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Tuberculosis case detection among HIV positive persons in a hospital in EthiopiaTedla Mezemir Damte 28 March 2014 (has links)
Collaborative TB/HIV management is essential to prevent and treat TB among
HIV-positive TB patients, and to ensure that HIV-positive TB patients are
detected and treated appropriately.
This quantitative, descriptive, contextual study identified problems encountered
during the implementation of TB case detection among HIV-positive individuals in
one Ethiopian hospital. During December 2012, 300 checklists were completed
about HIV-positive patients’ TB/HIV collaborative management, as reflected in
their files.
Only 60.2% of HIV-positive patients, who should have received Isoniazid
preventive treatment (IPT), were placed on this treatment. X-rays and laboratory
examinations of sputum samples were not done according to the Ethiopian
guidelines. Most TB patients’ initial screening was done by nurses, not doctors,
and included only symptom screening without CD4 count considerations.
Managers and healthcare personnel should improve IPT, especially for those
with early HIV infection and timely effective treatment for those suffering from TB,
before complications arise / Health Studies / Health Studies / M.A. (Public Health)
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Controle da Hanseníase: Detecção precoce através do exame de contatos e avaliação do tratamento dos pacientes submetidos a 12 doses de poliquimioterapia (PQT/OMS) / Leprosy control: early detection by surveillance of contacts and treatment of multibacillary patients treated with multidrug therapy - (12 doses/WHO)Anna Maria Sales 28 April 2011 (has links)
O diagnóstico precoce e o tratamento são imprescindíveis para o controle da hanseníase, pois visam eliminar o mais precocemente possível as fontes de transmissão. O principal critério de cura da doença é o tempo de tratamento, relacionado às doses fixas da poliquimioterapia. O tempo de tratamento dos pacientes multibacilares foi reduzido de 24 para 12 doses em até 18 meses em 1998. Os objetivos desta tese foram: avaliar a detecção de casos de hanseníase entre os contatos dos pacientes e avaliar fatores de risco associados à piora das incapacidades físicas nos pacientes após a alta do tratamento poliquimioterápico com as 12 doses mensais. Dois artigos foram elaborados. O primeiro artigo avaliou características dos pacientes com hanseníase e de seus contatos associadas ao risco de adoecimento entre os contatos. O segundo artigo avaliou fatores de risco relacionados à piora das incapacidades físicas dos pacientes com hanseníase
multibacilar, submetidos ao tratamento com 12 doses fixas da poliquimioterapia. Os resultados mostraram que o risco para hanseníase, relacionado aos contatos foi o tipo de convivência com o caso índice. Entre os fatores dos casos índices, a carga
bacilar foi o único associado ao adoecimento dos contatos. Além desses fatores, os contatos que apresentam relação de consangüinidade com o caso índice e os contatos dos pacientes com menor nível de escolaridade mostraram maior chance
de se apresentarem doentes no momento do diagnóstico do caso índice. A cicatriz BGC e a vacina recebida após o diagnóstico do caso índice contribuíram independentemente como fatores de proteção. A neuropatia piorou em 40% dos
pacientes durante o período de 10 anos após a alta do tratamento. Esta piora foi associada à presença de incapacidades físicas e ao número de lesões cutâneas no
momento do diagnóstico assim como à presença de neurite durante o acompanhamento. / Early diagnosis and treatment are essential for the control of leprosy disease, since they aim to eliminate as soon as possible sources of transmission. The main criterion for cure of the disease is the treatment time, related to fixed doses of multidrug therapy. The duration of treatment of multibacillary patients was reduced from 24 to 12 doses up to 18 months in 1998. The aim of this thesis is to evaluate the detection of leprosy among contacts of patients and to evaluate risk factors
associated with worsening of physical disability in patients after discharge from the treatment with 12 monthly doses. Two articles have been prepared. The first article evaluated characteristics of leprosy patients and their contacts related to risk of disease among the contacts. The second article evaluated risk factors related to the worsening of the physical disabilities of patients with multibacillary leprosy, undergoing treatment with fixed doses of 12 multidrug therapy. The results showed that the risk for leprosy among contacts was related to the type of relationship with the index case. Among the factors of the index cases, the bacterial load was the only factor associated with the disease among contacts. Besides these factors, the contacts that are related to consanguinity with the index case and contacts of patients with lower education level showed a greater chance of presenting patients at diagnosis of the index case. The scar and the BGC vaccine received after the
diagnosis of the index case contributed independently as protective factors. Neuropathy worsened in 40% of patients during the 10 years after the discharge of treatment. This worsening was associated with the presence of physical disabilities and number of lesions at time of diagnosis as well as the presence of neuritis during monitoring.
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Trends in the presenting clinical profile of patients with pulmonary tuberculosis in the Western Cape, 1991 - 2009de Jager, Veronique Rejean January 2017 (has links)
Magister Public Health - MPH (Public Health) / Over the past two decades, despite a growing tuberculosis (TB) epidemic, the South African
health system and National TB Programme (NTP) have taken significant steps to ensure
improved clinical awareness, early diagnosis, prompt treatment initiation and follow-up of
treatment outcomes in cases of TB. The effects of these programmatic measures over time on
changes in the severity of disease and presenting clinical profile of patients with pulmonary
TB have not been studied. Doing so may provide another window on the impact of TB control
initiatives in South Africa.
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