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Background: This is the first survey to use the World Health Organization (WHO) methodology to document the magnitude and main drivers of tuberculosis (TB) patient costs in order to guide policies on cost mitigation and to produce a baseline measure for the percentage of TB-affected households experiencing catastrophic costs in Myanmar. Methods: A nationally representative cross-sectional survey was administered to 1000 TB patients in health facilities from December 2015 to February 2016, focusing on costs of TB treatment (direct and indirect), household income, and coping strategies. A total cost was estimated for each household by extrapolating reported costs and comparing them to household income. If the proportion of total costs exceeded 20% of the annual household income, a TB-affected household was deemed to have faced catastrophic costs. Results: 60% of TB-affected households faced catastrophic costs in Myanmar. On average, total costs were USD 759, and the largest proportion of this total was accounted for by patient time (USD 365), followed by food costs (USD 200), and medical expenses (USD 130). Low household wealth quintile and undergoing MDR-TB treatment were both significant predictors for households facing catastrophic costs. Conclusions: The high proportion of TB-affected households experiencing catastrophic costs suggests the need for TB-specific social protection programs in patient-centered healthcare. The survey findings have led the government and donors to increase support for MDR-TB patients. The significant proportion of total spending attributable to lost income and food or nutritional supplements suggests that income replacement programs and/or food packages may ameliorate the burdensome costs.

The aim of this study was to develop appropriate autonomous learning materials of structure and written expression of TOEFL preparation for autonomous learners for the Centre for Language and Development of Yogyakarta State University based on the learning needs and target needs of the autonomous learners. The research was an educational research and development (R&D) adapting ADDIE model (Branch, 2009). Two instruments (questionnaire and test) for needs analysis and two instruments for validation were used. The data from the needs analysis and the material validation were analyzed quantitatively through descriptive statistics. The research findings revealed that the autonomous learning materials were appropriate in terms of input, learning activities, layout, design and organization. The learners’ role is to learn the materials individually and teacher's role is to be a guide and cooperator. All of the learning activities include reading of explanations of forms and functions, doing practices for forms and functions, multiple choice, and doing reflection. Every unit has the following organizing unit title, instructions for learners, grammatical form and functions, activities of forms, functions, and TOEFL tests items, online activities for further learning, learning essentials, reflection, self-test (TOEFL) and answer keys.

There is no published evidence on contact investigation among multidrug-resistant tuberculosis (MDR-TB) patients from Myanmar. We describe the cascade of contact investigation conducted in 27 townships of Myanmar from January 2018 to June 2019 and its implementation challenges. This was a mixed-methods study involving quantitative (cohort analysis of programme data) and qualitative components (thematic analysis of interviews of 8 contacts and 13 health care providers). There were 556 MDR-TB patients and 1908 contacts, of whom 1134 (59%) reached the health centres for screening (chest radiography and symptoms). Of the latter, 344 (30%) had presumptive TB and of them, 186 (54%) were investigated (sputum microscopy or Xpert MTB/RIF®). A total of 27 TB patients were diagnosed (six bacteriologically-confirmed including five with rifampicin resistance). The key reasons for not reaching township TB centres included lack of knowledge and lack of risk perception owing to wrong beliefs among contacts, financial constraints related to loss of wages and transportation charges, and inconvenient clinic hours. The reasons for not being investigated included inability to produce sputum, health care providers being unaware of or not agreeing to the investigation protocol, fixed clinic days and times, and charges for investigation. The National Tuberculosis Programme needs to note these findings and take necessary action.

SPSS is powerful to analyze business and marketing data. This paper intends to support business and marketing leaders the benefits of data forecasting with applied SPSS. It showed the sale quantity forecasting based on unit price and advertising. As SPSS's background algorithms, it showed the regression algorithm for data forecasting and ANOVA algorithm for data significant. It includes one sample data was downloaded from Google and was analyzed and viewed. It used IBM SPSS statistics version 23 and PYTHON version 3.7. Aung Cho | Aung Si Thu "Applied SPSS for Data Forecasting of Sale Quantity" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd26378.pdf

SPSS is powerful to analyze nurses data. This paper intends to support hospital leaders the benefits of data analyzing with applied SPSS. This paper intends to support the hospital managers and its office managers to know whether hourly salary depends upon nurse experiences and nurse types such as hospital nurse and office nurse. Moreover it analyzes the interesting deviation condition of hospital nurses and office nurses salaries. As SPSS's background algorithms, it showed the means algorithm for tables and graph. And then Sample data 'hourly wage data.sav' was downloaded from Google and was analyzed and viewed. It used IBM SPSS statistics version 23 and PYTHON version 3.7. Aung Cho | Aung Si Thu "Nurses Data Analysis by Applied SPSS" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd25329.pdf

SPSS is powerful to analyze employee data. This paper intends to support business leaders the benefits of data analyzing with applied SPSS. This paper shows whether facility rates is harmony on each employee rank or not. It showed the data analysis of employee facilities such as care, support, workplace, meaningful, salary and happiness given rates between 1 to 10. As SPSS's background algorithms, it showed the mean algorithm for the tables. And then Sample data 'bank clean.sav' was downloaded from Google free share and was analyzed and viewed. It used IBM SPSS statistics version 23 and PYTHON version 3.7. Aung Cho | Aung Si Thu "Employees Data Analysis by Applied SPSS" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd25213.pdf

SPSS is powerful to analyze data clustering and forecasting. This paper intends to support people who are interesting the species of flowers the benefits of data forecasting with applied SPSS. It showed the species value forecasting based on sepal length and sepal width. As SPSS's background algorithms, it showed the KNN algorithm for data clustering and data forecasting. It includes one sample data was downloaded from Google and was analyzed and viewed. It used IBM SPSS statistics version 23 and PYTHON version 3.7 Aung Cho | Aung Si Thu | Aye Mon Win "Applied SPSS for Data Forecasting of Flowers Species Name" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-5 , August 2019, URL: https://www.ijtsrd.com/papers/ijtsrd26665.pdf

Background: HIV-associated TB is a serious public health problem in Myanmar. Study objectives were to describe national scale-up of collaborative activities to reduce the double burden of TB and HIV from 2005 to 2016 and to describe TB treatment outcomes of individuals registered with HIV-associated TB in 2015 in the Mandalay Region. Methods: Secondary analysis of national aggregate data and, for treatment outcomes, a cohort study of patients with HIV-associated TB in the Mandalay Region. Results: The number of townships implementing collaborative activities increased from 7 to 330 by 2016. The number of registered TB patients increased from 1577 to 139 625 in 2016, with the number of individuals tested for HIV increasing from 432 to 114 180 (82%) in 2016: 10 971 (10%) were diagnosed as HIV positive. Uptake of co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) nationally in 2016 was 77% and 52%, respectively. In the Mandalay Region, treatment success was 77% and mortality was 18% in 815 HIV-associated TB patients. Risk factors for unfavourable outcomes and death were older age (≥45 years) and not taking CPT and/or ART. Conclusion: Myanmar is making good progress with reducing the HIV burden in TB patients, but better implementation is needed to reach 100% HIV testing and 100% CPT and ART uptake in TB-HIV co-infected patients.

Background The community-based MDR-TB care (CBMDR-TBC) project was implemented in 2015 by The Union in collaboration with national TB programme (NTP) in 33 townships of upper Myanmar to improve treatment outcomes among patients with MDR-TB registered under NTP. They received community-based support through the project staff, in addition to the routine domiciliary care provided by NTP staff. Each project township had a project nurse exclusively for MDR-TB and a community volunteer who provided evening directly observed therapy (in addition to morning directly observed therapy by NTP). Objectives To determine the effect of CBMDR-TBC project on death and unfavourable outcomes during the intensive phase of MDR-TB treatment. Methods In this cohort study involving record review, all patients diagnosed with MDR-TB between January 2015 and June 2016 in project townships and initiated on treatment till 31 Dec 2016 were included. CBMDR-TBC status was categorized as “receiving support” if project initiation in patient’s township was before treatment initiation, “receiving partial support” if project initiation was after treatment initiation, and “not receiving support” if project initiation was after intensive phase treatment outcome declaration. Time to event analysis (censored on 10 April 2017) and cox regression was done. Results Of 261 patients initiated on treatment, death and unfavourable outcomes were accounted for 13% and 21% among “receiving support (n = 163)”, 3% and 24% among “receiving partial support (n = 75)” and 13% and 26% among “not receiving support (n = 23)” respectively. After adjusting for other potential confounders, the association between CBMDR-TBC and unfavourable outcomes was not statistically significant. However, when compared to “not receiving support”, those “receiving support” and “receiving partial support” had 20% [aHR (0.95 CI: 0.8 (0.2–3.1)] and 90% lower hazard [aHR (0.95 CI: 0.1 (0.02–0.9)] of death, respectively. This was intriguing. Implementation of CBMDR-TBC coincided with implementation of decentralized MDR-TB centers at district level. Hence, patients that would have generally not accessed MDR-TB treatment before decentralization also started receiving treatment and were also included under CBMDR-TBC “received support” group. These patients could possibly be expected to sicker at treatment initiation than patients in other CBMDR-TBC groups. This could be the possible reason for nullifying the effect of CBMDR-TBC in “receiving support” group and therefore similar survival was found when compared to “not receiving support”. Conclusion CBMDR-TBC may prevent early deaths and has a scope for expansion to other townships of Myanmar and implications for NTPs globally. However, future studies should consider including data on extent of sickness at treatment initiation and patient level support received under CBMDR-TBC.