Follow-up Study of Retreatment TB Patients with Sputum Smear and/or Culture Positive Two Years after They were Declared Cured with First-line Anti-TB Drugs in Shandong Province

This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence in order to improve long-time treatment outcome. 5 cities were selected as research locations. Recurrence of TB was judged by chest X-ray examination together with sputum smear and culture examination.

Factors Undermining the Investigation of Child Contacts of TB Patients： The Case of FCT, Abuja, Nigeria

Facility records of 320 TB （tuberculosis） patients were examined over a one-year-period; January-December 2009 to ascertain the screening of children under 6 years of age who have had contacts with sputum smear positive TB patients as stipulated in the NTBLCP （National Tuberculosis and Leprosy Control Program） guidelines. In addition, semi-structured questionnaires were administered to 28 DOTS （directly-observed treatment strategy） clinicians to elicit information to help explain findings from the analysis of the routine data. Over 60% of children less than 6 years of age who had contacts with TB patients were not investigated in the health facilities included in the survey. The level of educational attainment of DOTS providers was associated with the screening of TB patients＇ contacts （P = 0.008）. Forgetfulness by clinicians to ask for or screen children of TB patients in the facilities is the singular most important factor undermining contact investigation. The proportion of under 6 years TB contacts screened or not screened for TB in the facilities was similar according to the age and gender of TB patients, and the type of health facilities where treatment was accessed by patients （P = 0.325）. The study underscored the need for the state program to evaluate the quality of service provision as well as counseling provided to TB patients at the facilities.

Detection of Myobacterium Tuberculosis in the Samples of 122 TB Patients Using Polymerase Chain Reaction Technique

By means of polymerase chain reaction(PCR) technique,direct smear fluorescence microscopy and bacterial culture,the sputa and purulent secretion of 122 TB patients were examined to detect mycobacterium tuberculosis.

Patient Health Seeking Behavior and Choice of Place of Care among Tuberculosis Clients in Selected States in Nigeria

Background: Tuberculosis (TB) remains a major global public health problem. Early detection and initiation of treatment shortens infectious period and is key to TB control. A considerable proportion of TB patients presenting with advanced symptoms suggests delay in seeking care. As TB control programs rely on passive case finding, TB care-seeking behavior is critical as un-diagnosed cases act as reservoirs for transmission. This study assessed patient health seeking behavior and choice of place of care among TB patients in Nigeria. Methods: This was a pro-gramme implementation, facility-based cross-sectional study in 14 states, 92 facilities across three levels of care. Interviewer-administered semi-structured questionnaires were used. Information on personal characteristics and health seeking behavior was collected from June 2020 to December 2021. The analysis was based on the various healthcare providers where the respondents first sought care. Data analysis was done using IBM SPSS and summarized using frequency and percentages. Chi square test was used for associations of characteristics of patients and choice of place of care at p Results: In all 14 states, distribution of overall first place of seeking care for TB symptoms was: 7208 (75.8%) health facilities (range 57% to 88%), while 2294 (24.2%) visited other places including community pharmacist, patent medicine vendor, traditional/home, un-specified/none. For Health facilities, the majority were at public facilities 6563 (69.1%) and private 641 (6.7%). Moreover, 6 states had >20% of respondents who first sought care at PMVs, while 3 states (Delta, Imo, and Rivers) had 10% of respondents who first sought care at Community Pharmacist. Conclusions: Nearly a quarter of people with TB first sought care outside health facilities, suggesting the need to align availability of services with their needs.

Is tuberculosis patients management improved in the integrated TB control model in West China?A survey in Guizhou Province,China

Background:Tuberculosis(TB)patient management(TPM)is crucial to improve patient compliance to treatment.The coverage of TPM delivered by TB dispensaries or Centers for Disease Control and Prevention(CDC)was not high under the previous CDC model of TB control in China.In the integrated TB control model in China,TB patient management(TPM)was mainly delivered by lay health workers(LHWs)in primary health care(PHC)sectors.This study aims to investigate TPM delivery in resource-limited western China and to identify factors affecting TPM delivery by LHWs under the integrated TB control model.Methods:A stratified random sampling was used to select study sites.Pulmonary TB(PTB)patients≥15 years old from selected counties/districts in Guizhou Province were surveyed from August 2015 to May 2016.Structured questionnaires were used to collect data.Aχ^2 test and logistic regression were used to identify factors associated with self-administered treatment(non-TPM).Results:In total,638 PTB patients were included in the final analysis.Close to 30%of patients were ethnic minorities.More than 30%of patients were from counties with high TB burden,and 24.9%of patients had poor compliance to treatment.Only 37.1%of patients received TPM delivered by LHWs under the integrated TB control model throughout the treatment period.The main reasons for unwillingness to manage reported by patients included social stigma and no perceived need.Being ethnic minorities(OR=3.35)was a main factor associated with lower likelihood of receiving TPM,while living in areas with middle or high TB burden may increase the likelihood of receiving TPM(OR=0.17 and 0.25,respectively).Among current management approaches,more than 85%of patients chose phone reminder as their preferred TPM by LHWs.Conclusions:TPM under the integrated model in West China is still low and need further improvement,and the impeding factors of TPM need to be addressed.Strengthening patient-centered and community-based TPM and developing more feasible approaches of TPM delivery should be explored in future research in this region.