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Determinants of delayed tuberculosis case findings in Makana Local Municipality, Eastern CapeOnaga, Juliet Onyinye 29 August 2014 (has links)
BACKGROUND: The prevalence of tuberculosis (TB) has been rapidly on the
ascendency in the recent years globally due to its co-infection with HIV/AIDS. TB
case finding is one of the technical pillars of the Directly Observed Treatment Short
course (DOTS) TB strategy and there has been advocacy for early TB case
detection to be the new focus of TB control efforts.
PURPOSE: The purpose of this non-experimental study was to assess the
determinants of TB case finding among pulmonary TB patients registered for treatment
in Makana Municipality
METHOD: A quantitative, non-experimental, cross sectional descriptive study among
PTB patients registered for treatment at the primary health care clinics in Makana
Municipality was done. Data collection was by self-administered questionnaires while
sampling was by systematic sampling of PTB patients at five systematically selected
clinics.
RESULTS: Patient–related delay contributed more to total delay, in this study
sample, than health system-related delay. Health system delay was found to be
significantly associated with poorer finances, passive smoking history, seeking care
from multiple health providers, initially visiting a non- NTCP health provider, TB
stigma , overcrowding in the household and having difficulty with breathing as an
initial symptom (p<0.05).
CONCLUSION: There was a significant delay in TB case finding among PTB
patients in this local municipality and patient related determinants contributed more
than health system related determinants to this delay. There is need for the
municipal TB programme to embark on an aggressive health education programme
to furnish the populace with accurate information about TB, improve their health
seeking behaviour and help address the issue of stigma associated with TB. / Health Studies
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Outcomes of TB treatment in HIV co-infected TB patients in EthiopiaSolomon Ahmed Ali 27 July 2015 (has links)
The purpose of this study was to determine and compare the outcomes of tuberculosis (TB) treatment among Human Immunodeficiency Virus (HIV) co-infected TB patients, and identify factors associated with these outcomes. A quantitative cross-sectional analytic design was used. Patient level secondary data was collected and analysed for the study. A total of 575 TB patients, including 360 non-HIV infected, 169 HIV co-infected and 46 without a documented HIV status, were enrolled. The overall treatment success rate was 91.5%, and HIV co-infected TB patients had a high rate (11.8%) of unfavourable outcomes. The cure rate was significantly lower (10.1% versus 24.2%) and the death rate higher in HIV co-infected patients (8.3% versus 2.5%). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care, but 22% of HIV co-infected TB patients were taking ART when they developed TB disease / Health Studies / M.A. (Public Health)
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Knowledge of tuberculosis patients about their disease in Tshwane, South AfricaAdekanmbi, Motunrayo Helen 07 September 2015 (has links)
The purpose of the study was to investigate the knowledge of TB patients receiving TB treatment at a clinic in Tshwane regarding the condition and their treatment.
A descriptive cross-sectional survey was conducted. Data was collected using a self-designed structured questionnaire administered by the researcher and nurses. The population consisted of diagnosed TB patients. The total sample consisted of 74 respondents.
The respondents were described in terms of inter alia their demographics, aspects of their health and TB and aspects related to clinic visits. For the knowledge about TB a competency indicator was set at 70% which means that those that achieved this were regarded as knowledgeable. Those that were found to be not knowledgeable were 41.9% of the sample. The mean score achieved by the group was 61% with a standard deviation of 25.
Recommendations were made to amend knowledge deficits of TB patients and for further research / Health Studies / M.A. (Public Health)
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Factors contributing to under utilisation of HIV testing services among TB patients in MalawiKamba, Grace Dhora Maggie 27 January 2014 (has links)
A quantitative, descriptive, explorative survey was conducted to explore and describe
factors contributing to underutilisation of HIV testing services among tuberculosis
patients and clients in Malawi. Sampled were 282 participants attending an outpatient
clinic. A self administered questionnaire was used. The findings revealed that 80.5% of
the respondents perceived themselves susceptible to HIV infection, 55% believed there
were negative consequences of HIV Testing and Counselling (HTC), 87.6% perceived
HTC had benefits, most of the respondents (76.8%) mentioned the benefit of knowing
the HIV status helping one to plan life, 65% believed in themselves, that they could
accept and undergo HIV testing with ease. The study recommends that all HTC
providers be thoroughly trained in knowledge and skills to offer services with
confidentiality and avoid stigma and discrimination of those found HIV positive. The
importance and benefits of HTC should be emphasised in all behaviour communication
messages / Health Studies / M.A. (Public Health)
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Gene expression and cytokine pattern of pulmonary tuberculosis patients and their contacts in EthiopiaBekele, Adane Mihret 03 1900 (has links)
Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The immune response against M. tuberculosis is multifactorial, involving a network of innate
and adaptive immune responses. Characterization of the immune response, a clear
understanding of the dynamics and interplay of different arms of the immune response and
the identification of infection-stage specific biomarkers are critical to allow the
development of better tools for combating tuberculosis. In an attempt to identify such
biomarkers, we studied pulmonary tuberculosis patients and their contacts in Addis Ababa,
Ethiopia as part of EDCTP and BMGF funded tuberculosis projects by using multiplex
techniques. We analysed 45 genes using the Multiplex Ligation Dependent Probe
Amplification (MLPA) technique and the expression of IL-4δ2, BLR1, MARCO, CCL-19, IL7R, Bcl2, FcyR1A, MMP9, and LTF genes discriminate TB cases from their healthy contacts.
FoxP3, TGFß1 and CCL-19 discriminate latently infected from uninfected contacts. Single
genes predict with an area under the Receiver Operating Characteristic (ROC) curve of 0.68
to 0.85 while a combination of genes identified up to 95% of the different groups. Similarly,
the multiplex analysis of cytokines and chemokines also showed that single or combinations
of plasma cytokines and chemokines discriminate between different clinical groups
accurately. The median plasma level of EGF, fractalkine, IFN-y, IL-4, MCP-3 and IP-10 is
significantly different (p<0.05) in active tuberculosis and non active tuberculosis infection
and the median plasma levels of IFN-y, IL-4, MCP-3, MIP-1ß and IP-10 were significantly
different (p<0.05) before and after treatment. We also found a significant difference
(p<0.05) in plasma levels of cytokines of patients infected with the different lineages and
different families of the modern lineage. The plasma level of IL-4 was significantly higher in
patients infected with lineage 3 (p<0.05) as compared to lineage 4 and the CAS familyinfected
patients had a higher plasma level of IL-4 (P<0.05) as compared to patients infected
with H and T families but there was no difference between H and T families.
We identified genes and cytokines which had been reported from other studies in different
settings and we believe that these molecules are very promising biomarkers for classifying
active tuberculosis, latent infection, absence of infection and treated infection. These
markers may be suitable for the development of clinically useful tools but require further
validation and qualification in different populations and in larger studies. / AFRIKAANSE OPSOMMING: Die immuunrespons teen M. tuberculosis is multifaktoriaal en betrek ‘n netwerk van niespesifieke
and spesifieke immuunresponse. Karakterisering van die immuunrespons, ‘n
duidelike insig in die dinamika en tussenspel deur die verskillende arms van die
immuunrespons en die identifikasie van spesifieke biomerkers is krities belangrik om die
ontwikkeling van nuwe hulpmiddels teen tuberkulose te bevorder. In ‘n poging om sulke
biomerkers te identifiseer het ons pulmonale tuberkulose pasiënte en hulle kontakte in
Addis Ababa, Etiopië, as deel van die EDCTP en BMGF befondste tuberkulose projekte
bestudeer met multipleks tegnieke. Ons het 45 gene analiseer met ‘Multiplex Ligation
Dependent Probe Amplification (MLPA)’ en gevind dat die geenuitdrukking van IL-4•2, BLR1,
MARCO, CCL-19, IL7R, Bcl2, Fc•R1A, MMP9, en LTF TB pasiënte van hulle kontakte
onderskei. FoxP3, TGF•1 en CCL-19 onderskei tussen latent infekteerde en ongeïnfekteerde
kontakte. Enkele gene voorspel met ‘n area onder die ‘Receiver Operating Characteristic
(ROC)’ kurwe van 0.68 tot 0.85 terwyl die kombinasie van gene 95% van die verskillende
groepe identifiseer. Soortgelyk het multipleks analise van sitokiene en chemokiene
verskillende kliniese groepe akkuraat van mekaar onderskei. Die mediane plasmavlakke van
EGF, fractalkine, IFN-•, IL-4, MCP-3 en IP-10 is beduidend verskillend (p<0.05) in aktiewe
tuberkulose en nie-aktiewe tuberkulose infeksie en die mediane plasmavlak van IFN-•, IL-4,
MCP-3, MIP-1• en IP-10 was beduidend verskillend voor en na behandeling. Ons het ook
beduidende verskille (p<0.05) in plasmavlakke van sitokiene in pasiënte gevind wat
infekteer is met verskillende stamme and verskillende families van die moderne stamme.
Die plasmavlak van IL-4 was beduidend hoër in pasiënte wat infekteer is met stam 3
(p<0.05) teenoor stam 4 en die CAS familie-infekteerde pasiënte het ‘n hoër plasmavlak van
IL-4 (p<0.05) teenoor pasiënte met H en T familie infeksie hoewel daar geen versikke was
tussen die H en T families nie. Ons het gene en sitokiene identifiseer wat deur ander werkers onder verskillende
omstandighede ook beskryf is en ons glo dat hierdie molekules baie belowende biomerkers
is om aktiewe tuberkulose, latent tuberkulose, die afwesigheid van infeksie en behandelde
infeksie van mekaar te onderskei. Hierdie merkers mag toepaslik wees vir die ontwikkeling
van bruikbare kliniese hulpmiddele maar benodig verdere validasie en kwalifikasie in
verskillende populasiegroepe en in groter studies. / Bill and Melinda Gates Foundation (BMGF) / European and Developing Countries Clinical Trials Partnership (EDCTP) / African European Tuberculosis Consortium (AE TBC).
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Major spoligotype families of Mycobacterium tuberculosis strains isolated from tuberculosis patients in Port Elizabeth, Eastern Cape, South AfricaNqini, Babalwa J January 2012 (has links)
South Africa is burdened with tuberculosis (TB) which is aggravated by the concurrent epidemic of HIV as well as the emergence of drug resistance. In most developed countries molecular techniques have been used to look at the dynamics of the TB epidemic however, despite the prevalence that is high in sub-Saharan Africa, there is little data on strain types that are available in Port Elizabeth. This study aims to find the major clades of M. tuberculosis that are circulating in Port Elizabeth. Two hundred MDR-TB DNA samples were obtained from the National Health Laboratory Services TB laboratory in Port Elizabeth. Spoligotyping and MIRU-VNTR were used to genotype the strains. Two hundred strains were sent to the University of Stellenbosch for spoligotyping and 179 of those were typed. Spoligotype defined families were further typed by MIRU-VNTR typing, so as to further differentiate and assess clonal diversity within the spoligotype families. The Beijing family was the dominant family and the MANU family being the least dominant, with percentages of 71 percent and 0.5 percent respectively. A comparison of spoligotyping results with the international spoligotyping database (SITVIT2) showed a total of 15 shared international types. Forty four percent (44 percent) of the isolates that were typed by MIRU-VNTR showed similarities, suggesting epidemiological relatedness. Thirty eight percent of isolates from spoligotyping were from the same family, the Beijing family, with the same shared international type STI1, but when typed by 12 MIRU-VNTR they showed no epidemiological relatedness and 18 percent of the isolates showed no relatedness when typed by 12 MIRU-VNTR but spoligotyping showed that they were from the LAM family. Results from our study illustrate the effectiveness of MIRU-VNTR typing together with spoligotyping in epidemiological studies in the region of Port Elizabeth.
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Outcomes of TB treatment in HIV co-infected TB patients in EthiopiaSolomon Ahmed Ali 27 July 2015 (has links)
The purpose of this study was to determine and compare the outcomes of tuberculosis (TB) treatment among Human Immunodeficiency Virus (HIV) co-infected TB patients, and identify factors associated with these outcomes. A quantitative cross-sectional analytic design was used. Patient level secondary data was collected and analysed for the study. A total of 575 TB patients, including 360 non-HIV infected, 169 HIV co-infected and 46 without a documented HIV status, were enrolled. The overall treatment success rate was 91.5%, and HIV co-infected TB patients had a high rate (11.8%) of unfavourable outcomes. The cure rate was significantly lower (10.1% versus 24.2%) and the death rate higher in HIV co-infected patients (8.3% versus 2.5%). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care, but 22% of HIV co-infected TB patients were taking ART when they developed TB disease / Health Studies / M.A. (Public Health)
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Knowledge of tuberculosis patients about their disease in Tshwane, South AfricaAdekanmbi, Motunrayo Helen 07 September 2015 (has links)
The purpose of the study was to investigate the knowledge of TB patients receiving TB treatment at a clinic in Tshwane regarding the condition and their treatment.
A descriptive cross-sectional survey was conducted. Data was collected using a self-designed structured questionnaire administered by the researcher and nurses. The population consisted of diagnosed TB patients. The total sample consisted of 74 respondents.
The respondents were described in terms of inter alia their demographics, aspects of their health and TB and aspects related to clinic visits. For the knowledge about TB a competency indicator was set at 70% which means that those that achieved this were regarded as knowledgeable. Those that were found to be not knowledgeable were 41.9% of the sample. The mean score achieved by the group was 61% with a standard deviation of 25.
Recommendations were made to amend knowledge deficits of TB patients and for further research / Health Studies / M.A. (Public Health)
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Experiences of the mobile injection team for multi drug resistant-tuberculosis patients in Ugu District, KwaZulu-NatalArjun, Sitha Devi 21 July 2016 (has links)
The purpose of the study was to investigate and describe the experiences of a mobile injection team for multi drug resistant-tuberculosis outpatients, and to design and recommend a mobile injection team guideline based on the experiences of the team members in Ugu District, KwaZulu-Natal and to indicate the support that the MIT require. Phenomenological research was conducted. Convenient census sampling was used as all the seven members of the Ugu District mobile injection team were included. The inclusion criteria was at least six months’ working experience with MDR-TB patients in a mobile injection team at Ugu District, be an enrolled nurse registered with the South African Nursing Council as an enrolled nurse and must have an annual practicing certificate, or be a TB assistant, be willing to participate in the study and be located at the decentralised and satellite site. Data were collected through individual in-depth interviews with the participants. Data were analysed using Giorgi’s method of data analysis. The research findings revealed four broad themes (the perceptions held by the team, challenges, available support and needs to promote the service) and 73 sub-themes. The findings of the study indicate that the MDR-TB outreach injection teams experience many challenges in the community and need to be supported by their management in order to provide quality care to the patients. This study contributes to the development of guidelines to assist the mobile injection teams to provide quality patient care and effective service delivery. Based on the findings, the recommendation is that an intervention study be performed to compare the utilisation of the mobile MDR-TB injection team after implementing the recommendations made and the guidelines developed in this study / Health Studies / D. Litt. et Phil. (Health Studies)
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Development implementation and process evaluation of an adapted tuberculosis directly observed treatment programme in Limpopo ProvinceMabunda, Jabu Tsakani 05 1900 (has links)
PhD / Department of Public Health / See the attached abstract
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