Benson R Kidenya1, Stephen E Mshana2, Lisa Gerwing-Adima3, Jeremiah Kidola4, Christa Kasang5. 1. Department of Biochemistry and Molecular Biology, Catholic University of Health and Allied Sciences (CUHAS)-Bugando Mwanza Tanzania, P.O. Box 1464, Mwanza, Tanzania. Electronic address: benkidenya@yahoo.com. 2. Department of Medical Microbiology and Immunology, Catholic University of Healthand AlliedSciences (CUHAS)-Bugando, Mwanza Tanzania, P.O. Box 1464, Mwanza, Tanzania. 3. Tuberculosis Laboratory, Bugando Medical Centre, Mwanza Tanzania, P.O. Box 1370, Mwanza, Tanzania. 4. National Institute for Medical Research (NIMR), Mwanza Tanzania, P.O. Box 1462, Mwanza, Tanzania. 5. Department of Infectious Diseases, Medical Mission Institute, Wurzburg, Germany.
Abstract
OBJECTIVES: The study aimed at assessing the Tuberculosis (TB) medication adherence level and the efficacy of smear microscopy in the diagnosing pulmonary TB at month 2. METHODS: A prospective study was conducted at the four sites located in the Northern-western Tanzania. New smear positive, pulmonary TB patients were followed up and their adherence to TB medication assessed after 2 months of the treatment. In addition, the acid fast bacilli (AFB) smear microscopy was performed after 2 and 5 months of the treatment. All smear positive samples were subjected to geneXpert (MTB/RIF) assay and culture on the Lowenstein Jensen (LJ) media. RESULTS: A total of 331 smear positive, newly diagnosed patients with pulmonary TB were enrolled. The median age was 36 [Interquartile range (IQR): 28-45] years and males formed the slightly majority, 187 (56.5%) of the participants. A total of 105 (31.7%) patients were infected with HIV. Out of 331 patients, 36 (10.9%) were still AFB smear positive at the end of two month. Of these 19 (52.8%) were positive on GeneXpert MTB RIF and none was Rifampicin resistant. Of note, only 13 (31.1%) were culture positive (viable). None of the patients was positive at month 5. Poor adherence to TB medications in the first 2 months of treatment was observed in 56/331 (16.9%) [95% CI=12.9-21.0] of the patients. CONCLUSION: Over two thirds of smear positive patients are wrongly put in one month extension of the intensive phase treatment; this may cause increased costs and drug toxicity. Culture should be advocated to confirm smear positivity after 2 months of medications. TB treatment drug adherence in our setting is good and is associated with successful cure. No multidrug resistant tuberculosis (MDR-TB) was observed. Continued surveillance and emphasizing of TB drug adherence should be kept upbeat in order to control tuberculosis in developing countries.
OBJECTIVES: The study aimed at assessing the Tuberculosis (TB) medication adherence level and the efficacy of smear microscopy in the diagnosing pulmonary TB at month 2. METHODS: A prospective study was conducted at the four sites located in the Northern-western Tanzania. New smear positive, pulmonary TB patients were followed up and their adherence to TB medication assessed after 2 months of the treatment. In addition, the acid fast bacilli (AFB) smear microscopy was performed after 2 and 5 months of the treatment. All smear positive samples were subjected to geneXpert (MTB/RIF) assay and culture on the Lowenstein Jensen (LJ) media. RESULTS: A total of 331 smear positive, newly diagnosed patients with pulmonary TB were enrolled. The median age was 36 [Interquartile range (IQR): 28-45] years and males formed the slightly majority, 187 (56.5%) of the participants. A total of 105 (31.7%) patients were infected with HIV. Out of 331 patients, 36 (10.9%) were still AFB smear positive at the end of two month. Of these 19 (52.8%) were positive on GeneXpert MTB RIF and none was Rifampicin resistant. Of note, only 13 (31.1%) were culture positive (viable). None of the patients was positive at month 5. Poor adherence to TB medications in the first 2 months of treatment was observed in 56/331 (16.9%) [95% CI=12.9-21.0] of the patients. CONCLUSION: Over two thirds of smear positive patients are wrongly put in one month extension of the intensive phase treatment; this may cause increased costs and drug toxicity. Culture should be advocated to confirm smear positivity after 2 months of medications. TB treatment drug adherence in our setting is good and is associated with successful cure. No multidrug resistant tuberculosis (MDR-TB) was observed. Continued surveillance and emphasizing of TB drug adherence should be kept upbeat in order to control tuberculosis in developing countries.
Authors: Florencia S Buchera; Vitus Silago; Geofrey Japhet; Conjester I Mtemisika; Prisca Damiano; Helmut A Nyawale; Martha F Mushi; Mariam M Mirambo; Jeremiah Seni; Stephen E Mshana Journal: Microorganisms Date: 2022-03-25
Authors: Cylia Nkechi Iweama; Olaoluwa Samson Agbaje; Prince Christian Ifeanachor Umoke; Chima Charles Igbokwe; Eyuche Lawretta Ozoemena; Nnenna Lois Omaka-Amari; Benjamin Mudi Idache Journal: SAGE Open Med Date: 2021-01-30
Authors: Elizabeth J Ragan; Christopher J Gill; Matthew Banos; Tara C Bouton; Jennifer Rooney; Charles R Horsburgh; Robin M Warren; Bronwyn Myers; Karen R Jacobson Journal: JMIR Res Protoc Date: 2021-06-16