BackgroundEarly diagnosis and prompt effective therapy are crucial for the prevention of tuberculosis (TB) transmission, particularly in regions with high levels of multi-drug resistant TB. This study aimed to evaluate the extent of delay in diagnosis and treatment of TB in Uzbekistan and identify associated risk factors.MethodsA cross-sectional study was performed on hospital patients with newly diagnosed TB. The time between the onset of respiratory symptoms and initiation of anti-TB treatment was assessed and delays were divided into patient, health system and total delays. Univariable and multivariable logistic regression analysis was used to evaluate determinants of diagnostic and treatment delay.ResultsAmong 538 patients enrolled, the median delay from onset of symptoms until treatment with anti-TB drugs was 50 days. Analysis of the factors affecting health-seeking behaviour and timely treatment showed the presence of the patient factor. Self-medication was the first health-seeking action for 231 (43%) patients and proved to be a significant predictor of delay (p = 0.005), as well as coughing (p = 0.009), loss of weight (p = 0.001), and visiting private and primary healthcare facilities (p = 0.03 and p = 0.02, respectively).ConclusionTB diagnostic and treatment delay was mainly contributed to by patient delay and should be reduced through increasing public awareness of TB symptoms and improving public health-seeking behaviour for timely initiation of anti-TB treatment. Efforts should be made to minimise irrational use of antibiotics and support interventions to restrict over-the-counter availability of antibiotics.
Treatment of MDR-TB with a standard PZA regimen does not appear to improve treatment outcomes, regardless of PZA susceptibility or duration of treatment.
Relevance: Globocan reports 19.3 million new cases of malignant neoplasms in 2020 globally. Mammary gland cancer has become the most commonly diagnosed oncological pathology, followed by lung, colon and rectum, prostate, and stomach cancers. In Uzbekistan, malignant neoplasms of the breast, stomach, cervix, lungs, and brain dominate the structure of cancer incidence. The study aimed to analyze the cancer incidence trends and structure in the Republic of Uzbekistan in 2020. Results: In 2020, 21976 new cancer cases were registered in Uzbekistan. The ratio of men and women newly diagnosed with cancer was 0.7:1.4. Cancers of the breast, cervix, and ovary were the most common in women; cancers of the stomach, lung, and prostate — in men. Hemoblastoses were more common at a young age, breast cancer – at working age, and stomach cancer – at old age. Conclusions: The statistical information analysis showed that in 2020 the cancers of the mammary gland, stomach, and cervix were leading in the overall cancer structure, with significant differences in different age categories. This determines the need for further improvement of cancer care in Uzbekistan.
project to help patients get treatment for cancer (palliative care). In view of this we aimed to find out the factors which influence their late presentation at Hospitals. The World Health Organization (2015) has reported that cancer is the second most common cause of death and was responsible for over 25000 deaths in 2015, approximately 80% occurring in developing countries. It was projected that thiswill increase by 25% over the next 10 years if nothing is done such as putting adequate screening, treatment and prevention measures in place. Methods: The study took place across the three sites of Hospice Africa Uganda. It has cared for about 70500 patients of which 55300 are cancer patients. A qualitative study was used to interview the patients so as to get a deep understanding of the reasons why patients with cancer present late for treatment at regional hospitals and national referral hospitals. Using the semi structured questionnaire guided the interviewers because it helped the patients to discuss freely the reasons why they report late. Then, data was transcribed and analyzed. A report was written and shared with the team of Hospice Africa Uganda across the three branches. These patients were interviewed at the three sites of hospice because come for the palliative care and during the outreach only patients with cancer were elegible for the study. The researchers used local language during the interviews since the majority of patients are more fluent in local language than English. A recording tape was used to store all the discussions for flexibility. Results: Of theses patients, 68.5% did not have financial support to carry out early investigation, were peasant farmers, with little knowledge of cancer,17.9% had the financial support but were lazy to go to the hospital for checkup.14.3% did not give clear reason, while others were coming far away from the health units. Conclusions: There is a very big role for the government, and health workers to sensitize the public, set up more health facilities and train more healthcare workers.
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