It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of th...It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of the developing world. The aim of the review was to elucidate the natural history and characteristics of abdominal TB and ascertain the indications for surgery. TB can affect the intestine as well as the peritoneum and the most important aspect of abdominal TB is to bear in mind the diagnosis and obtain histological evidence. Abdominal TB is generally responsive to medical treatment, and early diagnosis and management can prevent unnecessary surgical intervention. Due to the challenges of early diagnosis, patients should be managed in collaboration with a physician familiar with anti-tuberculous therapy. An international expert consensus should determine an algorithm for the diagnosis and multidisciplinary management of abdominal TB.展开更多
Background: Efforts to combat tuberculosis in Nigeria focus on evaluation of strategies for treatment and prevention, with little attention paid to the impact of the burden of illness and its therapy on the HRQoL of T...Background: Efforts to combat tuberculosis in Nigeria focus on evaluation of strategies for treatment and prevention, with little attention paid to the impact of the burden of illness and its therapy on the HRQoL of TB patients. This study evaluated the quality of life (QoL) of TB patients in relation to their financial, psychological and social well-being. Method: In 2011, following an active case finding for TB in Akwa Ibom State of Nigeria, a structured questionnaire for evaluating HRQoL was distributed to TB patients who had been on treatment in four DOTs centres of the state for at least three months. The questions were to elicit responses that conveyed the respondents’ perspective of the disease. One hundred and eight TB patients (54 males and 54 females) aged 15 - 80 years were studied. Results: Negative emotions including fear, frustration and worry characterized the reactions of all subjects following news of their diagnosis with TB. However, following treatment, 62% of subjects expressed high expectation of being cured. Inability to continue functioning in their roles at home or as heads of households was recorded in 48.1% (52/108) and 59% (23/39) of respondents respectively and contributed to the negative emotions expressed above. Lack of basic supplies such as food and finances to meet personal and family needs constituted the most important socio-economic challenges. Socio-economic status of respondents revealed that 61% had no regular means of income with at least 94% earning less than $50 (8000 naira) a month. Subsistent farmers and petty traders constituted more than 66% of the respondents: 98% obtained less than or equivalent of high school education. Socially, all health workers and 87% of family members were sympathetic and supportive compared to friends, with 42% exhibiting stigmatization. The most frequent forms of support from family members were financial (25%) and provision of food (37%). Up to 28% were regularly prompted by family to take their medication. Conclusion: In the midst of obvious socio-economic challenges confronting TB patients in this study, the initial negative emotions declined following the supportive roles of mainly health care workers and family members. Patients were optimistic of achieving cure at the end of the treatment.展开更多
文摘It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of the developing world. The aim of the review was to elucidate the natural history and characteristics of abdominal TB and ascertain the indications for surgery. TB can affect the intestine as well as the peritoneum and the most important aspect of abdominal TB is to bear in mind the diagnosis and obtain histological evidence. Abdominal TB is generally responsive to medical treatment, and early diagnosis and management can prevent unnecessary surgical intervention. Due to the challenges of early diagnosis, patients should be managed in collaboration with a physician familiar with anti-tuberculous therapy. An international expert consensus should determine an algorithm for the diagnosis and multidisciplinary management of abdominal TB.
文摘Background: Efforts to combat tuberculosis in Nigeria focus on evaluation of strategies for treatment and prevention, with little attention paid to the impact of the burden of illness and its therapy on the HRQoL of TB patients. This study evaluated the quality of life (QoL) of TB patients in relation to their financial, psychological and social well-being. Method: In 2011, following an active case finding for TB in Akwa Ibom State of Nigeria, a structured questionnaire for evaluating HRQoL was distributed to TB patients who had been on treatment in four DOTs centres of the state for at least three months. The questions were to elicit responses that conveyed the respondents’ perspective of the disease. One hundred and eight TB patients (54 males and 54 females) aged 15 - 80 years were studied. Results: Negative emotions including fear, frustration and worry characterized the reactions of all subjects following news of their diagnosis with TB. However, following treatment, 62% of subjects expressed high expectation of being cured. Inability to continue functioning in their roles at home or as heads of households was recorded in 48.1% (52/108) and 59% (23/39) of respondents respectively and contributed to the negative emotions expressed above. Lack of basic supplies such as food and finances to meet personal and family needs constituted the most important socio-economic challenges. Socio-economic status of respondents revealed that 61% had no regular means of income with at least 94% earning less than $50 (8000 naira) a month. Subsistent farmers and petty traders constituted more than 66% of the respondents: 98% obtained less than or equivalent of high school education. Socially, all health workers and 87% of family members were sympathetic and supportive compared to friends, with 42% exhibiting stigmatization. The most frequent forms of support from family members were financial (25%) and provision of food (37%). Up to 28% were regularly prompted by family to take their medication. Conclusion: In the midst of obvious socio-economic challenges confronting TB patients in this study, the initial negative emotions declined following the supportive roles of mainly health care workers and family members. Patients were optimistic of achieving cure at the end of the treatment.
