Cochlear Dysfunction after Kanamycin Injection in Multidrug Resistant Tuberculosis Patients

Brahmono, Aditya; Purnami, Nyilo; Surarso, Bakti

doi:10.20473/fmi.v56i3.24559

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…3 This could be because of a paradoxical reaction or microbiological relapse, possibly due to misuse of drugs for the treatment of the existing TB infection, causing the organism to be drug-resistant. [4][5][6] Drug resistance (DR) to Rifampin (RR) and multidrug resistance (MDR) is a serious concern where the estimated proportion of MDR/RR among TB in Ethiopia in the year 2021 was 1.1% in new cases and 12% in previously treated cases. 7 A higher rate of DR (14%) was shown by another study from Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Microbiological Investigations of Fine Needle Aspirates from Newly Suspected and Previously Treated Tubercular Lymphadenitis Patients

Atnafu,

Wassie,

Tilahun

et al. 2023

IDR

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Background Extrapulmonary tuberculosis (EPTB), particularly tubercular lymphadenitis (TBLN), remains to pose a huge public health problem in Ethiopia. A significant number of TBLN patients who completed a full course anti-TB treatment regimen were reported to have enlarged lymph nodes and other TB-like clinical presentations. This could either be from a paradoxical reaction or microbiological relapse, possibly due to mono/multi-drug resistance. Objective To investigate the rate of mono and multidrug resistance patterns of Mycobacterium tuberculosis as a cause of the observed treatment failures in clinically diagnosed and anti-TB treatment (newly or previously)-initiated LN patients. Methods A cross-sectional study was conducted on 126 TBLN-suspected and previously treated patients between March and September 2022. Data were analyzed using SPSS (Version 26.0). Descriptive statistics were used to determine the frequency, percentage, sensitivity, specificity, and positive and negative predictive values. The level of agreement was determined using Cohen’s kappa and a Chi-square test was used to measure the association between risk factors and laboratory test outcomes. A P -value <0.05 was considered statistically significant. Results Mycobacterium tuberculosis was confirmed in 28.6% (N=36) of the 126 cases using BACTEC MGIT 960 culture detection method. Approximately, 13% (N=16) of the samples were collected from previously treated TBLN patients, of which 5/16 (31.3%) were multi-drug resistant, 7/16 were drug-sensitive and 4/16 were culture negative. To rule out other non-tuberculous agents, all samples were grown on blood and Mycosel agar plates, and no growth was detected. Conclusion The emergence of drug resistant (DR) TB seems to not just be limited to pulmonary form but also to TBLN. In this study we observed a considerable number of microbiologically confirmed relapses among previously treated cases, possibly indicating the need for confirmation of drug resistance using rapid molecular methods or phenotypical methods during treatment follow up.

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Section: Introductionmentioning

confidence: 99%

Microbiological Investigations of Fine Needle Aspirates from Newly Suspected and Previously Treated Tubercular Lymphadenitis Patients

Atnafu,

Wassie,

Tilahun

et al. 2023

IDR

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“…Additionally, there is no dose change in a clinical setting for tuberculosis patients with diabetes. Exposure to concentrations less than the minimum inhibitory concentration will result in the development of drug-resistant tuberculosis, most notably rifampicin-resistant tuberculosis (85). There may be some interaction between oral anti-diabetics and tuberculosis regimens, but no conclusive proof exists.…”

Section: A Diabetesmentioning

confidence: 99%

Cost effectiveness of oral health care program implementation in primary school in Bangkok, Thailand

Herman¹

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Background: Diagnosis of Pulmonary Rifampicin Resistant Tuberculosis (RR-TB) with the Drug-Susceptibility Test (DST) is costly and time-consuming, and the GeneXpert for rapid diagnosis is not widely available in Indonesia. This study aims to develop an Artificial Neural Network model and evaluate the deployed model performance for RR-TB screening. Methods: A cross-sectional study involved suspected RR-TB patients with complete sputum Lowenstein Jensen DST (reference) and 19 clinical, laboratory, and radiology parameter results, retrieved from medical records in hospitals under the Faculty of Medicine, Hasanuddin University Indonesia, from January 2015-December 2019. The Artificial Neural Network (ANN) models were built along with other classifiers. The model was tested on participants recruited from January 2020-October 2020 and deployed into CUHAS-ROBUST (index test) application. Sensitivity, specificity, and accuracy were obtained for assessment. A qualitative approach with content analysis was performed from September 2020 to October 2020. Medical staff from the primary care center were invited online for application trials and in-depth video call interviews. Transcripts were derived as a data source. An inductive thematic data saturation technique was conducted. Descriptive data of participants, user experience, and impact on the health service was summarized. Cost-effectiveness analysis of direct cost was made using the data of 330 participants who underwent Genexpert and Model, confirmed by DST. The Quality Adjusted Life years of TB being untreated was used as the approximation of the undiagnosed TB (acute morbidity, chronic morbidity, and mortality). The Incremental Cost-Effectiveness Ratio (ICER) was calculated. Results: A total of 487 participants (32 Multidrug-Resistant/MDR 57 RR-TB, 398 drug-sensitive) were recruited for model building and 157 participants (23 MDR and 21 RR) in prospective testing. The ANN full model yields 88% (95% CI 85-91) accuracy, 84% (95% CI 76-89) sensitivity, and 90% specificity (95% CI 86-93). This ANN model outperforms other classifiers and selected for the CUHAS-ROBUST application. A total of 33 participants (an average of 33.12 years old) were recruited from all parts of Indonesia. The findings show that DR-TB is a new threat, and its diagnosis faces obstacles particularly prolonged waiting time and inevitable delayed treatment. Despite overcoming the RR-TB screening problems with fast prediction, the dubious screening performance, and the reliability of data collection for input parameters were the main concerns of CUHAS-ROBUST. Nevertheless, this application increases confidence in decision making, promotes medical procedure compliance, active surveillance, and enhancing a low-cost screening approach. A cost-effectiveness analysis was made. The ICER Mortality value is -3601.706137. The ICER Acute Morbidity value is -17225.55 and The ICER Chronic Morbidity value is -825.391. The very minimum sensitivity of the model to not surpass the willingness to pay (WTP) of 100 USD per QALYs gained is 80.6%. The ideal prevalence of RR-TB according to the screening using model is 14.8% to 23.3%. Using the average cost, the results still consistent, showing the model as the dominant intervention Conclusions: Despite showing lower sensitivity than global GeneXpert results. The ANN-CUHAS ROBUST outperforms other AI classifier models, and by deploying it into the application, the health staff can utilize the tool for screening purposes particularly at the primary care level. Moreover, this study demonstrates AI's roles in enhancing healthcare quality and boost public health efforts against tuberculosis. The advantage of this device is cost-effective although it should need a bigger test expansion.

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Cochlear Dysfunction after Kanamycin Injection in Multidrug Resistant Tuberculosis Patients

Cited by 2 publications

References 12 publications

Microbiological Investigations of Fine Needle Aspirates from Newly Suspected and Previously Treated Tubercular Lymphadenitis Patients

Microbiological Investigations of Fine Needle Aspirates from Newly Suspected and Previously Treated Tubercular Lymphadenitis Patients

Cost effectiveness of oral health care program implementation in primary school in Bangkok, Thailand

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