Search

Background & Objectives: This study was aimed to know the treatment outcome of category I tuberculosis patients under RNTCP in a tuberculosis unit of Ahmedabad Municipal Corporation. Method: It was a longitudinal (follow up) study conducted from January 2014 to October 2014 in Rakhiyal tuberculosis unit in Ahmadabad city. Total 187 patients of category I were studied. Data was collected using predesigned questionnaire by interviewing the patients thrice (1st visit on base line data second after completion of intensive phase and third after completion of continuation phase. Verbal consent was taken). Tools of study: Pre-designed questionnaire was prepared before study and two follow up visit were done at end of intensive phase first visit(at end of two month) and second at the end of continue phase (at end of six month). During study first of all basic demography profile was collected and verbal consent was taken from all patients and then all the participants were enrolled in this study. Result: The majority of study population was in reproductive age group (67.52%).The ratio of Pulmonary: Extra-pulmonary was 1.3:1.Almost half (48.12%) patients were new sputum smear positive (NSP), (43.32%) New extra-pulmonary and (8.56%) were new sputum smear negative. NSP (New sputum positive): NSN(New sputum negative) ratio was 5.6:1. In majority of patients (61.18%) DOTS was provided by TB Health workers. Sputum conversation rate was (75.56%) after two months. Majority (88.3%) completed the continuous phase. HIV coinfection was found 5.88%. Interpretation and conclusion: Study result showed that all the patients took treatment under the supervision whether in the presence of Community DOTS providers or Private practitioners and all the patients completed the intensive phase of the therapy. This reflects the responsible functioning of the healthcare providers to achieve the primary aim of the tuberculosis programme, which is to detect and cure infectious tuberculosis cases in order to reduce the transmission, morbidity and mortality. Overall sputum conversion rate (75.56%) which was low. The outcome indicates well within acceptable presence of RNTCP which reflect deep programme is being effectively implemented in Tuberculosis Unit. Increased switch over to MDR (4.81%) found in the study could be explained by HIV-TB co-infection and Diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Smoking and tuberculosis are the two major, global health problems. Not only active smokers but also passive smokers are at risk of becoming infected with tuberculosis. Through many mechanisms, smoking decreases immunity and predisposes to numerous infections. This has a negative impact on our health system. This knowledge of the association between smoking and tuberculosis can be utilized to develop a program for TB prevention and control.Method: This is a retrospective observational study carried out over a period of 18 months on 100 diagnosed cases of sputum smear-positive pulmonary tuberculosis patients undergoing treatment at Mumbai Maharashtra India as a part of the Revised National Tuberculosis Control Program (RNTCP).Results: 1+ sputum positivity was observed in a higher number of nonsmokers (77%) followed by ex-smokers (43%) and smokers (2%), 2 3+ sputum positivity was observed in a higher number of smokers (63% and 35%, respectively) followed by ex-smokers (29%) and nonsmokers (18% and 5%, respectively). Conclusion: Smokers demonstrated extensive infiltrates as compared to nonsmokers. Additionally, as the severity of smoking increased (smoking index), and the bacterial load also increased (higher grades of sputum positivity). Smokers also had poorer treatment outcomes than did nonsmokers.

Tuberculosis (TB) is a major worldwide health problem, particularly in India, where it accounts for a quarter of infections. Adherence to the directly observed treatment, short-course (DOTS), which is necessary for TB treatment, is difficult in resource-limited circumstances. This study addressed the knowledge, attitude, and perceived barriers related to TB and DOTS adherence among patients and caregivers. A cross-sectional survey was undertaken at the selected TB clinics between November 2023 and March 2024. Purposive sample yielded 180 patients and 217 caregivers. Data were obtained using validated, self-structured questionnaires that assessed knowledge, attitude, and perceived barriers to TB and DOTS adherence. Statistical analysis was carried out with IBM SPSS version 23.0. The study found that caregivers had considerably greater TB knowledge than patients (p

Abstract Background Engagement of healthcare providers is one of the World Health Organization strategies devised for prevention and provision of patient centered care for multidrug resistant tuberculosis. The need for current research question rose because of the gaps in evidence on health professional’s engagement and its factors in multidrug resistant tuberculosis service delivery as per the protocol in the prevention and management of multidrug resistant tuberculosis. Purpose The purpose of this study was to explore the level of health care providers’ engagement in multidrug resistant tuberculosis prevention and management and influencing factors in Hadiya Zone health facilities, Southern Ethiopia. Methods Descriptive phenomenological qualitative study design was employed between 02 May and 09 May, 2019. We conducted a key informant interview and focus group discussions using purposely selected healthcare experts working as directly observed treatment short course providers in multidrug resistant tuberculosis treatment initiation centers, program managers, and focal persons. Verbatim transcripts were translated to English and exported to open code 4.02 for line-by-line coding and categorization of meanings into same emergent themes. Thematic analysis was conducted based on predefined themes for multidrug resistant tuberculosis prevention and management and core findings under each theme were supported by domain summaries in our final interpretation of the results. To maintain the rigors, Lincoln and Guba’s parallel quality criteria of trustworthiness was used particularly, credibility, dependability, transferability, confirmability and reflexivity. Results Total of 26 service providers, program managers, and focal persons were participated through four focus group discussion and five key informant interviews. The study explored factors for engagement of health care providers in the prevention and management of multidrug resistant tuberculosis in five emergent themes such as patients’ causes, perceived susceptibility, seeking support, professional incompetence and poor linkage of the health care facilities. Our findings also suggest that service providers require additional training, particularly in programmatic management of drug-resistant tuberculosis. Conclusion The study explored five emergent themes: patient’s underlying causes, seeking support, perceived susceptibility, professionals’ incompetence and health facilities poor linkage. Community awareness creation to avoid fear of discrimination through provision of support for those with multidrug resistant tuberculosis is expected from health care providers using social behavioral change communication strategies. Furthermore, program managers need to follow the recommendations of World Health Organization for engaging healthcare professionals in the prevention and management of multidrug resistant tuberculosis and cascade trainings in clinical programmatic management of the disease for healthcare professionals.

Objective Tuberculosis is a global health challenge with one-third of the world’s population infected by it. Although ocular side effects of Anti-tubercular drugs are well known, the patients generally report late in the course which can result in irreversible vision loss. The purpose of this study was to study the visual field changes during the time course of anti-tubercular therapy (ATT). Methods A total of 48 patients were studied in this prospective type of study. All patients newly diagnosed with TB and started on treatment were included in the study. Baseline examination which included visual acuity, color vision, anterior segment, IOP, Amsler grid, fundus, and visual field test were performed before starting ATT and at 6-month follow-up. Results The mean age of the study population was 35.90 ± 10.2 years. 35 (72.9%) were males and 13 (27.1%) females. 32(66.6%) had pulmonary TB and the rest 16 (33.3%) had extrapulmonary TB. MDR TB was diagnosed in 27 (56.3%) of the patients with the rest 21 (43.8%) being drug sensitive. The baseline examination was normal in all 48 patients. 3(6.3%) out of 45 patients presented with visual complaints after the treatment initiation. Altogether 7 patients out of 48, had visual field defects at the 6-month follow-up. The incidence of visual field defects in our study was 14.6% with the value being significant (0.016). 8.3% had peripheral constriction of visual fields, 2.1% with Severe generalized depression of visual fields and 2.1% with central scotoma. Out of the 45 patients with no visual complaints at 6-month follow-up, 4 (8.33%) showed peripheral field constriction. Conclusion Visual field defects caused by ATT can precede clinical symptoms. Visual field evaluation can be an important tool for the early detection of optic neuropathy in patients receiving ATT in clinical settings where Visual evoked potential testing and RNFL-OCT are not available.

Objective Tuberculosis is a global health challenge with one-third of the world’s population infected by it. Although ocular side effects of Anti-tubercular drugs are well known, the patients generally report late in the course which can result in irreversible vision loss. The purpose of this study was to study the visual field changes during the time course of anti-tubercular therapy (ATT). Methods A total of 48 patients were studied in this prospective type of study. All patients newly diagnosed with TB and started on treatment were included in the study. Baseline examination which included visual acuity, color vision, anterior segment, IOP, Amsler grid, fundus, and visual field test were performed before starting ATT and at 6-month follow-up. Results The mean age of the study population was 35.90 ± 10.2 years. 35 (72.9%) were males and 13 (27.1%) females. 32(66.6%) had pulmonary TB and the rest 16 (33.3%) had extrapulmonary TB. MDR TB was diagnosed in 27 (56.3%) of the patients with the rest 21 (43.8%) being drug sensitive. The baseline examination was normal in all 48 patients. 3(6.3%) out of 45 patients presented with visual complaints after the treatment initiation. Altogether 7 patients out of 48, had visual field defects at the 6-month follow-up. The incidence of visual field defects in our study was 14.6% with the value being significant (0.016). 8.3% had peripheral constriction of visual fields, 2.1% with Severe generalized depression of visual fields and 2.1% with central scotoma. Out of the 45 patients with no visual complaints at 6-month follow-up, 4 (8.33%) showed peripheral field constriction. Conclusion Visual field defects caused by ATT can precede clinical symptoms. Visual field evaluation can be an important tool for the early detection of optic neuropathy in patients receiving ATT in clinical settings where Visual evoked potential testing and RNFL-OCT are not available.

Background: Engagement of healthcare providers is one of the World Health Organization strategies devised for prevention and provision of patient centered care for multidrug resistant tuberculosis. The need for current research question rose because of the gaps in evidence on health professional's engagement and its factors in multidrug resistant tuberculosis service delivery as per the protocol in the prevention and management of multidrug resistant tuberculosis. Purpose: The purpose of this study was to explore the level of health care providers' engagement in multidrug resistant tuberculosis prevention and management and influencing factors in Hadiya Zone health facilities, Southern Ethiopia. Methods: Descriptive phenomenological qualitative study design was employed between 02 May and 09 May, 2019. We conducted a key informant interview and focus group discussions using purposely selected healthcare experts working as directly observed treatment short course providers in multidrug resistant tuberculosis treatment initiation centers, program managers, and focal persons. Verbatim transcripts were translated to English and exported to open code 4.02 for line-by-line coding and categorization of meanings into same emergent themes. Thematic analysis was conducted based on predefined themes for multidrug resistant tuberculosis prevention and management and core findings under each theme were supported by domain summaries in our final interpretation of the results. To maintain the rigors, Lincoln and Guba's parallel quality criteria of trustworthiness was used particularly, credibility, dependability, transferability, confirmability and reflexivity. Results: Total of 26 service providers, program managers, and focal persons were participated through four focus group discussion and five key informant interviews. The study explored factors for engagement of health care providers in the prevention and management of multidrug resistant tuberculosis in five emergent themes such as patients' causes, perceived susceptibility, seeking support, professional incompetence and poor linkage of the health care facilities. Our findings also suggest that service providers require additional training, particularly in programmatic management of drug-resistant tuberculosis. Conclusion: The study explored five emergent themes: patient's underlying causes, seeking support, perceived susceptibility, professionals' incompetence and health facilities poor linkage. Community awareness creation to avoid fear of discrimination through provision of support for those with multidrug resistant tuberculosis is expected from health care providers using social behavioral change communication strategies. Furthermore, program managers need to follow the recommendations of World Health Organization for engaging healthcare professionals in the prevention and management of multidrug resistant tuberculosis and cascade trainings in clinical programmatic management of the disease for healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a disease that is a public health priority, because it was the leading infectious disease killer before COVID-19 which caused more than 1.4 million deaths in 2019. Non-compliance of TB patients to undergo regular treatment can be an obstacle in achieving a cure rate. and high treatment success. This study aimed to analyze the effect of the Health Belief Model application on Direct Observed Treatment Short-Course (DOTS) treatment adherence for Tuberculosis in Karanganyar Regency. Subjects and Method: Cross-sectional study was conducted in Karanganyar, Central Java, Indonesia. The study population was Tuberculosis patients undergoing Direct Observed Short-Course Treatment. A total of 200 Tuberculosis Patients undergoing DOTS was selected using purposive sampling. The dependent variable was DOTS compliance. The independent variable was construct of health belief model. Data were collected using a questionnaire and analyzed using a multiple logistic regression. Results: Perceived threat (b= 0.20; 95% CI= 0.06 to 0.35; p= 0.007), perceived benefit (b= 0.31; 95% CI= 0.14 - 0.49; p= 0.001), and self-efficacy (b= 0.24; 95% CI= 0.13 to 0.36; p< 0.001) significantly increased TB-DOTS compliance. Perceived barrier significantly decreased TB-DOTS compliance (b= -0.21; 95% CI= -0.31 to -0.11; p< 0.001). Conclusion: Perceived threat, perceived benefit, and self-efficacy significantly increase TB-DOTS compliance. Perceived barrier significantly decreases TB-DOTS compliance. [ABSTRACT FROM AUTHOR]

ABSTRACT The host immune responses play a pivotal role in the establishment of long-term memory responses, which effectively aids in infection clearance. However, the prevailing anti-tuberculosis therapy, while aiming to combat tuberculosis (TB), also debilitates innate and adaptive immune components of the host. In this study, we explored how the front-line anti-TB drugs impact the host immune cells by modulating multiple signaling pathways and subsequently leading to disease relapse. Administration of these drugs led to a reduction in innate immune activation and also the cytokines required to trigger protective T cell responses. Moreover, these drugs led to activation-induced cell death in the mycobacterial-specific T cell leading to a reduced killing capacity. Furthermore, these drugs stalled the T cell differentiation into memory subsets by modulating the activation of STAT3, STAT4, FOXO1, and NFκB transcription factors and hampering the Th1 and Th17-mediated long-term host protective memory responses. These findings suggest the urgent need to augment directly observed treatment, short-course (DOTS) therapy with immunomodulatory agents to mitigate the adverse effects linked to the treatment.IMPORTANCEAs a central component of TB eradication initiatives, directly observed treatment, short-course (DOTS) therapy imparts immune-dampening effects during the course of treatment. This approach undermines the host immune system by delaying the activation process and lowering the immune response. In our investigation, we have unveiled the impact of DOTS on specific immune cell populations. Notably, the signaling pathways involving STAT3 and STAT4 critical for memory responses and NFκβ associated with pro-inflammation were substantially declined due to the therapy. Consequently, these drugs exhibit limited effectiveness in preventing recurrence of the disease. These observations highlight the imperative integration of immunomodulators to manage TB infection.

Iwan Shalahuddin,1 Sandra Pebrianti,2 Theresia Eriyani,3 Indra Maulana4 1Department of Community of Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia; 2Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia; 3Department of Basic Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia; 4Department of Psychiatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, IndonesiaCorrespondence: Indra Maulana, Department of Psychiatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Ir. Soekarno KM. 21, Hegarmanah, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel/Fax +62 (022) 7795596, Email keperawatan@unpad.ac.id; indra.maulana@unpad.ac.idAbstract: Management of care for people with Pulmonary TB at home using Information and Communication Technology (ICT) tools and innovative approaches, such as tools for telecommunications online education. In the nursing sector, the use of telecommunications is called telenursing. The purpose of this study is to determine the types of telecommunications-based interventions, especially telenursing, in monitoring the level of treatment adherence in patients with pulmonary TB. This study used a scoping review method approach to determine the type of telecommunications-based interventions, especially telenursing, in monitoring the level of treatment adherence in patients with pulmonary TB. Literature distribution using several sources, namely EBSCOhost, Scopus (Elsevier), and PubMed. To facilitate obtaining appropriate literature, PICO techniques are used in conducting literature searches, P (population/problem/patient), I (intervention, prognostic factor, exposure), C (comparison, control), and O (outcome). Keywords used in English “Tuberculosis OR Pulmonary Tuberculosis AND Telehealth OR Telehealth Nursing AND Medication Adherence OR Medication Compliance OR Behavior”. In total from the 13 articles obtained, the articles used several telehealth to pulmonary TB patients with various implementations, such as the Directly Observed Therapy, Short Course (DOTS) (n = 7). These four implementations have the same goal and support adherence to taking medication and daily recovery in pulmonary TB patients. Overall characteristics of pulmonary TB patients in the reviewed articles are pediatric TB patients (0– 14 years), adult TB (18– 30 years). A total of 9 studies used a sample population of adult TB patients (18– 30 years), TB undergoing Directly Observed Treatment Short-course (DOTS), TB receiving medical care and TB patients actively receiving treatment. The most influential effectiveness of telehealth in helping the treatment process of Pulmonary TB patients is Directly Observed Treatment Short-course (DOTS) because the main focus of the DOTS strategy is patient discovery and cure, priority is given to infectious TB patients without ruling out other types of TB.Keywords: effectiveness, intervention, pulmonary tuberculosis, telenursing, DOTS

The study investigated the utilization of digital library services for blended learning by students in library schools in Rivers State, Nigeria. Three (3) objectives and hypotheses guided the conduct of the study. The study adopted a descriptive survey design with a sample size of 420 students from the faculty of education selected by random sampling. The study was guided by three research questions and three null hypotheses, which were tested at the 0.05 α-level of significance. A questionnaire of 15 items was used to collect data, while a Cronbach Alpha reliability coefficient value of 0.84 was estimated for the instrument. The research questions were determined by mean and standard deviation, and the hypothesis was tested by linear regression statistics. The study found a positive relationship between OPAC and blended learning among students at Rivers State University. Also, it was revealed that there exists a positive relationship between digital reference and blended learning among students. It was further found that there is a positive relationship between internet-based users' education and blended learning among students. The study therefore recommends that the university management should make an effort to upgrade and enhance the digital library system to be more beneficial to students, the institution should organize training workshops and seminars at least once a semester for the students to enable them to effectively utilize and benefit from digital library services and blended learning and the library management should provide a feedback system that can reveal users' responses to the performance of each digital library service and their level of satisfaction. [ABSTRACT FROM AUTHOR]

The distinctive squared dots in Principia Mathematica have two uses, to replace parentheses or brackets to indicate the scope of connectives and operators as well as to symbolize the sentential connective "and". The explanation of the use of dots in the Introduction shows that the punctuation dots express conjunction by symbolizing the juxtaposition of formulas, following Peano, and so they are always used as punctuation. This paper thus supports Turing's assertion that conjunction in Principia is expressed by juxtaposition. This analysis avoids Curry's proposal that an "auxiliary" connective for conjunction should be involved in interpreting the dot notation. [ABSTRACT FROM AUTHOR]

Background: The Directly Observed Treatment Short Course (DOTS) is a well-established and cost-effective strategy for treating Tuberculosis. It efficiently transforms infectious cases into noninfectious ones, effectively interrupting the transmission cycle of the disease. Objectives: Measure the treatment outcomes in TB patients during 2016-2020, describe the socio-demographic and clinical profile of TB patients and evaluate the performance of the National TB program in Babil governorate based on WHO indicators. Methods: A descriptive cross-sectional study was done. All TB patients in the NTP Center of Babil governorate under the DOTS program from 2016 to 2020 were included. A form was developed to compile socio-demographic data, clinical presentation, and treatment outcomes. Results: A total number of cases was 1723. The mean age was 40.0 (± 21.0) years. The female constituted 53.8% of cases. The patients aged ≥ 65 years had the highest percentage of total cases 279 (16.2%). Pulmonary tuberculosis (PTB) constituted 56.1% of the cases 50.5% of them had smear-positive. The most common site for extrapulmonary tuberculosis (EPTB) was lymph nodes 41.1%. Treatment success was attained in 93.7%, while 3.3% of patients dead. The patients aged ≥ 65 years have the lowest success rate and highest treatment unsuccess rate opposite to young age groups (p 0.002). Conclusion: The treatment outcome target planned by WHO was achieved. The case detection rate of all form was low. The age and the site of TB significantly affected the outcome of treatment. [ABSTRACT FROM AUTHOR]

Derege Teka,1 Sahilu Assegid,1 Jemal Ahmed,2 Adera Debella,3 Eyobel Amentie,4 Girma Wami,4 Addis Eyeberu3 1School of Public Health, Department of Epidemiology, Jimma University, Jimma, Ethiopia; 2School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Addis Eyeberu, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, 138, Dire Dawa, Harar, Ethiopia, Tel +251 910005436, Email addiseyeberu@gmail.comBackground: Even though Ethiopia’s Federal Ministry of Health has been implementing several programs aimed at reducing the burden of tuberculosis (TB), It does not demonstrate adequate progress. As a result, identifying the determinants of unsuccessful outcomes of directly observed treatment, short-course (DOTS) is critical.Purpose: This study aimed to assess the determinants of unsuccessful TB treatment outcomes among patients with DOTS in Jimma town, southwest Ethiopia.Patients and Methods: An unmatched case-control study using secondary data was conducted among 118 cases and 472 controls from April 1 to June 1, 2021. Cases were TB cases with unsuccessful treatment courses whereas controls were those of successful treatment. Data were collected using a standardized tool. Statistical analysis was done using SPSS version 23 software. A binary logistic regression model was used to identify the determinants.Results: We found that the determinants including age > 35 years (AOR=1.9, 95% CI: 1.14– 3.2), lack of contact person (AOR= 27, 95% CI: 15.8– 46.3), being HIV positive (AOR=7.3, 95% CI: 3.7– 14.2)), and being malnourished (AOR=4.5, 95% CI: 1.5– 12.9) were significantly associated with unsuccessful tuberculosis treatment outcome.Conclusion: In this study, advanced age, being HIV positive, lack of contact person, and being malnourished were determinant factors for unsuccessful TB treatment outcomes. Hence, careful monitoring, screening, and management of risk factors are recommended.Keywords: unsuccessful treatment outcome, TB, DOTS, southwest Ethiopia

Background: One of the major health concerns reported in the Indian subjects is Tuberculosis which also poses a high burden on the economic and social status of India along with the healthcare sector. With the implementation of DOTS and other treatment strategies, there is control in India for tuberculosis. However, one of the major drawbacks associated with anti-tubercular drugs is hepatotoxicity. Aims: The present clinical study was conducted to assess the hepatotoxicity frequency in subjects taking anti-tubercular drugs and to assess the methods, risk factors, and predictive factors in subjects developing hepatotoxicity with anti-tubercular drugs. Methods: The present prospective clinical study screened 140 subjects, and 120 subjects were finally included in the study as 5 subjects died due to hepatic and extra-hepatic reasons and 15 did not turn for follow-up. The data was collected for hepatotoxicity and were analyzed for the formulation of the result. Results: Among 120 study subjects, antituberculosis drug-induced hepatotoxicity (AIH) was seen in 3.33% (n=4) study subjects where there were 2.5% (n=3) males and 0.83% (n=1) females with antituberculosis drug-induced hepatotoxicity (AIH). In the age range, 2.5% (n=3) subjects were in the age range of 20-39 years and 0.83% (n=1) subjects in the age range of 40-59 years. All 4 study subjects with antituberculosis drug-induced hepatotoxicity (AIH) were in the BMI range of <18. On assessing the clinical features in the study subjects, nausea was seen in 5 study subjects had nausea where 80% (n=4) subjects had AIH, 4 subjects had vomiting where 75% (n=3) subjects had AIH, 2 subjects had ascites where 100% (n=1) had AIH, 5 subjects had jaundice where 80% (n=4) had AIH, 1 subject had edema where 100% (n=1) had AIH along with edema, 1 subject had encephalopathy where 100% (n=1) subject had AIH and encephalopathy both, and 1 subject had coagulopathy where all 100% (n=1) had coagulopathy with AIH. Conclusion: The present study concludes that a low prevalence of hepatotoxicity is seen in subjects with tuberculosis, and hence, RNTCP and DOTS can be successfully implemented in subjects with tuberculosis without restricting much for hepatotoxicity. [ABSTRACT FROM AUTHOR]

Background Tuberculosis (TB) is well-known for causing wasting. Patients on treatment gain weight and weight loss is associated with unfavorable treatment outcomes. There is limited description of weight loss and its predictors during intensive treatment phase. The objective of this study was to assess the predictors of weight loss during intensive phase and to see if there is any association exists with sputum conversion at the end of intensive phase of treatment. Methods Data collected as a part of the prospective TB cohort (Regional Prospective Observational Research for TB India Phase 1) conducted in Pondicherry, Cuddalore and Viluppuram districts of Tamil Nadu were used for this study. Sputum smear and body weight comparison were made in the baseline and at the end of second month of treatment. Results In all, 726 participants had weight measurements at the two time points and 18.7% had weight loss; mean weight lost being 2.3 kg (SD 3.05). Mean weight loss was more among males (2.4 kg, SD 3.2), diabetics (2.8 kg, SD 3.9) and alcoholics (2.1 kg, SD 2.4). Alcohol consumption was the only predictor of weight loss after adjusting for age, diabetes, marital status and BMI (aRR 1.52, P 0.02). Weight loss was not associated with sputum conversion at the end of second month. Conclusions Alcohol use emerged as the major predictor for weight loss during intensive phase. [ABSTRACT FROM AUTHOR]

Abstract Background Tuberculosis (TB) is among the leading causes of death globally. The disease has a huge burden in Namibia, with a case notification rate of at least 442 per 100,000. To date, Namibia is among the countries with the highest global TB burden, despite all efforts to reduce it. This study aimed to determine the factors associated with the unsuccessful treatment outcomes of the Directly Observed Therapy Short course (DOTS) programme in the Kunene and Oshana regions. Methods The study utilised a mixed-methods explanatory-sequential design to collect data from all TB patient records and healthcare workers who work directly with the DOTS strategy for TB patients. The relationship between independent and dependent variables was analysed using multiple logistic regression analysis, while interviews were analysed using inductive thematic analysis. Results The overall treatment success rates of the Kunene and Oshana regions throughout the review period were 50.6% and 49.4%, respectively. The logistic regression analyses showed that in the Kunene region, the type of DOT used (Community-based DOTS) (aOR = 0.356, 95% CI: 0.835–2.768, p = 0.006) was statistically significant with the unsuccessful treatment outcomes. While in the Oshana region, age groups 21–30 years old (aOR = 1.643, 95% CI = 1.005–2.686, p = 0.048), 31–40 years old (aOR = 1.725, 95% CI = 11.026–2.9, p = 0.040), 41–50 years old (aOR = 2.003, 95% CI = 1.155–3.476, p = 0.013) and 51–60 years old (aOR = 2.106, 95% CI = 1.228–3.612, p = 0.007) had statistically significant associations with the poor TB-TO. Inductive thematic analysis revealed that patients in the Kunene region were challenging to reach owing to their nomadic lifestyle and the vastness of the area, adversely affecting their ability to observe TB therapy directly. In the Oshana region, it was found that stigma and poor TB awareness among adult patients, as well as mixing anti-TB medication with alcohol and tobacco products among adult patients, was a prevalent issue affecting TB therapy. Conclusion The study recommends that regional health directorates embark on rigorous community health education about TB treatment and risk factors and establish a robust patient observation and monitoring system to enhance inclusive access to all health services and ensure treatment adherence.

Because of their prospective applications and exceptional features, graphene quantum dots (GQDs) have gotten a lot of recognition as a new class of fluorescent carbon materials. One of the carbon family’s newest superstars is the GQD. Due to its exceptional optoelectrical qualities, it has sparked a lot of curiosity since its debut in 2008. Two of the most important traits are a band gap that is not zero, biocompatibility, and highly changeable characteristics. GQDs have several important characteristics. GQDs have shown potential in a variety of fields, for instance, catalysis, sensing, energy devices, drug delivery, bioimaging, photothermal, and photodynamic therapy. Because this area constantly evolves, it is vital to recognize emerging GQD concerns in the current breakthroughs, primarily since some specific uses and developments in the case of GQDs synthesis have not been thoroughly investigated through previous studies. The current results in the properties, synthesis, as well as benefits of GQDs are discussed in this review study. As per the findings of this research, the GQD’s future investigation is boundless, mainly if the approaching investigation focuses on purifying simplicity and environmentally friendly synthesis, as well as boosting photoluminescence quantum output and manufacturing output of GQDs.

Lea Mediatrix Y Janwarin, Joan Herly Herwawan, Fandro Armando Tasijawa Faculty of Health, Universitas Kristen Indonesia Maluku, Ambon, Maluku Province, IndonesiaCorrespondence: Fandro Armando Tasijawa, Faculty of Health, Universitas Kristen Indonesia Maluku, Ambon, Maluku Province, Indonesia, Email fandrotasidjawa@gmail.com

Carbon-based nanoparticles (CNPs) have demonstrated great potential in biomedical applications because of their unique physical and chemical properties, and excellent biocompatibility. Herein, we have studied two types of CNPs with gadolinium (Gd) impurities (Gd-CNPs), which were prepared by microwave synthesis (MWS) and hydrothermal synthesis (HTS), for potential applications as photoluminescent (PL) labels and contrast agents in magnetic resonance imaging (MRI). The prepared Gd-CNPs were investigated by means of transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy, UV–visible absorption spectroscopy, and magnetic-resonance relaxometry, which allowed us to reveal specific features and functional properties of the prepared samples. While the TEM data showed similar size distributions of both types of Gd-CNPs with mean sizes of 4–5 nm, the optical absorption spectroscopy showed higher absorption in the visible spectral region and stronger PL in the red and near-infrared (NIR) spectral regions for the MWS samples in comparison with those prepared by HTS. Under green light excitation the former samples exhibited the bright red-NIR PL with quantum efficiency of the order of 10%. The proton relaxometry measurements demonstrated that the HTS samples possessed longitudinal and transverse relaxivities of about 42 and 70 mM−1s−1, whereas the corresponding values for the MWS samples were about 8 and 13 mM−1s−1, respectively. The obtained results can be useful for the selection of appropriate synthesis conditions for carbon-based nanoparticles for bimodal bioimaging applications. [ABSTRACT FROM AUTHOR]

Introduction: A control programme termed Directly Observed Treatment Short-Course (DOTS) is adopted to promote early TB detection and effective TB treatment. An indicator of a successful DOTS programme is the Sputum Conversion Rate (SCR) which is obtained at the end of the two-month intensive treatment to measure the treatment outcome by SCR. The present study determined the association between several factors and the SCR among TB patients attending the DOTS clinic at the Kinta District Health Office (PKD Kinta) in 2017. Methods: The factors included are sociodemographic factors, physical factors, knowledge, attitude, and practice of TB patients. All groups of 150 sputum smear positive pulmonary TB patients enrolled for treatment at PKD Kinta between January and September 2017 were recruited for this study by the cross-sectional questionnaire method. A statistical analysis was performed to determine the association between the variables and the SCR of the TB patients in the DOTS programme. Results: At the end of the two-month intensive period, an SCR of 96.0% was obtained. According to the statistical analysis of the association among sociodemographic factors and SCR, there are no statistical differences between the variables. Similarly, no association was found between the physical characteristics and SCR in the current study. Conclusion: SCR methods are perfect methods used in regular medicine to monitor TB cases' treatment. The identification of factors influencing the DOTS programme is critical to ensuring the program's success in eradicating TB in society. [ABSTRACT FROM AUTHOR]

Mycobacterium tuberculosis causing the infectious disease tuberculosis has a predilection for the lungs although it is common to see other organs involved. India has adopted the TB-DOTS program for the treatment of the same. Undernutrition and tuberculosis are mutually inclusive. Micronutrients like zinc and copper play a key role in cytokine kinetics and immunity and thus are important in an individual's response to infectious disease. Serum copper and zinc levels in patients with pulmonary tuberculosis (pTB) before and after two months of directly observed treatment short course (DOTS) were assessed in this study. The serum samples of 39 pTB patients were collected before the commencement of anti-tubercular therapy (ATT) and tested for copper and zinc levels. At the end of the intensive phase of treatment, blood samples of 31 out of the 39 pTB patients were again collected and tested for the same trace elements. In the pre-post comparison of 31 patients who could be followed up, an increase in serum zinc levels [101 (74.9) µg/dl vs 112(155.5) µg/dl)] after the treatment was not statistically significant (p=0.15). The serum copper levels [184(105.7) µg/dl vs 247(80.8) µg/dl)] were significantly (p<0.01) increased after two months of DOTS therapy. Sputum negativity was close to 81%.Serum copper, as well as zinc levels, were increased after DOTS therapy for two months. Since the response to therapy was 69%, supplementation of copper and zinc may benefit the pTB patients in achieving sputum negativity sooner and completely. [ABSTRACT FROM AUTHOR]

BACKGROUND: Major adverse drug reactions (ADRs) can cause significant morbidity and can compromise the treatment regimen. This can result in substantial additional cost due to added outpatient visits to the health facility or laboratory investigations or hospitalization in serious instances. Treatment is often prolonged with additional challenge of compliance. Hence, there is a need to monitor and manage these ADRs timely for better patient care and outcome. This study was carried out with the objective of studying the pattern of ADRs due to first-line antitubercular drugs and to carry out the causality and severity assessment of the reported ADRs. METHODOLOGY: A prospective observational study was conducted at four DOTS centers. All tuberculosis (TB) patients registered and receiving treatment under DOTS were enrolled for the study and were followed up at regular intervals till the end of their treatment. Patients' demographic, personal, disease, investigation, and ADRs details were entered in a predesigned patient recording form. Causality assessment of all ADRs were done using Naranjo algorithm. Severity assessment was done using modified Hartwig and Siegel scale. The study was approved by the institutional ethics committee of the institute. Statistical analysis was conducted using IBM SPSS Statistics for Windows. RESULTS: Of 186 patients, 23 patients (12.26%) developed one or more ADRs. The average number of ADRs per person was 1.43. Majority of the ADRs were reported in the 20–40 years of age group and ADRs were more likely to be among females compared to males. There was no association between type of TB, site of TB, regimen of anti-TB drugs, treatment outcomes, and ADRs. Around 84.85% and 15.15% of ADRs were classified as of mild and moderate severity, respectively, as per modified Hartwig and Siegel scale, while, as per Naranjo algorithm, 72.73% of the ADRs were classified as probable and 27.27% of ADRs as possible. No ADRs were classified as definite. CONCLUSION: Thorough understanding of the various ADRs and their management will help in the effective treatment of TB as well as designing effective counseling methods, which will help in adherence to treatment and also to have better compliance.

Background: Tuberculosis (TB) is among the leading causes of death globally. The disease has a huge burden in Namibia, with a case notification rate of at least 442 per 100,000. To date, Namibia is among the countries with the highest global TB burden, despite all efforts to reduce it. This study aimed to determine the factors associated with the unsuccessful treatment outcomes of the Directly Observed Therapy Short course (DOTS) programme in the Kunene and Oshana regions. Methods: The study utilised a mixed-methods explanatory-sequential design to collect data from all TB patient records and healthcare workers who work directly with the DOTS strategy for TB patients. The relationship between independent and dependent variables was analysed using multiple logistic regression analysis, while interviews were analysed using inductive thematic analysis. Results: The overall treatment success rates of the Kunene and Oshana regions throughout the review period were 50.6% and 49.4%, respectively. The logistic regression analyses showed that in the Kunene region, the type of DOT used (Community-based DOTS) (aOR = 0.356, 95% CI: 0.835–2.768, p = 0.006) was statistically significant with the unsuccessful treatment outcomes. While in the Oshana region, age groups 21–30 years old (aOR = 1.643, 95% CI = 1.005–2.686, p = 0.048), 31–40 years old (aOR = 1.725, 95% CI = 11.026–2.9, p = 0.040), 41–50 years old (aOR = 2.003, 95% CI = 1.155–3.476, p = 0.013) and 51–60 years old (aOR = 2.106, 95% CI = 1.228–3.612, p = 0.007) had statistically significant associations with the poor TB-TO. Inductive thematic analysis revealed that patients in the Kunene region were challenging to reach owing to their nomadic lifestyle and the vastness of the area, adversely affecting their ability to observe TB therapy directly. In the Oshana region, it was found that stigma and poor TB awareness among adult patients, as well as mixing anti-TB medication with alcohol and tobacco products among adult patients, was a prevalent issue affecting TB therapy. Conclusion: The study recommends that regional health directorates embark on rigorous community health education about TB treatment and risk factors and establish a robust patient observation and monitoring system to enhance inclusive access to all health services and ensure treatment adherence. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) control activities are implemented in the country for more than 50 years. The countrywide lockdown in 2020 adversely impacted routine health-care services including those for the management of TB. Operational research is needed to know whether Revised National Tuberculosis Control Program (RNTCP) (National Tuberculosis Elimination Program) is heading in the right direction as far as the pace and quality of implementation of the program are concerned. Aims and Objectives: The aim of the present study was to investigate the strength, weaknesses, and opportunities of RNTCP. An analysis of RNTCP was done to identify competencies and gaps. Materials and Methods: The present retroprospective and observational study was carried out at the RNTCP facility of a Government Medical College in the Central India in Madhya Pradesh during the year 2019–20. Samples of 238 patients registered under RNTCP for anti-tubercular treatment were taken in the study. Data were collected using a structured schedule from the RNTCP center and tabulated in a Microsoft Excel sheet, to assess the compliance of RNTCP norms in the management of TB. Results: The most commonly affected age was 16–49 years and the male: female ratio was 3:2. The most common basis of diagnosis was microbiological (60.92%). Follow-up sputum testing was done on time in 64.71% of patients. Adherence to anti-tubercular treatment (ATT) was regular in 78.57% of patients. All patients were telephoned while 43.14% of patients were home visited as a default action. After default action, 35.29% of patients return to regular ATT. Out of all registered patients initiated on ATT, 81.09% were treatment success, while 7.14% lost to follow-up, 2.1% became defaulters, and 4.62% patients died. Conclusion: We conclude that treatment success of TB unit was near the RNTCP norm of 85% which is below the national 88%. The probable reasons for the higher default rate and loss to follow-up rate during the study period could be the ongoing COVID-19 pandemic.

Background: Tuberculosis (TB) is a major public health problem worldwide. It is one of the main causes of infectious disease and mortality, especially in the developing countries, and has been recognized as one of the top ten causes of death worldwide by the World Health Organization. Aims and Objectives: The aims of this study were to assess clinical pattern and efficacy of Directly Observed Treatment Short-Course (DOTS) in management of peripheral tubercular lymphadenitis. Materials and Methods: This was a prospective, observational study among pediatric peripheral tubercular lymphadenitis patients to assess the clinical pattern, investigations, and treatment outcome. Results: In this study, 72 patients having peripheral tubercular lymphadenitis were enrolled. Most cases had cervical node involvement (81%). Discharging sinus was found in 28.98% cases. Acid-fast bacillus (AFB) was detected by fine needle aspiration and cytology (FNAC) in 21 cases (30.43%). Among them, pulmonary TB was found in two cases (9.52%), one patient being sputum positive. After treatment completion, lymph node(s) enlargement persisted in 6 (8.69%) cases, of which two patients (2.89%) had persistent discharging sinus. On repeat FNAC, acid-fast bacilli were seen in two patients. Success rate was 91.3% confirming the efficacy of DOTS in the management of tubercular lymphadenitis. Conclusions: Cervical lymphadenitis was found to be most common type of peripheral lymphadenitis. Cytopathology from the suspected lymph nodes had better success rate than AFB detection or CBNAAT of FNAC samples for diagnosing tubercular etiology in the study. DOTS strategy was effective for peripheral tubercular lymphadenitis with high success rate in this study.

BACKGROUND: Major adverse drug reactions (ADRs) can cause significant morbidity and can compromise the treatment regimen. This can result in substantial additional cost due to added outpatient visits to the health facility or laboratory investigations or hospitalization in serious instances. Treatment is often prolonged with additional challenge of compliance. Hence, there is a need to monitor and manage these ADRs timely for better patient care and outcome. This study was carried out with the objective of studying the pattern of ADRs due to first-line antitubercular drugs and to carry out the causality and severity assessment of the reported ADRs. METHODOLOGY: A prospective observational study was conducted at four DOTS centers. All tuberculosis (TB) patients registered and receiving treatment under DOTS were enrolled for the study and were followed up at regular intervals till the end of their treatment. Patients' demographic, personal, disease, investigation, and ADRs details were entered in a predesigned patient recording form. Causality assessment of all ADRs were done using Naranjo algorithm. Severity assessment was done using modified Hartwig and Siegel scale. The study was approved by the institutional ethics committee of the institute. Statistical analysis was conducted using IBM SPSS Statistics for Windows. RESULTS: Of 186 patients, 23 patients (12.26%) developed one or more ADRs. The average number of ADRs per person was 1.43. Majority of the ADRs were reported in the 20-40 years of age group and ADRs were more likely to be among females compared to males. There was no association between type of TB, site of TB, regimen of anti-TB drugs, treatment outcomes, and ADRs. Around 84.85% and 15.15% of ADRs were classified as of mild and moderate severity, respectively, as per modified Hartwig and Siegel scale, while, as per Naranjo algorithm, 72.73% of the ADRs were classified as probable and 27.27% of ADRs as possible. No ADRs were classified as definite. CONCLUSION: Thorough understanding of the various ADRs and their management will help in the effective treatment of TB as well as designing effective counseling methods, which will help in adherence to treatment and also to have better compliance. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) are closely correlated and continue to cause deleterious effects in co-infected patients. This study aimed to determine the prevalence and associated factors of TB/HIV co-infection among directly observed treatment short-course (DOTs) clinic clients in Ogun State, Nigeria. Methods: The TB register and treatment cards of patients that visited the DOTs centre in Federal Medical Centre Abeokuta between January 2015 and December 2019 were reviewed. Results: A total of 726 TB patients' records were reviewed, among which 186 (22.5%) were co-infected with HIV. TB/HIV co-infection was significantly associated with the ⩽19 years age group 54 (37.2%), females 85 (26.7%), divorced and separated 8 (34.8%), rural residents 18 (34.0%), those who had no formal education 53 (39.8%) and the unemployed 63 (31.7%). Gender and educational status remained significant predictors of TB/HIV co-infection after adjustment for confounding factors. Discussion: Gender-sensitive programming and interventions geared towards improving knowledge of TB and HIV using a wide array of approaches should be considered. [ABSTRACT FROM AUTHOR]

Objective: The present study compares the efficacy of Daily Anti- Tubercular Therapy (ATT) with Directly Observed Treatment and Short Course (DOTS) in patients with spinal tuberculosis without any neurological deficit. Study design: Analytical cross-sectional study Place and Duration: This study was conducted in People's University of Medical and Health Sciences for Women Nawabshah from May 2020 to May 2022. Methodology: A total of 26 patients were included in the study and they were divided into two groups with thirteen patients in each group. One of the groups was treated with DOTS and the other was treated with Daily ATT. Patients were diagnosed by clinical examination, ESR values, radiological assessment, and biopsy. During follow-up, patients were assessed and compared regarding Erythrocyte Sedimentation Rate (ESR) values, and radiological findings. It was pre-defined that patients with VAS pain scores of 30 mm or less would be categorized as having mild pain, those with scores of 70 mm or more were categorized as having severe pain and those from 31 mm to 69 mm, moderate pain Results: Before treatment with DOTS, the mean pain score measured on the Visual Analogue Scale (VAS) was 40 mm and it was 12 mm after the treatment. The mean pain score before treatment with Daily ATT was 50 mm and the mean pain score after the treatment was 12 mm and was not statistically significant (p >0.05). After 1.5 years of treatment with DOTS and Daily ATT, the radiological assessment of patients in both groups showed similar outcomes (p >0.05). The mean difference in the ESR score of the Daily ATT and DOTS groups was 74.68±9.54% and 75.51±9.23%, respectively (p >0.05). Conclusion: The response to the disease was remarkable with both types of treatment and no relapse was observed on the follow-up visits. DOTS therapy has proven to be an efficient means of treatment in patients with spinal tuberculosis having no neurological deficit. [ABSTRACT FROM AUTHOR]

Abstract Background A major constraint to tuberculosis control is low case finding with under-reporting to national authorities. Evidence shows that Patent Medicine Dealers are first port of call for most people with symptoms of tuberculosis, yet there is poor referral of such clients to tuberculosis treatment facilities for further evaluation. This study investigated constraints to involvement of Patent Medicine Dealers in tuberculosis control. Methods This was a cross-sectional qualitative study among Patent Medicine Dealers and Tuberculosis Control Programme Managers in Ebonyi State Nigeria. Sixty-four Patent Medicine Dealers and five Tuberculosis Control Programme Managers were interviewed using Focus Group Discussion and In-Depth Interview respectively. Data was collected with electronic audio-recording device and analyzed using thematic approach. Results There are some knowledge gaps about tuberculosis signs, symptoms, free-treatment policy and mode of operation of care service among Patent Medicine Dealers. Patent Medicine Dealers and Tuberculosis Control Programme Managers are willing to collaborate in tuberculosis control effort but constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to keep up with such demands are obvious constraints. Conclusions Knowledge gaps in tuberculosis, its control, constant demand for incentives by Patent Medicine Dealers and inability of National Tuberculosis Control Programme to satisfy such demands are constraints to involvement of Patent Medicine Dealers in tuberculosis control. More robust engagement of Patent Medicine Dealers in tuberculosis control with clear job description through tuberculosis education and provision of incentives to support them are recommended policy approaches to improve linkage of clients to tuberculosis treatment facilities.

Carbon-based nanoparticles (CNPs) have demonstrated great potential in biomedical applications because of their unique physical and chemical properties, and excellent biocompatibility. Herein, we have studied two types of CNPs with gadolinium (Gd) impurities (Gd-CNPs), which were prepared by microwave synthesis (MWS) and hydrothermal synthesis (HTS), for potential applications as photoluminescent (PL) labels and contrast agents in magnetic resonance imaging (MRI). The prepared Gd-CNPs were investigated by means of transmission electron microscopy (TEM), Fourier-transform infrared spectroscopy, UV–visible absorption spectroscopy, and magnetic-resonance relaxometry, which allowed us to reveal specific features and functional properties of the prepared samples. While the TEM data showed similar size distributions of both types of Gd-CNPs with mean sizes of 4–5 nm, the optical absorption spectroscopy showed higher absorption in the visible spectral region and stronger PL in the red and near-infrared (NIR) spectral regions for the MWS samples in comparison with those prepared by HTS. Under green light excitation the former samples exhibited the bright red-NIR PL with quantum efficiency of the order of 10%. The proton relaxometry measurements demonstrated that the HTS samples possessed longitudinal and transverse relaxivities of about 42 and 70 mM−1s−1, whereas the corresponding values for the MWS samples were about 8 and 13 mM−1s−1, respectively. The obtained results can be useful for the selection of appropriate synthesis conditions for carbon-based nanoparticles for bimodal bioimaging applications.

Background: Tuberculosis (TB) control activities are implemented in the country for more than 50 years. The countrywide lockdown in 2020 adversely impacted routine health-care services including those for the management of TB. Operational research is needed to know whether Revised National Tuberculosis Control Program (RNTCP) (National Tuberculosis Elimination Program) is heading in the right direction as far as the pace and quality of implementation of the program are concerned. Aims and Objectives: The aim of the present study was to investigate the strength, weaknesses, and opportunities of RNTCP. An analysis of RNTCP was done to identify competencies and gaps. Materials and Methods: The present retroprospective and observational study was carried out at the RNTCP facility of a Government Medical College in the Central India in Madhya Pradesh during the year 2019–20. Samples of 238 patients registered under RNTCP for anti-tubercular treatment were taken in the study. Data were collected using a structured schedule from the RNTCP center and tabulated in a Microsoft Excel sheet, to assess the compliance of RNTCP norms in the management of TB. Results: The most commonly affected age was 16–49 years and the male: female ratio was 3:2. The most common basis of diagnosis was microbiological (60.92%). Follow-up sputum testing was done on time in 64.71% of patients. Adherence to anti-tubercular treatment (ATT) was regular in 78.57% of patients. All patients were telephoned while 43.14% of patients were home visited as a default action. After default action, 35.29% of patients return to regular ATT. Out of all registered patients initiated on ATT, 81.09% were treatment success, while 7.14% lost to follow-up, 2.1% became defaulters, and 4.62% patients died. Conclusion: We conclude that treatment success of TB unit was near the RNTCP norm of 85% which is below the national 88%. The probable reasons for the higher default rate and loss to follow-up rate during the study period could be the ongoing COVID-19 pandemic. Background: Tuberculosis (TB) control activities are implemented in the country for more than 50 years. The countrywide lockdown in 2020 adversely impacted routine health-care services including those for the management of TB. Operational research is needed to know whether Revised National Tuberculosis Control Program (RNTCP) (National Tuberculosis Elimination Program) is heading in the right direction as far as the pace and quality of implementation of the program are concerned. Aims and Objectives: The aim of the present study was to investigate the strength, weaknesses, and opportunities of RNTCP. An analysis of RNTCP was done to identify competencies and gaps. Materials and Methods: The present retroprospective and observational study was carried out at the RNTCP facility of a Government Medical College in the Central India in Madhya Pradesh during the year 2019–20. Samples of 238 patients registered under RNTCP for anti-tubercular treatment were taken in the study. Data were collected using a structured schedule from the RNTCP center and tabulated in a Microsoft Excel sheet, to assess the compliance of RNTCP norms in the management of TB. Results: The most commonly affected age was 16–49 years and the male: female ratio was 3:2. The most common basis of diagnosis was microbiological (60.92%). Follow-up sputum testing was done on time in 64.71% of patients. Adherence to anti-tubercular treatment (ATT) was regular in 78.57% of patients. All patients were telephoned while 43.14% of patients were home visited as a default action. After default action, 35.29% of patients return to regular ATT. Out of all registered patients initiated on ATT, 81.09% were treatment success, while 7.14% lost to follow-up, 2.1% became defaulters, and 4.62% patients died. Conclusion: We conclude that treatment success of TB unit was near the RNTCP norm of 85% which is below the national 88%. The probable reasons for the higher default rate and loss to follow-up rate during the study period could be the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a major public health problem worldwide. It is one of the main causes of infectious disease and mortality, especially in the developing countries, and has been recognized as one of the top ten causes of death worldwide by the World Health Organization. Aims and Objectives: The aims of this study were to assess clinical pattern and efficacy of Directly Observed Treatment Short-Course (DOTS) in management of peripheral tubercular lymphadenitis. Materials and Methods: This was a prospective, observational study among pediatric peripheral tubercular lymphadenitis patients to assess the clinical pattern, investigations, and treatment outcome. Results: In this study, 72 patients having peripheral tubercular lymphadenitis were enrolled. Most cases had cervical node involvement (81%). Discharging sinus was found in 28.98% cases. Acid-fast bacillus (AFB) was detected by fine needle aspiration and cytology (FNAC) in 21 cases (30.43%). Among them, pulmonary TB was found in two cases (9.52%), one patient being sputum positive. After treatment completion, lymph node(s) enlargement persisted in 6 (8.69%) cases, of which two patients (2.89%) had persistent discharging sinus. On repeat FNAC, acid-fast bacilli were seen in two patients. Success rate was 91.3% confirming the efficacy of DOTS in the management of tubercular lymphadenitis. Conclusions: Cervical lymphadenitis was found to be most common type of peripheral lymphadenitis. Cytopathology from the suspected lymph nodes had better success rate than AFB detection or CBNAAT of FNAC samples for diagnosing tubercular etiology in the study. DOTS strategy was effective for peripheral tubercular lymphadenitis with high success rate in this study. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes Mellitus and Tuberculosis are two major diseases that often present together and complicate each other at many levels. The epidemic growth of Diabetes Mellitus has occurred in developing countries where Tuberculosis (TB) is highly endemic. As a result, Diabetes Mellitus and TB are increasingly present together. Objectives: To estimate the prevalence of diabetes in tuberculosis patients currently on DOTS treatment and to determine the socio-demographic factors associated with it. Method: A cross sectional study was carried out among pulmonary TB patients receiving DOTS treatment. Total 340 patients were included using convenient sampling who received treatment between August and October 2018. Results: Out of 340 patients, 208 (61%) were males and 132 (39%) were females. The prevalence of diabetes in patients of tuberculosis was found to be 11.5%. Among diabetics, 59% had only diabetes and 41% had other co-morbid disease apart from it. About 56.4% of diabetic TB patients were consuming tobacco. Age, Illiteracy, re-treatment regime were significantly associated with presence of diabetes among TB patients.Conclusion: Diabetes was found to be prevalent in 11.5% of the patients of tuberculosis. Diabetes is significantly associated with the severity of TB, old age and literacy of the TB patients in this study.

Semiconductor Silicon quantum dots (SiQDs) and magnetic nanomaterials have been studied extensively for their variety of applications. We have presented a new method for the preparation of Magnetic Silicon Quantum Dots (Fe3O4/SiQDs) heterostructure nanocomposites. These nanocomposites are fluorescent, have excellent magnetic properties as well as high photocatalytic activity. Magnetic nanoparticles-semiconductor nanocomposites served as an effective recoverable photocatalyst for melamine degradation. In addition, due to their easy magnetic separation, these nanocomposites showed optimum catalytic activity for 15 cycles of usage.

Tuberculosis (TB) will be a serious threat if not handled quickly and appropriately. The relatively long treatment in time and the high risk of death is a challenge in controlling the spread of this disease. The DOTS (Directly Observed Treatment Short-course) strategy is considered capable of controlling the spread of TB because of the high success rate, reaching 91%. The mathematical model of the spread of TB has been widely studied to determine the potential for the spread of this disease in an area. The purpose of this study is to build a model of tuberculosis spread in Lamongan to determine the rate of its spread and to predict whether it will be endemic or not. Using disease spread mathematical model type SEITR, this research has examined based on 2018 and 2019 data from the Lamongan health office then simulates the result. The research begins with the construction of the model followed by a stability analysis of the model by determining the basic reproduction number ( ), which is simulated after the parameter approach was carried out. From the simulation results, the result shows that means that TB will not endemic in Lamongan. Besides, the results of the effect of parameter ω on I(t) were obtained, which concluded that seeking and treating active TB alone would only reduce infected individuals but not reduce the length of time TB spread. Identification of the effect of parameter φ on I(t) has also been carried out which results in the conclusion that more treatment for susceptible individuals, in addition to reducing the number of infected individuals, will also reduce the length of time TB spreads in that area. This result will be a good suggestion for the government to deal faster with tuberculosis transmission.

Background: Nontuberculous mycobacteria (NTM) are ubiquitous and are well known to cause lung diseases. Recently, pulmonary NTM infection rates have dramatically increased worldwide. Major obstacles in addressing NTM disease include the challenges of diagnosis and lack of active research.The inability to differentiate NTM from MTB by sputum smear microscopy may lead to erroneous diagnoses of tuberculosis, leading in turn to inappropriate therapy. Aim: This study is aimed to identify the proportion of suspected NTM infections among AFB smear-positive patients usingcartridge based nucleic acid amplification test(CBNAAT) and the number of such patients erroneously started on ATT. Material and Methods: This was a retrospective study conducted in the department of medicine. We included all pulmonary tuberculosis suspected patients who underwent sputum smear microscopy and CBNAAT during the study period from February 2018 to July 2018. Data was collected from the DOTS centre. Results: A total of 2322 sputum samples were subjected to smear microscopy for AFB and CBNAAT. 2138 samples were negative by both smear and CBNAAT.184 samples were sputum smear AFB positive and were diagnosed as having pulmonary tuberculosis. Out of 184 sputum smear-positive samples, only 180 were CBNAAT positive and the remaining 4 (2.17%) were CBNAAT negative. These negative samples were subjected again to CBNAAT to confirm the negativity. Since the second samples were also negative for CBNAAT other AFB positive organisms were strongly suspected and samples were subjected to culture. Thus these can be other potentially pathogenic mycobacteria called nontuberculous mycobacteria. Conclusion: Inefficient screening of TB patients may contribute to overdiagnosis of TB cases. NTM infections should be considered a cause of morbidity especially when CBNAAT is negative and smear microscopy shows AFB positivity, particularly while managing chronic TB cases who do not respond to anti-tubercular drugs to provide appropriate treatment. [ABSTRACT FROM AUTHOR]

Background: Non- adherence is one of the major risk factors for the emergence of MDR and XDR TB. It is also one of the key factors responsible for treatment failure, disease relapse, prolonged infection and death. This study was conducted to explore the various factors contributing to non-adherence to the Anti-TB medication. Methods: A qualitative study was done on Adult Pulmonary and extra pulmonary TB patients who were in course of the treatment. A total of 20 patients were enrolled. Socio –demographic details and specific questions regarding TB were collected using a semi-structured questionnaire. In depth telephonic interviews were conducted among all participants. Results: The study participants comprised between 15 to 68 years of age with a mean age of 36 ±14.9years. Factors influencing non-adherence to medication were grouped under Patient, medication, Socio-economic and Health care related factors, Motive. Almost all patients reported more than one factor. Conclusion: Increasing the awareness of various TB services in the community may increase knowledge and improve attitude among the patients. Providing more information about the effects of medication may reduce the risk of being non adherent. TB anonymous groups can be organized for patients to discuss their challenges while on treatment.

Background: Tuberculosis (TB) is still the most common infectious disease globally, affecting 1.5 million people per year.1 Prior to COVID-19 outbreak, India was struggling with a rampant attack of Tuberculosis. With the surge of COVID-19, implementation of all national health programs including NTEP was disrupted. Prioritization of services, availability of drugs, the challenges to reaching all types of communities and the role of stigmatization, and the possibility of increased disease transmission were few problems in the implementation of DOTS during the lockdown. Aim: To assess effect of pandemic on DOTS treatment during COVID-19 lockdown. A cross-sectional study was Methods: conducted among 254 tuberculosis patients who were under DOTS during Covid-19 lockdown in Belagavi district. Participants who were on DOTS during 2019 to 2021 period. Of 254 Result: participants, only 5 (2.0%) were supervised while taking drugs, 67(26.4%) of subject's empty blister packs were taken back by health personnel and 106(41.7%) participants were regularly followed up for treatment by health department. The variables like gender, literacy status, socioeconomic status, and occupation were all significantly associated with hampered access to DOTS during the lockdown period at p<0.05. This study concluded Conclusion: that the participants had hampered accessibilities to DOTS during lockdown [ABSTRACT FROM AUTHOR]

Abstract Background Ethiopia has highly diversified population with notable socioeconomic and cultural differences. Regardless of the differences, short course directly observed treatment,where patients should take drugs under direct observasion of health care providers, is uniformly applied all over the country. Evidences are scarce on how well does this uniform approach fits with the pastoral community setting. The purpose of this study was to explore lived experiences of TB patients in the pastoral community under the uniform approach, and their implications to early case identification and management. Method Qualitative method with phenomenological study design was undertaken to explore lived experiences of TB patients. Patients from all levels of health care (hospital, health center and health post) were included. Experience of both drug susceptible and drug resistant TB patients were documented. Twenty one patients, who consented to in the study, were selected by a convenience sampling method. In-depth interview was conducted using a semi-structured interview guide and the interview ended subsequent to information saturation. The interview was audio recorded; and field notes were also taken. Data analysis was done concurrently with the data collection using a word processor designed for qualitative text analysis. InductiveThematic analysis was undertaken to identify key themes. Results Twenty one patients (eight from hospitals, nine from health centers and four from health posts) were interviewed. Three of the eight hospital patients were on drug resistant tuberculosis (TB) treatment. Sixty two codes, five code categories and three themes emerged from the interviews. The three themes were health system, stigma and discrimination, and socioeconomic problem related experiences. Inaccessibility to health facilities due to scattered settlement and mobility, delay in care seeking TB symptoms, low index of suspecting TB by care providers, fear of stigma and indirect treatment related costs were some of the codes identified. Conclusion TB patients in the pastoral setting were experiencing multifaceted challenges with the current application of ‘one-size-fits-all’ approach which implied hampered timely case identification and compromised patient management. Therefore, designing context appropriate intervention approach is required to ensure unprejudiced services.

Isoniazid is the most commonly used drug for treatment of tuberculosis, and is administered individually or in combination with other drugs as standard first line therapy. Offsetting its efficacy, severe adverse effects, especially peripheral neuropathy and hepatotoxicity, are associated with isoniazid therapy, limiting its use in tuberculosis. Isoniazid is acetylated in vivo producing hydrazine and acetyl hydrazine, which are responsible for hepatotoxicity. Marked pharmacogenetic differences in acetylation have been reported among different population across the globe. This study evaluates isoniazid acetylation patterns in tuberculosis patients receiving DOT therapy under the Revised National Tuberculosis Control Program (RNTCP) in a specialized tuberculosis hospital in north India. Of 351 patients from whom samples were taken for biochemical analysis of adverse events, 36 were assessed for acetylation patterns. Blood samples were taken 1 h after administration of a 600 mg dose of isoniazid, and plasma concentrations of isoniazid were determined using a validated HPLC method. Of these 36 patients, 20 (55.56%) were slow acetylators and 16 (44.44%) were fast acetylators. Our results are consistent with those of an earlier study conducted in a different region of India. Most biochemical changes produced during long-term isoniazid therapy resolve after therapy is terminated.

Introduction: Rural healthcare providers (RHCPs) are the first point of contact for majority of patients in rural parts of India. A total of 75 RHCPs were trained and engaged in Hazaribagh to identify presumptive tuberculosis (TB) patients (PrTBPs) and refer them for diagnosis. Patients diagnosed with TB were initiated on directly observed treatment short course (DOTS) under the programme. Based on patients' choice, the treatment providers were either RHCPs or community health workers (CHWs). In this paper, we aim to compare the treatment outcomes of TB patients who received DOTS from RHCPs with CHWs. Method: This is a retrospective cohort study using secondary data routinely collected through project and Revised National TB Control Programme. Results: Over the period of 24 months, 57 RHCPs continued to be engaged with project and a total of 382 referrals were made out of which 72 (19%) were diagnosed with TB. Based on choice made, 40 (55%) of TB patients chose RHCPs and 32 (45%) CHWs as their treatment provider. The mean successful treatment completion rate was 87% in the RHCP group compared with 81% for CHWs (P value 0.464). The percentages of unsuccessful outcomes were similar for both groups. Conclusions: Our study demonstrates the process to engage RHCPs in TB prevention and care. The study highlights community preference for RHCPs as DOT provider who can produce similar TB treatment success rates as that of CHWs identified by programme.