Non-conversion of sputum culture among patients with smear positive pulmonary tuberculosis in Cameroon: a prospective cohort study

Pefura-Yone, E.W.; Kengne, André Pascal; Kuaban, Christopher

doi:10.1186/1471-2334-14-138

Cited by 41 publications

(37 citation statements)

References 7 publications

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“…The prevalence of HIV in Cameroon is the highest in the sub-region of West and Central Africa, standing at 5.1% [5]. Also, about 33,000 tuberculosis infections are recorded each year, with over 2000 annual deaths [6] mostly in association with HIV [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon

et al. 2017

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BackgroundIn Cameroon, poverty-related diseases (PRDs) are a major public health concern. Research and policies addressing PRDs are based on a particular understanding of the interaction between poverty and disease, usually an association between poverty indicators and health indicators for a specific country or region. Such indicators are useful but fail to explain the nature of the linkages between poverty and disease or poverty and health. This paper presents results of a study among university students, unravelling how they perceive diseases, the linkages with poverty, their responses to diseases and the motivations behind reported responses.Based on the health belief model, this cross-sectional study was carried out among 272 students at the universities of Buea and Yaoundé in Cameroon. Data were collected using questionnaires containing items matching the research objectives. The questionnaires were self-completed.ResultsMalaria was considered as the most common disease perceived and also a major PRD. Contrary to official rankings of HIV/AIDS and TB, cholera and diarrhoea were considered as other major PRDs. Also, typhoid fever was perceived to be more common and a PRD than HIV/AIDS and TB combined. The most prominently attributed cause for disease was (lack of) hygiene. In response, students deployed formal and/or informal healthcare strategies, depending on factors like available money, perceived severity of the disease and disease type. Discrepancies were observed in respondents’ response to diseases generally and to malaria in particular. Even though, overall, respondents pre-dominantly reported a formal healthcare response toward diseases in general, for malaria, informal responses dominated. There was an overall strong awareness and (pro)activity among students for dealing with diseases.ConclusionsAlthough the high use of informal facilities and medication for malaria may well be a reason why eradication is problematic, this seems to be a deliberate strategy linked to an awareness of the limitations of the formal health system. In any intervention intended to foster health, it is therefore vital to consider people’s perceptions toward diseases and their response strategies. Our results give important leads to health promotion interventions to develop group-specific programs.

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Section: Introductionmentioning

confidence: 99%

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon

et al. 2017

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“…Mounting evidence from a number of countries in both the developed and developing worlds attests not only to the predisposing effect of smoking for the development of pulmonary TB [105][106][107][108][109][110][111][112], but also for more severe disease progression [113], decreased efficacy of antimicrobial chemotherapy [114], prolonged infectivity [115][116][117], recurrence of disease [118], poor outcomes of multidrug-resistant TB [119] and possibly impaired post-treatment lung function [120].…”

Section: Tuberculosismentioning

confidence: 99%

Impact of HIV infection and smoking on lung immunity and related disorders

2015

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HIV-infected persons not only have higher rates of smoking than the general population, but are also unusually vulnerable to the associated adverse health effects, both infective and noninfective in origin. Indeed, in the setting of well-organised care and availability of highly active antiretroviral therapy, HIV-infected smokers lose more life-years to smoking than to HIV infection per se, presenting a major challenge to healthcare providers. Not surprisingly, the respiratory system is particularly susceptible to the damaging interactive chronic inflammatory and immunosuppressive effects of HIV and smoking, intensifying the risk of the development of opportunistic infections, as well as lung cancer and obstructive lung disorders. The impact of smoking on the immunopathogenesis and frequencies of these respiratory conditions in the setting of HIV infection, as well as on the efficacy of antiretroviral therapy, represent the primary focus of this review. @ERSpublications Smoking exacerbates the immunosuppressive/pro-inflammatory effects of HIV, increasing the risk of pulmonary disease

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“…This high sputum conversion rate compares to the WHO standard for a well-functioning NTP, which is a conversion rate of at least 75% among new smear-positive PTB cases, and is higher than rates recently reported from other settings. 8,9 Our…”

Section: Discussionmentioning

confidence: 99%

Changing from single-drug to fixed-dose combinations: Experience from Fiji

2015

Indian Journal of Tuberculosis

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T uberculosis (TB) is a major cause of morbidity and mortality worldwide, with the highest prevalence in resource-limited countries. Fiji reported a TB case notification rate of 24 per 100 000 population in 2012, and this compares to a case notification rate of 31/100 000 in 1990. 1 TB control is an ongoing challenge, with 614 new and relapse TB cases reported to the World Health Organization (WHO) from 2010 to end 2012. Reported treatment success rates, an important indicator of TB control, have been variable over the last decade, ranging from 62% to 90%. 1 There are many possible reasons for inadequate treatment outcomes, some of which may relate directly to medication, such as interrupted anti-tuberculosis drug supplies or poor patient adherence. To improve adherence, the WHO and the International Union Against Tuberculosis and Lung Disease (The Union) now recommend the use of fixed-dose combinations (FDCs) for first-line treatment of drug-susceptible TB. 2 TB patients were previously treated with a combination of single-drug preparations of isoniazid (H, INH), rifampicin (R, RMP), pyrazinamide (Z, PZA) and ethambutol (E, EMB). Prospective, randomised trials covering multiple sites in TB-endemic settings have concluded that treatment outcomes were not inferior when using FDCs than when using single-drug preparations. 3,4 Since FDCs were introduced into the Fiji National Tuberculosis Programme (NTP) in November 2011, it has been observed anecdotally that the sputum conversion rate among new sputum smear-positive TB patients is lower than when treatment consisted of single-drug preparations. Although the WHO TB treatment guidelines limit the intensive phase of treatment for new patients to 2 months, this perception resulted in clinicians occasionally prolonging the intensive phase of treatment in patients receiving FDCs. This observation of lower sputum conversion rates has not, however, been evaluated or quantified.We therefore aimed to evaluate whether the introduction of FDCs had affected treatment response among TB patients in Fiji. METHODS Study settingThis was a retrospective cohort study comparing anti-tuberculosis treatment outcomes between those receiving FDCs and those receiving single-drug preparations undertaken at all three NTP TB treatment centres in Fiji. The Fiji NTP was established in 1951, and the DOTS strategy was introduced in 1997. 5 The case detection rate rose from an estimated 28% in 1990 to 79% in 2010. 1 The three TB treatment centres are the only providers of anti-tuberculosis drugs in Fiji. Sputum smear microscopy with Ziehl-Neelsen staining for acid-fast bacilli (AFB) is undertaken for initial diagnosis and after 2 months of standard first-line treatment for all sputum smear-positive cases to assess smear conversion to sputum smear-negative. For those patients who do not convert by 2 months, follow-up smear examination is carried out monthly. Results are recorded in the AFB register.TB has been treated according to the Fiji NTP guidelines since before 2010: standard first-line trea...

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Non-conversion of sputum culture among patients with smear positive pulmonary tuberculosis in Cameroon: a prospective cohort study

Cited by 41 publications

References 7 publications

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon

Impact of HIV infection and smoking on lung immunity and related disorders

Changing from single-drug to fixed-dose combinations: Experience from Fiji

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