Objective:To judge for reasons of interrupting the treatment as told by patient himself/herself and see for adherence to therapy and treatment outcome after counselling.Methods:All patients with history of interruptin...Objective:To judge for reasons of interrupting the treatment as told by patient himself/herself and see for adherence to therapy and treatment outcome after counselling.Methods:All patients with history of interrupting the treatment presenting to chest OPD were included in this study.Counselling was done by medical officer on first interaction and by health care worker(as guidance of medical officer) subsequently.Reasons for interrupting the treatment were noted.Patients and their relatives were counselled about the urgent need for strict adherence to therapy with special focus on reasons for which that particular patient had defaulted.Results:Total 56 patients were included in the study during First Quarter of year 2007.Treatment outcomes of 40 patients were available.6 out of them had interrupted the treatment(15%)(National figures;19%and Maharashtra: 21%),13 patients died during the treatment(5 of them were Cat 2 defaulters).Multiple reasons for interrupting the treatment were present.Most common reasons were alcoholism and feeling of relief with treatment (46.4%).Conclusion:There is an urgent need for stressing upon counselling during Revised National Tuberculosis Control Programme(RNTCP) sensitization and training.Medical officers can play an important role in reducing the defaulter rate by counselling of patient and their relatives.展开更多
Background: The Tuberculosis (TB) disease has immense impact on physical, psychological, economic and social well-being of an individual. It is desired that the patient with any kind of TB disease should lead a respec...Background: The Tuberculosis (TB) disease has immense impact on physical, psychological, economic and social well-being of an individual. It is desired that the patient with any kind of TB disease should lead a respectable and happier life during their course of TB treatment. Currently, the quality of life (QOL) is an important indicator to assess the well-being of a person and there is paucity of such information among TB patients. Hence, we conducted to assess and compare the QOL of Revised National TB Control Programme registered Drug sensitive TB patients, Drug resistant TB patients and general population of Gadag district in Karnataka, India. Methods: A cross-sectional study was conducted in Gadag district, Karnataka from March 2017 through March 2018 among drug sensitive, drug resistant TB patients and general population. A Non-probability purposive sampling was adopted to select the samples that were matched for age, gender and ward. The select patients were administered WHO QOL-BREF questionnaire by trained personnel. Data were analyzed using SPSS version 12 analysis software. Results: The scores obtained for the four domains of QOL were (a) physical health: 69.62 + 18.29 (b) Psychological: 66.96 + 18.62 (c) Environment: 60.99 + 15.05 and (d) Social relationships: 53.5 + 19.93. Conclusions: The drug resistant TB patients have poor QOL when compared to drug sensitive and general population.展开更多
Background: In India, tuberculosis remains as a major public health problem amongst the tribal population. Poor physical access to diagnosis and treatment under the Revised National TB control programme (RNTCP) still ...Background: In India, tuberculosis remains as a major public health problem amongst the tribal population. Poor physical access to diagnosis and treatment under the Revised National TB control programme (RNTCP) still remains the problem for the population. RNTCP implements Tribal Action Plan (TAP) for tribal patients. We conducted the study to determine the trends of financial utilisation for the special provisions available under tribal action plan like patient honorarium, incentive for sputum collection and transport, incentive for programme staff and incentive for vehicle maintenance. Methods: A cross-sectional study based on mixed method study approach was conducted in Chhattisgarh, India during Nov. 16 to Jun. 17. District TB Officers implementing TAP were interviewed telephonically using a semi-structured questionnaire to ascertain and analyse the reasons for low fund utilization in their districts. Retrospective financial data for five financial years from 13 TAP districts for 2012-2013 to 2016-2017 was collected, compiled and analysed. Results: Overall, the trends on states expenditure on tribal action plan in terms of absolute numbers has increased over the past five years;however, in terms of fund utilization against received ranges from 37% - 86% with the utilization rate less than 44% in the recent years (2014-2017). Conclusion: The trends of utilisation of TAP is less than 44% over the recent years. There is an urgent need for the administrators to intervene and improve the efficiency of fund utilisation at State and district levels.展开更多
Objective:To study the prevalence and cure rate of tuberculosis(TB) and the people affected by TB in selected areas,considering different factors like age,sex,percentage of people affected,dosage forms,role of hospita...Objective:To study the prevalence and cure rate of tuberculosis(TB) and the people affected by TB in selected areas,considering different factors like age,sex,percentage of people affected,dosage forms,role of hospitals, and patient category.Methods:A detailed survey was carried out in and around Perinthalmanna and Wayanad(Urban and Rural) to understand the burden and overall trend of TB in our locality and how effective our TB control programme.More than 250 treatment cards were collected from the Government hospitals and TB Sanatorium.Results:In the study,at Perinthalmanna and Wayanad,out of 250 TB patients it was found that males is more susceptible than females,rural area accounting for the greater proportion of TB patients. Greater proportion were affected with pulmonary than extra pulmonary Tuberculosis.The incidence of tuberculosis in different age groups varied according to the area.Half proportion in both rural and urban areas were belonging to categoryⅡfollowed by categoryⅢ.Conclusion:The nature and magnitude of TB is more in rural area than urban area mainly because of the lack of awareness of the severity of disease and improper follow up of preventive measures.Our study suggests that the combined and committed efforts of government,non government organizations,medical and paramedical professional and society is required at large,to reach all patients and ensure that they receive high quality care.展开更多
When discovered, anti-tuberculosis drugs were always administered in Daily-doses; it worked wonders! Later, studies claimed these drugs could cure even in thrice-weekly doses （intermittently）. Not everyone believed ...When discovered, anti-tuberculosis drugs were always administered in Daily-doses; it worked wonders! Later, studies claimed these drugs could cure even in thrice-weekly doses （intermittently）. Not everyone believed that. Three Reviews （Cochrane, Thorax, Azhar） appear unconvinced! Also, most nations （including 20 High TB Burden Countries） continue to practice time-tested Daily dosing! INDIA adopted a unique low-cost, thrice-weekly regimen around 2000. During 15 years, under national program, Thrice-weekly doses have been administered to 15 million TB patients, self-claiming 85% success. To revisit long-term outcome of all registered patients in a district; identify the one, who didn＇t achieve long-lasting recovery with a single course, was later found re-registered for a second innings; his name figures twice in national registry （a Repeater）. Author heads District Tuberculosis Center, Faridabad, India; monitors thousands of current/ex-patients on Thrice-weekly regimen. By providence, he enjoys unique access to registered patients, data, district TB-workers. Two methods of data collection： 1. Author motivated district work-force; jointly conducted systematic Retrospective Record Review of hand-written registers of past 15 years, one at a time--thus identified over 1,575 Repeaters. 2. Author has been conducting ongoing Clinical Audit in his busy TB OPD for 6 years. He is able to cherry-pick （average） one Repeater per day; thus tracked 3,100 Repeaters-about half come in from Delhi＇s premier TB institutes, duly diagnosed, referred in for local registration for Re-treatment. Long-term fate of 36,785 registered TB patients could be analyzed. 4,675 patients observed to have returned sick, meriting Re-registration, Re-treatment; thus over 12.7 % registered twice/thrice （names, unique govt. ID＇s, irrefutable evidence enclosed）-an adverse outcome, unreported thus far-a bubble. Besides, study recorded 1,590 （5%） Deaths; 2,590 （8%） Defaulters. Under India＇s routine program conditions, Thrice-weekly regimen is ineffective. Too many （12.7%） patients come back sick, which may promote drug-resistance on industrial scale! A global threat!展开更多
文摘Objective:To judge for reasons of interrupting the treatment as told by patient himself/herself and see for adherence to therapy and treatment outcome after counselling.Methods:All patients with history of interrupting the treatment presenting to chest OPD were included in this study.Counselling was done by medical officer on first interaction and by health care worker(as guidance of medical officer) subsequently.Reasons for interrupting the treatment were noted.Patients and their relatives were counselled about the urgent need for strict adherence to therapy with special focus on reasons for which that particular patient had defaulted.Results:Total 56 patients were included in the study during First Quarter of year 2007.Treatment outcomes of 40 patients were available.6 out of them had interrupted the treatment(15%)(National figures;19%and Maharashtra: 21%),13 patients died during the treatment(5 of them were Cat 2 defaulters).Multiple reasons for interrupting the treatment were present.Most common reasons were alcoholism and feeling of relief with treatment (46.4%).Conclusion:There is an urgent need for stressing upon counselling during Revised National Tuberculosis Control Programme(RNTCP) sensitization and training.Medical officers can play an important role in reducing the defaulter rate by counselling of patient and their relatives.
文摘Background: The Tuberculosis (TB) disease has immense impact on physical, psychological, economic and social well-being of an individual. It is desired that the patient with any kind of TB disease should lead a respectable and happier life during their course of TB treatment. Currently, the quality of life (QOL) is an important indicator to assess the well-being of a person and there is paucity of such information among TB patients. Hence, we conducted to assess and compare the QOL of Revised National TB Control Programme registered Drug sensitive TB patients, Drug resistant TB patients and general population of Gadag district in Karnataka, India. Methods: A cross-sectional study was conducted in Gadag district, Karnataka from March 2017 through March 2018 among drug sensitive, drug resistant TB patients and general population. A Non-probability purposive sampling was adopted to select the samples that were matched for age, gender and ward. The select patients were administered WHO QOL-BREF questionnaire by trained personnel. Data were analyzed using SPSS version 12 analysis software. Results: The scores obtained for the four domains of QOL were (a) physical health: 69.62 + 18.29 (b) Psychological: 66.96 + 18.62 (c) Environment: 60.99 + 15.05 and (d) Social relationships: 53.5 + 19.93. Conclusions: The drug resistant TB patients have poor QOL when compared to drug sensitive and general population.
文摘Background: In India, tuberculosis remains as a major public health problem amongst the tribal population. Poor physical access to diagnosis and treatment under the Revised National TB control programme (RNTCP) still remains the problem for the population. RNTCP implements Tribal Action Plan (TAP) for tribal patients. We conducted the study to determine the trends of financial utilisation for the special provisions available under tribal action plan like patient honorarium, incentive for sputum collection and transport, incentive for programme staff and incentive for vehicle maintenance. Methods: A cross-sectional study based on mixed method study approach was conducted in Chhattisgarh, India during Nov. 16 to Jun. 17. District TB Officers implementing TAP were interviewed telephonically using a semi-structured questionnaire to ascertain and analyse the reasons for low fund utilization in their districts. Retrospective financial data for five financial years from 13 TAP districts for 2012-2013 to 2016-2017 was collected, compiled and analysed. Results: Overall, the trends on states expenditure on tribal action plan in terms of absolute numbers has increased over the past five years;however, in terms of fund utilization against received ranges from 37% - 86% with the utilization rate less than 44% in the recent years (2014-2017). Conclusion: The trends of utilisation of TAP is less than 44% over the recent years. There is an urgent need for the administrators to intervene and improve the efficiency of fund utilisation at State and district levels.
文摘Objective:To study the prevalence and cure rate of tuberculosis(TB) and the people affected by TB in selected areas,considering different factors like age,sex,percentage of people affected,dosage forms,role of hospitals, and patient category.Methods:A detailed survey was carried out in and around Perinthalmanna and Wayanad(Urban and Rural) to understand the burden and overall trend of TB in our locality and how effective our TB control programme.More than 250 treatment cards were collected from the Government hospitals and TB Sanatorium.Results:In the study,at Perinthalmanna and Wayanad,out of 250 TB patients it was found that males is more susceptible than females,rural area accounting for the greater proportion of TB patients. Greater proportion were affected with pulmonary than extra pulmonary Tuberculosis.The incidence of tuberculosis in different age groups varied according to the area.Half proportion in both rural and urban areas were belonging to categoryⅡfollowed by categoryⅢ.Conclusion:The nature and magnitude of TB is more in rural area than urban area mainly because of the lack of awareness of the severity of disease and improper follow up of preventive measures.Our study suggests that the combined and committed efforts of government,non government organizations,medical and paramedical professional and society is required at large,to reach all patients and ensure that they receive high quality care.
文摘When discovered, anti-tuberculosis drugs were always administered in Daily-doses; it worked wonders! Later, studies claimed these drugs could cure even in thrice-weekly doses （intermittently）. Not everyone believed that. Three Reviews （Cochrane, Thorax, Azhar） appear unconvinced! Also, most nations （including 20 High TB Burden Countries） continue to practice time-tested Daily dosing! INDIA adopted a unique low-cost, thrice-weekly regimen around 2000. During 15 years, under national program, Thrice-weekly doses have been administered to 15 million TB patients, self-claiming 85% success. To revisit long-term outcome of all registered patients in a district; identify the one, who didn＇t achieve long-lasting recovery with a single course, was later found re-registered for a second innings; his name figures twice in national registry （a Repeater）. Author heads District Tuberculosis Center, Faridabad, India; monitors thousands of current/ex-patients on Thrice-weekly regimen. By providence, he enjoys unique access to registered patients, data, district TB-workers. Two methods of data collection： 1. Author motivated district work-force; jointly conducted systematic Retrospective Record Review of hand-written registers of past 15 years, one at a time--thus identified over 1,575 Repeaters. 2. Author has been conducting ongoing Clinical Audit in his busy TB OPD for 6 years. He is able to cherry-pick （average） one Repeater per day; thus tracked 3,100 Repeaters-about half come in from Delhi＇s premier TB institutes, duly diagnosed, referred in for local registration for Re-treatment. Long-term fate of 36,785 registered TB patients could be analyzed. 4,675 patients observed to have returned sick, meriting Re-registration, Re-treatment; thus over 12.7 % registered twice/thrice （names, unique govt. ID＇s, irrefutable evidence enclosed）-an adverse outcome, unreported thus far-a bubble. Besides, study recorded 1,590 （5%） Deaths; 2,590 （8%） Defaulters. Under India＇s routine program conditions, Thrice-weekly regimen is ineffective. Too many （12.7%） patients come back sick, which may promote drug-resistance on industrial scale! A global threat!
