Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross...Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross-sectional study was conducted. Four hundred and seventy new smear positive TB patients above 14 years of age were consecutively recruited between October 1 and December 31 2012 from 34 (23 public and 11 private) directly observed treatment short course (DOTS) facilities that offered TB treatment and microscopy services. They were followed up till treatment was completed. Logistic regression was used to assess the predictors of treatment interruption. Results: A significantly higher proportion of smokers (58.6% vs 38.3%, p = 0.030), patients supervised by treatment supporters (44.4% vs 34.7%, p = 0.032), patients not counselled before initiation of treatment (55.6% vs 38.2%, p = 0.041), patients managed at private DOTS facilities (50% vs 36.3%, p = 0.010) and TB/HIV co-infected patients (54.2% vs 38.6%, p = 0.038) had treatment interruption. Predictors of treatment interruption were supervision by treatment supporters, smoking, lack of pre-treatment counselling and TB/HIV co-infection. Conclusion: A higher proportion of patients supervised by treatment supporters had treatment interruption than those supervised by health care workers. There may be a need to review the concept of treatment supervision by treatment supporters in Lagos state Nigeria.展开更多
<strong>Introduction:</strong> COVID-19 pandemic caught many HIV programs completely unprepared, leading to massive interruptions in HIV treatment. Fear and anxiety caused by another infectious and potenti...<strong>Introduction:</strong> COVID-19 pandemic caught many HIV programs completely unprepared, leading to massive interruptions in HIV treatment. Fear and anxiety caused by another infectious and potentially deadly virus kept many PLHIV away from accessing ART services. Besides, the COVID-19 control measures imposed by the Government of Uganda, such as restrictions on movement due to the ban on both private and public transport, shortened travel hours due to the curfew imposed from 7 p.m. local time and limited resources at The AIDS Support Organization (TASO) Mbale clinic further frustrated access to ART services. The actual burden of treatment interruption in Uganda remains unclear. As such, this paper provides the magnitude of treatment interruption in TASO Mbale clinic during the April-June 2020 quarter—the COVID-19 pandemic peak period in Uganda. <strong>Methodology: </strong>We analyzed secondary and routine program data for all PLHIV on scheduled appointment in the quarters of January-March 2020 and April 2020-June 2020. We abstracted data from Uganda Electronic Medical Records (EMR) and linked with that from TASO Management Information system to make one dataset. This was then exported for final analysis in STATA version 15.<strong> Results: </strong>Out of 6744 PLHIV scheduled on appointment during April-June 2020 quarter, 1710 (25.3%) individuals missed their appointments, with the facility-based clients more affected than community-based (56.1% vs 43.9%) (p < 0.001), individuals with up-to-date viral load (VL) status were less likely to miss their appointment (p < 0.001) while sex was not associated with missed appointment (p-value = 0.269). Overall, there was a 356% increase in rate of missed appointment compared with that of January-March 2020 quarter (25.3% vs 7.1%) before COVID-19 pandemic hit Uganda. Moreover, PLHIV who received six-month’s drug refills were less likely to miss their appointment (p < 0.001) compared to those who received less. <strong>Conclusions: </strong>The COVID-19 pandemic significantly disrupted provision of ART services, leading to increased rate of missed appointment from 7.1% in the pre-COVID-19 quarter to 25.3%.展开更多
文摘Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross-sectional study was conducted. Four hundred and seventy new smear positive TB patients above 14 years of age were consecutively recruited between October 1 and December 31 2012 from 34 (23 public and 11 private) directly observed treatment short course (DOTS) facilities that offered TB treatment and microscopy services. They were followed up till treatment was completed. Logistic regression was used to assess the predictors of treatment interruption. Results: A significantly higher proportion of smokers (58.6% vs 38.3%, p = 0.030), patients supervised by treatment supporters (44.4% vs 34.7%, p = 0.032), patients not counselled before initiation of treatment (55.6% vs 38.2%, p = 0.041), patients managed at private DOTS facilities (50% vs 36.3%, p = 0.010) and TB/HIV co-infected patients (54.2% vs 38.6%, p = 0.038) had treatment interruption. Predictors of treatment interruption were supervision by treatment supporters, smoking, lack of pre-treatment counselling and TB/HIV co-infection. Conclusion: A higher proportion of patients supervised by treatment supporters had treatment interruption than those supervised by health care workers. There may be a need to review the concept of treatment supervision by treatment supporters in Lagos state Nigeria.
文摘<strong>Introduction:</strong> COVID-19 pandemic caught many HIV programs completely unprepared, leading to massive interruptions in HIV treatment. Fear and anxiety caused by another infectious and potentially deadly virus kept many PLHIV away from accessing ART services. Besides, the COVID-19 control measures imposed by the Government of Uganda, such as restrictions on movement due to the ban on both private and public transport, shortened travel hours due to the curfew imposed from 7 p.m. local time and limited resources at The AIDS Support Organization (TASO) Mbale clinic further frustrated access to ART services. The actual burden of treatment interruption in Uganda remains unclear. As such, this paper provides the magnitude of treatment interruption in TASO Mbale clinic during the April-June 2020 quarter—the COVID-19 pandemic peak period in Uganda. <strong>Methodology: </strong>We analyzed secondary and routine program data for all PLHIV on scheduled appointment in the quarters of January-March 2020 and April 2020-June 2020. We abstracted data from Uganda Electronic Medical Records (EMR) and linked with that from TASO Management Information system to make one dataset. This was then exported for final analysis in STATA version 15.<strong> Results: </strong>Out of 6744 PLHIV scheduled on appointment during April-June 2020 quarter, 1710 (25.3%) individuals missed their appointments, with the facility-based clients more affected than community-based (56.1% vs 43.9%) (p < 0.001), individuals with up-to-date viral load (VL) status were less likely to miss their appointment (p < 0.001) while sex was not associated with missed appointment (p-value = 0.269). Overall, there was a 356% increase in rate of missed appointment compared with that of January-March 2020 quarter (25.3% vs 7.1%) before COVID-19 pandemic hit Uganda. Moreover, PLHIV who received six-month’s drug refills were less likely to miss their appointment (p < 0.001) compared to those who received less. <strong>Conclusions: </strong>The COVID-19 pandemic significantly disrupted provision of ART services, leading to increased rate of missed appointment from 7.1% in the pre-COVID-19 quarter to 25.3%.
