A study on procedural delay in diagnosis and start of treatment in drug resistant tuberculosis under RNTCP

Sharma, Amit; Gupta, Neeraj; Verma, Satyadeep; Chandran, Arjun; Dixit, Ramakant

doi:10.1016/j.ijtb.2018.04.010

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Insufficient human resources as a major obstacle for initiating MDR/RR‐TB treatment have been widely reported in literature. A study in India found that HCWs were not properly incentivised to work in the area of MDR/RR‐TB, considering the difficult working environment and risk of being infected [26]. HCWs in our study also reported difficulty in hiring MDR/RR‐TB staff and their perceived need of more training on MDR‐TB, which echoes studies in other countries reporting a lack of knowledge in HCWs, even misconduct of HCWs who charge additional fees from patients [27, 28].…”

Section: Discussionmentioning

confidence: 99%

Factors affecting time to treatment initiation after diagnosis for multidrug‐resistant/rifampicin‐resistant tuberculosis patients: A mixed‐methods study in Jakarta, Indonesia

Silitonga

Jiang

Wyatt

et al. 2022

Tropical Med Int Health

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Objective: To investigate the time to treatment initiation (TTI) for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) patients after diagnosis in Indonesia and biological, psychological and social factors associated with the time interval. Methods: This study was conducted in Persahabatan Hospital, Jakarta using a mixedmethods approach. Registry data and medical records of MDR/RR-TB patients were collected and matched (hospital dataset), and linked with psychosocial assessment results (linked dataset). Descriptive analysis was conducted to understand patient characteristics and the distribution of TTI after RR-TB diagnosis by GeneXpert. Generalised linear regression was used to analyse factors associated with delay duration, and logistic regression to explore factors associated with the delay longer than the median duration for both datasets (basic vs. extended model). In-depth interviews were conducted with patients and healthcare workers to understand the procedure of treatment initiation and how different factors led to delay. Results: The hospital dataset included 275 patient-matched cases, and 188 were further linked with psychosocial assessment results. The median time interval was 24 days [interquartile range (IQR) 23.5] and 26 days (IQR 21.25), respectively. Regression analysis showed that in the extended model, comorbidities (exp [coefficient] = 1.93), unemployment (exp [coefficient] = 1.80) and poor knowledge of MDR/RR-TB (exp (coefficient) = 1.67) seemed to have the strongest effects on prolonging the time interval (p < 0.05). Unsuccessful TB treatment history was the only factor that significantly increased the risk of delay longer than the median duration (p < 0.05) in the basic model, while none of the factors were significant in the extended model. The qualitative study identified provider-side factors (centralised service provision and insufficient human resources) and patient-side factors (physical weakness, psychological stress and financial concern) associated with treatment delay. Conclusion: MDR/RR-TB patients in Persahabatan Hospital, Jakarta, Indonesia waited around 25 days for treatment initiation after RR-TB diagnosis. Health system solutions are needed to address challenges facing both MDR/RR-TB patients and healthcare providers to reduce delay in treatment initiation.K E Y W O R D S drug-resistant tuberculosis, health system, Indonesia, treatment initiation delay Permata Silitonga and Weixi Jiang contributed equally as first authors.

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Section: Discussionmentioning

confidence: 99%

Factors affecting time to treatment initiation after diagnosis for multidrug‐resistant/rifampicin‐resistant tuberculosis patients: A mixed‐methods study in Jakarta, Indonesia

Silitonga

Jiang

Wyatt

et al. 2022

Tropical Med Int Health

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“…The number of TB cases found in 2018 was around 566,000 cases. This figure increased from the TB disease data recorded in 2017, which was in the range of 446,000 cases(World Health Organization 2020) (Sharma et al 2019).…”

Section: Introductionmentioning

confidence: 87%

Empowerment of Sto.Yohanes Maria Vianey Catholic Church Youth Naibonat of East Kupang, East Nusa Tenggara as A Supervision of Tuberculosis Ingestion

Yudhaswara

Ayatullah

So’o

et al. 2022

ABDIMAS

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Tuberculosis (TB) is an infectious disease that causes death, and is the third leading cause of death in Indonesia. The increase in cases of tuberculosis infection is still a major health problem in Naibonat Village, Kupang Regency, East Nusa Tenggara Province. Treatment failure, among others, was caused by patient non-compliance in ingesting drugs. It is hoped that the presence of supervisors to swallow drugs for TB patients is expected to help reduce TB infection cases. In Indonesian, a person who supervisors to swallow drugs is called “PMO” or “Pengawas menelan obat (PMO)” . Church Youth is an educated / educated group that is expected to have the ability to function as PMO. The purpose of this activity is to carry out PMO training for STO. Yohanes Maria Vianey Naibonat church youth through the method of lectures, discussions and microscopic training. The level of knowledge was measured using a questionnaire in the pre-test and post-test training. Youth who have been trained will be directed to become PMO’s for their families and closest neighbors who suffer from TB as well as agents of change in changing healthy behavior to prevent TB infection. The results of the activity showed a change in the level of knowledge before and after training from72% enough category to be good 89%. It was concluded that empowering church youth as PMO is an effort to suppress the increase in TB cases. The provision of PMO training can increase level of knowledge about TB so that regular and scheduled training will increase the ability and understanding of the role of PMO in reducing the incidence of TB in the community.

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A study on procedural delay in diagnosis and start of treatment in drug resistant tuberculosis under RNTCP

Cited by 2 publications

References 5 publications

Factors affecting time to treatment initiation after diagnosis for multidrug‐resistant/rifampicin‐resistant tuberculosis patients: A mixed‐methods study in Jakarta, Indonesia

Factors affecting time to treatment initiation after diagnosis for multidrug‐resistant/rifampicin‐resistant tuberculosis patients: A mixed‐methods study in Jakarta, Indonesia

Empowerment of Sto.Yohanes Maria Vianey Catholic Church Youth Naibonat of East Kupang, East Nusa Tenggara as A Supervision of Tuberculosis Ingestion

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