions and 20 in-depth interviews were conducted to generate both qualitative and quantitative data for analysis. Results: Tuberculosis, known locally as Kesibine was identified as a major problem in the district. The two most frequently reported TB related dis-tresses were coughing (96.7%) and chest pains (95.0%). However, these distresses were reported more after probing for them. The most frequently spontaneously reported distress was reduced income (60.7%) for patients. The most prominent cause reported was sexual pollution (72.2%). Suspected tuberculosis patients are stigmatized and are denied sex by their partners as shown in the following narrative;I will not eat or have sex with her or eat any leftover from her plate (male local healer, In-depth interview). Case detection and treatment is hampered by lack of communication between sub-district facilities and the district hospital to aid laboratory diagnosis. Conclusion: There is therefore the need for vigorous health education to inform the people about the biomedical causes of TB and the availability of appropriate treatment for the disease at health facilities. However, the education should not aim at changing the “wrong beliefs” but focus on making people aware of the biomedical causes and see TB as treatable infection, which could be controlled.
文摘Background: India is a high TB (tuberculosis) burden country. The advent of HIV (Human immunodeficiency virus) and DR-TB (drug resistant TB) has worsened the ongoing TB control efforts. A study was conducted to (a) to determine the duration for developing drug resistant TB after diagnosis of HIV (b) to ascertain the patients status after one year of DR-TB treatment in Karnataka, India. Methods: It is a retrospective cross-sectional study involving review of records and reports at ART (Anti-retroviral treatment) centres and DR-TB centres in Karnataka during the period 2013-2014. Results: The median time from being known as HIV positive to being diagnosed as DR-TB was 1168 days (IQR: 571 - 1955). At the end of 14 months, nearly 39% of patients had died and 49% of patients were on treatment. Conclusion: The National Health programmes should prioritize monitoring of the HIV/TB patients and develop appropriate novel strategies for community involvement.
文摘The SSM （sputum smear microscopy） and five immunochromatographic tuberculosis antibody detection tests （DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB） were compared for diagnosis of active TB at the Leprosy and Tuberculosis Referral Hospital, Uzuakoli, Abia State, Nigeria. Sputum specimens from 150 study participants （male/female ratio, 0.81） were cultured on Lowenstein-Jensen slopes and direct smears were stained by Ziehl-Neelsen technique and examined by light microscopy. Sera were tested for anti-TB antibodies using the rapid TB tests. A total of 91 participants were culture positive, 79 （86.8%） for M. tuberculosis and 12 （13.2%） for nontuberculous mycobacteria. The sensitivity of SSM was 50% （95% CI： 39.0-61.0） and specificity was 92.3% （95% CI： 86.4-98.2） in those culture positive for M. tuberculosis. The sensitivity and specificity of the Rapid TB tests ranged from 24.1-39.2% and 78.4-87.8%, respectively. None of the five rapid TB tests had acceptable level of accuracy for diagnosis of active TB. The sensitivity of SSM though moderate is inadequate for long term TB control in this setting.
基金The Thyolo district HIV/AIDS programme is supported by Medecins sans Frontieres. EuropeAidla Direction Generale de la Cooperation au Developpement(Belgium Government)+6 种基金the Childrens Investment Fund FoundationELMA Foundationthe Global Fundthe International Union Against Tuberculosis and Lung DiseaseParisand the World Health Organization for their continuing support for HIV/AIDS activities in Malawi
基金financed by the Wyeth Pharmaceutical (Pvt) Ltd.The sponsor had no role in datacollectiondata analysisdata interpretation or writing of the report.The corresponding author had access to all data in the study and had final responsibility for the decision to submit for publication
