Ash: January 15, 2011 The Ministry of Health is currently preparing for the distribution of the national tuberculosis guideline in all government, semi government and private sectors to become a national reference when dealing with tuberculosis disease.
Dr. Mahmood Fikri, Assistant Undersecretary for Health Policies at the Ministry of Health, stated that the ministry aims for maintaining the country free of infectious diseases such as tuberculosis and following the recommendations of the World Health Organization (WHO) as well as taking the necessary procedures to face different health challenges.
He said: “Updating the guideline came as a result of the recommendations of the WHO and we formed a special committee from the ministry itself and the health authorities in Abu Dhabi and Dubai”.
The guideline that is issued in English language aims for addressing medical and technical staff to deal with patients and employees of the national tuberculosis program to fight tuberculosis. It consists of an introduction and 6 sections about the epidemiology of the disease in terms of the prevalence and mortality rates as well as the challenges of fighting the disease such as emergence of strains resistance to the treatment, relation of the disease to AIDS.
Dr. Kalthoom Mohamed, Director of Specialized Healthcare Department and Director of Tuberculosis National Program at the Ministry of Health, stated that the guideline gives a brief explanation about the role, goals and objectives of the national tuberculosis program in the UAE as part of the ministry’s strategy to fight tuberculosis.
“The second section included a detailed explanation about the methods of diagnosing the disease clinically and classifying tuberculosis in terms of location, type of infection and treatment results”, she added.
The third section discusses tuberculosis treatment methods, kinds of medicines, and ways of applying short term treatment policies according to the latest recommendations of the world health organization. It also emphasizes the relation of tuberculosis treatment in relation to pregnant women or patients who suffer from hepatic or renal insufficiency. In addition, the fourth section highlighted the symptoms, diagnosis and treatment of children tuberculosis.
Both fifth and sixth sections discuss direct contacts with TB patients, determining the duration of the disease, evaluation of patients during that time and the required treatment procedures.
Dr Kalthoom indicated the importance of notifying and recording any TB cases to ensure ongoing follow up and evaluation of the disease through the records derived statistics.
It is noted that the doctors are the most people to benefit from the guideline as it covers pulmonary TB. It is also useful for x-ray, lab and preventive medicine technicians. Universities and health colleges may benefit from the guideline through applying for an application in the ministry.
http://biomedme.com/general/ministry-of-health-updates-tuberculosis-national-guideline_30029.html
Showing posts with label TB treatment guidelines. Show all posts
Showing posts with label TB treatment guidelines. Show all posts
Tuesday, 18 January 2011
Monday, 23 August 2010
TUBERCULOSIS: issuues of excessively long treatment
Background
Few data are available on prescriber adherence to tuberculosis (TB) treatment guidelines. In particular, excessively long treatment carries a risk of avoidable adverse effects and represents a waste of healthcare resources. We examined factors potentially associated with excessively long treatment.
Methods
We reviewed the medical records of patients diagnosed with TB in 2004 in the eastern Paris region. Sociodemographic and clinical factors associated with excessively long treatment were identified by logistic regression analyses. Based on contemporary guidelines, excessively long treatment was defined as more than 6 months of a four-drug regimen for thoracic TB with full sensitive strains, and more than 12 months for patients with extrathoracic TB.
Results
Analyses concerned 478 patients with a median age of 36.0 +/- 13.5 years, of whom 48% were living in precarious conditions (i.e. poor living conditions and/or no health insurance), 80% were born abroad, and 17% were HIV-seropositive. TB was restricted to the chest in 279 patients (isolated pulmonary, pleuropulmonary, and isolated pleural TB in 245, 13, and 21 patients, respectively), exclusively extrathoracic in 115 patients, and mixed in the remaining 84 patients. Treatment was prescribed by a chest specialist in 211 cases (44.1%) and 295 patients (61.7%) were managed in a single institution. The treatment duration complied with contemporary guidelines in 316 cases (66.1%) and was excessively long in 162 cases (33.9%). The median duration of excessively long treatment was 313 days (IQR: 272-412). In multivariate analysis, isolated thoracic TB, previous TB, HIV infection, a prescriber other than a chest specialist, and management in more than one healthcare center during treatment were independently associated with excessively lengthy treatment.
Conclusion
One-third of TB patients received excessively long treatment, reflecting inadequate awareness of management guidelines or unwillingness to implement them.
http://www.biomedcentral.com/1471-2458/10/495
Few data are available on prescriber adherence to tuberculosis (TB) treatment guidelines. In particular, excessively long treatment carries a risk of avoidable adverse effects and represents a waste of healthcare resources. We examined factors potentially associated with excessively long treatment.
Methods
We reviewed the medical records of patients diagnosed with TB in 2004 in the eastern Paris region. Sociodemographic and clinical factors associated with excessively long treatment were identified by logistic regression analyses. Based on contemporary guidelines, excessively long treatment was defined as more than 6 months of a four-drug regimen for thoracic TB with full sensitive strains, and more than 12 months for patients with extrathoracic TB.
Results
Analyses concerned 478 patients with a median age of 36.0 +/- 13.5 years, of whom 48% were living in precarious conditions (i.e. poor living conditions and/or no health insurance), 80% were born abroad, and 17% were HIV-seropositive. TB was restricted to the chest in 279 patients (isolated pulmonary, pleuropulmonary, and isolated pleural TB in 245, 13, and 21 patients, respectively), exclusively extrathoracic in 115 patients, and mixed in the remaining 84 patients. Treatment was prescribed by a chest specialist in 211 cases (44.1%) and 295 patients (61.7%) were managed in a single institution. The treatment duration complied with contemporary guidelines in 316 cases (66.1%) and was excessively long in 162 cases (33.9%). The median duration of excessively long treatment was 313 days (IQR: 272-412). In multivariate analysis, isolated thoracic TB, previous TB, HIV infection, a prescriber other than a chest specialist, and management in more than one healthcare center during treatment were independently associated with excessively lengthy treatment.
Conclusion
One-third of TB patients received excessively long treatment, reflecting inadequate awareness of management guidelines or unwillingness to implement them.
http://www.biomedcentral.com/1471-2458/10/495
Thursday, 12 August 2010
TUBERCULOSIS: Prolonged Infectiousness of Tuberculosis Patients in a Directly Observed Therapy Short-Course Program with Standardized Therapy.
Background.
Effective tuberculosis control is compromised by a lack of clarity about the timeframe of viable Mycobacterium tuberculosis shedding after treatment initiation under programmatic conditions. This study quantifies time to conversion from smear and culture positivity to negativity in unselected tuberculosis patients receiving standardized therapy in a directly observed therapy short-course (DOTS) program.
Methods.
Longitudinal cohort study following up 93 adults initiating tuberculosis therapy in Lima, Peru. Baseline culture and drug susceptibility tests (DSTs) were performed using the MBBacT, proportion, and microscopic observation drug susceptibility (MODS) methods. Smear microscopy and MODS liquid culture were performed at baseline and weekly for 4 weeks then every other week for 26 weeks.
Results.
Median conversion time from culture positivity to culture negativity of 38.5 days was unaffected by baseline smear status. Patients with fully susceptible tuberculosis had a median time to culture conversion of 37 days; 10% remained culture positive at day 60. Delayed culture conversion was associated with multidrug resistance, regardless of DST method used; non-multidrug resistance as defined by the proportion method and MODS (but not MBBacT) was also associated with delay. Persistent day 60 smear positivity yielded positive and negative predictive values of 67% and 92%, respectively, for detecting multidrug resistance.
Conclusions.
Smear and culture conversion in treated tuberculosis patients takes longer than is conventionally believed, even with fully susceptible disease, and must be accounted for in tuberculosis treatment and prevention programs. Persistent day 60 smear positivity is a poor predictor of multidrug resistance. The industrialized-world convention of universal baseline DST for tuberculosis patients should become the standard of care in multidrug resistance-affected resource-limited settings.
http://medicine.journalfeeds.com/infectious-diseases/clin-infect-dis/prolonged-infectiousness-of-tuberculosis-patients-in-a-directly-observed-therapy-short-course-program-with-standardized-therapy/20100715/
Effective tuberculosis control is compromised by a lack of clarity about the timeframe of viable Mycobacterium tuberculosis shedding after treatment initiation under programmatic conditions. This study quantifies time to conversion from smear and culture positivity to negativity in unselected tuberculosis patients receiving standardized therapy in a directly observed therapy short-course (DOTS) program.
Methods.
Longitudinal cohort study following up 93 adults initiating tuberculosis therapy in Lima, Peru. Baseline culture and drug susceptibility tests (DSTs) were performed using the MBBacT, proportion, and microscopic observation drug susceptibility (MODS) methods. Smear microscopy and MODS liquid culture were performed at baseline and weekly for 4 weeks then every other week for 26 weeks.
Results.
Median conversion time from culture positivity to culture negativity of 38.5 days was unaffected by baseline smear status. Patients with fully susceptible tuberculosis had a median time to culture conversion of 37 days; 10% remained culture positive at day 60. Delayed culture conversion was associated with multidrug resistance, regardless of DST method used; non-multidrug resistance as defined by the proportion method and MODS (but not MBBacT) was also associated with delay. Persistent day 60 smear positivity yielded positive and negative predictive values of 67% and 92%, respectively, for detecting multidrug resistance.
Conclusions.
Smear and culture conversion in treated tuberculosis patients takes longer than is conventionally believed, even with fully susceptible disease, and must be accounted for in tuberculosis treatment and prevention programs. Persistent day 60 smear positivity is a poor predictor of multidrug resistance. The industrialized-world convention of universal baseline DST for tuberculosis patients should become the standard of care in multidrug resistance-affected resource-limited settings.
http://medicine.journalfeeds.com/infectious-diseases/clin-infect-dis/prolonged-infectiousness-of-tuberculosis-patients-in-a-directly-observed-therapy-short-course-program-with-standardized-therapy/20100715/
Sunday, 9 May 2010
TUBERCULOSIS: WHO Guidelines
Treatment of Tuberculosis: guidelines for national programmes
4th edition - English only
http://www.who.int/tb/publications/tb_treatmentguidelines/en/index.html
4th edition - English only
http://www.who.int/tb/publications/tb_treatmentguidelines/en/index.html
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