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Public Health Action

H Sunpath, T J Hatlen, K K Naidu, P Msimango, R N Adams, M-Y S Moosa, V C Marconi, R A Murphy, R T Gandhi, S Pillay, M Siedner, K Naidoo
Objective: To move closer to achieving the third target of the UNAIDS 90-90-90 goals, we prospectively implemented a viral load (VL) champion (VLC) program aimed at enhancing VL monitoring and recognition of treatment failure. Design: Three clinics in eThekwini, Kwa-Zulu Natal (low-, medium- and high-volume, encompassing 9184 patients overall) were each assigned a VLC. We employed a descriptive analysis (chart audit) to compare the pre-intervention period to a 1-year post-intervention period. The number of patients with a VL test performed 6 and 12 months after the intervention was calculated as a proportion of VL tests due at those time points (VL completion rate)...
December 21, 2018: Public Health Action
K C Takarinda, R C Choto, T Mutasa-Apollo, C Chakanyuka-Musanhu, C Timire, A D Harries
Setting: Following the operational research study conducted during the isoniazid preventive therapy (IPT) pilot phase in Zimbabwe, recommendations for improvement were adopted by the national antiretroviral therapy (ART) programme. Objectives: To compare before (January 2013-June 2014) and after the recommendations (July 2014-December 2015), the extent of IPT scale-up and IPT completion rates, and after the recommendations the risk factors for IPT non-completion, in 530 ART clinics. Design: Retrospective cohort study...
December 21, 2018: Public Health Action
E Nahimana, L May, A Gadgil, V Rapp, H Magge, M Kubwimana, A Nshimyiryo, F Kateera, H A Feldman, F Nkikabahizi, F Sayinzoga, A Hansen
Setting: Rural Rwandan hospitals, where thermoregulation is critical yet a challenge for pre-term, low-birth-weight (LBW) or sick newborns. Objective: To assess the safety, effectiveness, and feasibility of an inexpensive, reusable, non-electric warmer to complement kangaroo mother care (KMC). Methods: Prospective single-arm, non-randomized intervention study. Enrolled infants were hypothermic or at risk of hypothermia due to prematurity/LBW. Infants used the warmer in conjunction with KMC or as the sole source of external heat...
December 21, 2018: Public Health Action
N S Aye, M M Oo, A D Harries, M M Mon, S Hone, H N Oo, N M A Wan
Setting: Two drug treatment centres (DTCs) for people who inject drugs (PWID) and are enrolled in methadone maintenance therapy (MMT), Yangon, Myanmar. Objectives: To determine, in PWID enrolled for MMT from 2015 to 2017, 1) testing uptake and results for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV); 2) risk factors for infection; and 3) retention in care and risk factors for loss to follow-up (LTFU). Design: Cohort study using secondary data. Results: Of 642 PWID, 578 (90...
December 21, 2018: Public Health Action
N Ahuja, J Kathiresan, T Anand, P Isaakidis, D Bajaj
Setting and Objetives: Police personnel, alongside other key stakeholders, are responsible for implementing the Cigarettes and Other Tobacco Products Act (COTPA) in India. This study aimed to assess knowledge and attitudes about COTPA among police personnel and explore enablers and barriers in implementing it. Design: This convergent parallel mixed-methods study used a self-administered questionnaire (quantitative) and key informant interviews (qualitative). Of 300 police personnel across all eight police stations in Daman, 155 participated...
December 21, 2018: Public Health Action
A Velavan, A J Purty, K Shringarpure, K D Sagili, A K Mishra, K S Selvaraj, M Manikandan, V Saravanan
Setting: Four Tuberculosis (TB) Units in the Union Territory of Puducherry in India. Objectives: To identify factors associated with unfavourable outcomes among retreatment TB cases in Puducherry. Design: The study had a mixed-methods design in which routinely reported TB data from retreatment TB cases registered during 2014 and 2015 were used for the quantitative part; the qualitative phase comprised interviews and focus group discussions with health care providers. Results: Among the 392 retreatment cases, 297 (75...
December 21, 2018: Public Health Action
M H Phyu, K W Y Kyaw, Z Myint, A Thida, S Satyanarayana, S T Aung
Setting: Myanmar's National Tuberculosis Programme (NTP) uses the Xpert® MTB/RIF assay to diagnose rifampicin (RMP) resistance in sputum smear-positive (Sm+) pulmonary tuberculosis (TB) patients. The Xpert test may occasionally yield negative results (Xpert-) for Mycobacterium tuberculosis complex, indicating a false-positive sputum smear result, false-negative Xpert result or infection with non-tuberculous mycobacteria (NTM). Patients with NTM may respond poorly to first-line anti-tuberculosis treatment. Objective: To assess the burden of Sm+, Xpert- results at the national level and treatment outcomes of Sm+, Xpert- patients in Yangon Region...
December 21, 2018: Public Health Action
A Querri, A Ohkado, L Kawatsu, M A Remonte, A Medina, A M C Garfin
Objective: To quantitatively and qualitatively describe some of the challenges faced by the Philippines' health insurance programme, PhilHealth, in the era of Universal Health Coverage. Methods: A descriptive study using a mixture of quantitative and qualitative methods. Quantitative data were collected from various sources and semi-structured interviews were conducted among staff of relevant organisations. We focused particularly on the enrolment process among eligible individuals and the system of reimbursement in five local government units (LGUs)...
December 21, 2018: Public Health Action
E E Win, A M V Kumar, N T T Kyaw, N N Aye, K M Hteik, S Saw, M M Oo, K W Y Kyaw, S T Aung, T L Tun
Setting: Ten selected microscopy centres in Sagaing Region, Myanmar, functioning under an external quality assurance system with no reported major errors. Objective: To assess the pattern of serial sputum results (NN, both smear-negative; NP, first smear-negative and second smear-positive; PN, first smear-positive and second smear-negative; and PP, both smear-positive) among follow-up sputum microscopy examinations of tuberculosis (TB) patients (end of intensive phase, mid-continuation phase and end of treatment) conducted from 1 November 2017 to 15 April 2018...
December 21, 2018: Public Health Action
L Singhi, K D Sagili, B N Sharath, K Bhandari, P K Dadul, M Gautam, C Ravichandra, S Chadha, S Satyanarayana
Setting: Sikkim, India, has the highest proportion of tuberculosis (TB) patients on first-line anti-tuberculosis regimens with the outcome 'failure' or 'shifted to regimen for multidrug-resistant TB (MDR-TB)'. Objective: To assess the factors associated with non-response to treatment, i.e., 'failure' or 'shifted to MDR-TB regimen'. Methods: We conducted a retrospective cohort study using Revised National Tuberculosis Control Programme data of all TB patients registered in 2015 for first-line TB treatment. In addition, we interviewed 42 patients who had not responded to treatment to ascertain their current status...
December 21, 2018: Public Health Action
E R Schnaubelt, M Charles, M Richard, D L Fitter, W Morose, J P Cegielski
Setting: Tuberculosis (TB) treatment facilities in Haiti. Objective: To assess factors associated with loss to follow-up (LTFU) among patients receiving treatment for tuberculosis (TB) in Haiti. Design: We analyzed Haiti's national surveillance data for patients started on anti-tuberculosis treatment from 2011 to 2015 to determine factors associated with LTFU using multivariable logistic regression and describe LTFU in terms of subnational units to target future intervention strategies. We also conducted a survival analysis to estimate hazard ratios of factors associated with time to LTFU...
December 21, 2018: Public Health Action
D Richardson, C Bell
No abstract text is available yet for this article.
December 21, 2018: Public Health Action
L Kawatsu
No abstract text is available yet for this article.
December 21, 2018: Public Health Action
B P Prabhu, A Kunoor, S Sudhir, A Dutt, V Nampoothiri, P S Rakesh, S Singh, V P Menon
No abstract text is available yet for this article.
September 21, 2018: Public Health Action
A Rufu, V T S Chitimbire, C Nzou, C Timire, P Owiti, A D Harries, T Apollo
Setting: Sixteen mission hospitals in Zimbabwe that are implementing the 'Test and Treat' programme for people living with the human immunodeficiency virus (HIV). Objectives: To assess linkages of HIV diagnosis to care and treatment, time taken from being diagnosed with HIV infection to initiation of antiretroviral therapy (ART) and 3-month programmatic outcomes for those starting ART. Design: Cross-sectional study using secondary data. Results: Among 972 people newly diagnosed with HIV, 915 (94%) enrolled for HIV care and 771 (79%) were initiated on ART...
September 21, 2018: Public Health Action
K Mezwa, S McAnaw, C-Y Chiang, A Trébucq, C R Horsburgh
The past 4 years have seen the introduction of new regimens and new drugs to treat multidrug-resistant tuberculosis (MDR-TB). To identify implementation trends over time, the DR-TB Working Group of the International Union Against Tuberculosis and Lung Disease (The Union), in collaboration with RESIST-TB, launched an online survey to Union members around the world. Survey results showed substantial diversity in treatment roll-out: 36% of respondents stated that their country is using the 9-month regimen for MDR-TB treatment; 41% are using bedaquiline and delamanid, but not the 9-month regimen; 28% are using both; and 22% of respondents indicated that their country does not currently offer either of these treatment options...
September 21, 2018: Public Health Action
H O Essadek, J Mendioroz, I C Guiu, I Barrabeig, L Clotet, P Álvarez, A Rodés, J Gómez I Prat
Setting: Tuberculosis (TB) control requires the proper identification and treatment of affected patients and investigation of their contacts. In certain vulnerable immigrant groups, however, these tasks may be hindered due to their ethnic and sociocultural characteristics. Objective: To analyse the results of a community programme designed to locate hard-to-reach immigrants with TB. Design: Descriptive study of all cases diagnosed with confirmed TB referred to the Public and Community Health team of the Drassanes International Health Unit in Barcelona during 2012-2014 due to difficulties in tracing these patients...
September 21, 2018: Public Health Action
M Urakawa, A Yasukawa, Y Hoshino, T Shimamura, S Hirao, Y Nagata, M Ota
Background: Japan had a tuberculosis (TB) notification rate of 13.9 per 100 000 population in 2016. Objectives: To characterise TB-related enquiries received by the Research Institute of Tuberculosis, Tokyo, Japan, between January 2014 and December 2016. Design: A descriptive study of the time, place and other attributes of the enquiries. Results: A total of 1864 enquiries were listed for analysis. On average, 51.8 enquiries (range 30-77) were received per month. The enquiry rates were highest for Yamanashi (5...
September 21, 2018: Public Health Action
A Jokwiro, C Timire, A D Harries, P T Gwinji, A Mulema, K C Takarinda, P T Mafaune, C Sandy
Setting: Manicaland Province, Zimbabwe. Objectives: To compare the utilisation and results of deploying Xpert® MTB/RIF in 13 (one provincial, six district and six rural) hospitals between January and June 2016, when Xpert was recommended only for those with presumptive multidrug-resistant tuberculosis (MDR-TB) and coinfection with human immunodeficiency virus (HIV), and between January and June 2017, when Xpert was recommended for all presumptive TB patients. Design: This was a cross-sectional study. Results: Xpert assays averaged 759 monthly in 2016 and 1430 monthly in 2017 (88% increase)...
September 21, 2018: Public Health Action
T Shelby, A J Meyer, E Ochom, P Turimumahoro, D Babirye, A Katamba, J L Davis, M Armstrong-Hough
Setting: Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda. Objective: To evaluate the influence of household-level socio-economic characteristics on completion of TB evaluation during household contact investigation. Design: A cross-sectional study nested within the control arm of a randomized, controlled trial evaluating home-based sputum collection and short messaging service communications. We used generalized estimating equations to estimate the association between completion of TB evaluation and socio-economic determinants...
September 21, 2018: Public Health Action
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