Background: The burdens of tuberculosis (TB) and diabetes mellitus (DM) in Nigeria are high. DM often goes unrecognized in TB patients, resulting in poorer treatment outcomes compared with TB patients only. This study set out to compare TB treatment outcomes and associated factors in TB only and TBDM patients when a collaborative care (CC) model is in place. Methods: A prospective quasi-experimental study, modeled after the World Health Organization and The Union's Collaborative Framework for Care and Control of TB and DM was carried out among TB patients in two chest clinics in Lagos state. Patients were grouped into TB only, who received the usual TB care, directly observed treatment, short course (DOTS), and TBDM, who received DOTS and CC. Data were analyzed with IBM Statistical Package for the Social Sciences, version 23.0. Chi-square and multivariate analysis determined the association between treatment success and CC. Statistical tests were calculated at 95% confidence intervals and considered significant when P value is < 0.05. Results: Of 671 participants in the study, 52 (7.7%) had DM. At TB treatment completion, there was no statistically significant difference in outcomes between TBDM and TB-only patients (P = 0.40). Patients who received CC were about 32 (OR: 31.60, 95% CI: 3.38-293), and 5 times (OR: 5.08, 95% CI: 1.35-19.17) more likely to achieve success and cure, respectively, compared to those who did not. Conclusion: Provision of CC with DOTS ensured improved TB treatment outcomes in TBDM patients. Recommendations of WHO/The Union are feasible in our setting.
Background and Objective: Chronic or non-communicable diseases (NCDs) are rapidly emerging as leading causes of morbidity and premature mortalities globally, with greater effect being felt in low and middle income nations. As poor health behaviours practised in youthful years have been implicated in developing NCDs in later years in life, It is important to understand the level of awareness of young people regarding NCDs in order to remedy any knowledge gaps and encourage healthy practices among them that will reduce the burden of these diseases in later life. This study seeks to describe the knowledge of two groups of final year students of a tertiary institution in Nigeria on the awareness and knowledge of non-communicable diseases and their risk factors. Methods: The study was designed as a cross-sectional survey at the University of Lagos, Nigeria during the 2017/2018 academic session. A sample size of 422 final year students were used with convenient stratification. Self administered questionnaires was distributed to the class of students who consented to participating in the study. The questionnaires were used to assess the level of awareness of the students of non communicable diseases and their risk factors. Data obtained from the questionnaires was analyzed using SPSS version 21. Results: A result of 94.7% was obtained. The results show 89.5% versus 65% of students in health related discipline (college of medicine campus) and those in Akoka campus respectively had good knowledge of NCDs and their risk factors while 10.5% versus 35% had poor knowledge. Conclusion: Students in the campus of college of medicine had more knowledge of NCDs and their risk factors. Campus location of students had statistically significant relationship with awareness and knowledge on NCDs. (p, <0.05).
Tuberculosis (TB) and Diabetes mellitus (DM) are among the top ten causes of morbidity and mortality globally, with the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) also causing significant mortality as well. The HIV-TB link has been well recognized since the beginning of the HIV epidemic, but link between TB and DM has only returned to the fore-front recentlyafter effective treatments for each condition reduced the association that was reported earlier in thetwentieth century. Recently also, urbanization, increasing age and sedentary lifestyle has led to an increase in diabetes prevalence. Diabetes mellitus is associated with a 3-fold incident risk of tuberculosis and, to a lesser extent, tuberculosis may also increase the risk of developing diabetes. Both diseasesinteract negatively at multiple levels, exacerbating and worsening the outcomes of the other. The impact of these co-morbidities particularly in developing countries of Sub Saharan Africa, of which Nigeria is one, is likely to be large. An increasing prevalence of diabetes mellitus may hinder efforts aimed at tuberculosis control, making successful TB treatment and control more difficult. Improved management of tuberculosis and diabetes could build on the successes of the TB-HIV/AIDS collaborative activities, and DOTS strategy, which emphasizes support to patients, as well as a reliable supply of quality-assured medicines. This review aims to examine the association between these two important diseases, and explore ways to manage and reduce mortality caused by the duo.
Background: Diabetes mellitus (DM) increases the risk of developing tuberculosis (TB) three-fold. The cost of accessing care for TB-DM co-morbidity poses a significant burden on patients, as they bear both direct and indirect costs of treatment, mostly of out-of-pocket.Objective: To estimate the direct medical cost of illness in patients with TB-DM co-morbidity in two chest clinics in Lagos State.Materials and Methods: An observational study, carried out in two chest clinics in Lagos State to evaluate direct medical costs associated with TBDM co-morbidity during TB treatment. A semi structured questionnaire, pharmacy price list of drugs and an online transportation service lara.ng was employed to document and quantify prescribed medications, laboratory investigations, number of clinic attendance and attendant transportation costs.Results: Among the participants, 53.8% were females. The mean age was 50.7±9.7 years. The total direct medical and non-medical costs for TBDM management was NGN8,604,819 (USD24,585.20) for the duration of TB treatment. Average cost per patient (CPP) was NGN179,384.85 (USD512.53). This was equivalent to 49.8% of the current national minimum wage. Male patients incurred more mean direct medical cost than female patients (NGN26, 647.90 vs NGN24, 020.40), while female patients incurred more mean direct non-medical costs than the males (NGN22, 314.30 versus NGN13, 041.70). Patients aged 60 years and above incurred the highest mean direct costs compared to other age groups.Conclusion: Direct medical costs are substantial in TBDM co-morbidity and increase with age.
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