Journal Article > ResearchFull Text
Public Health Action. 21 October 2014; Volume 4 (Issue 2); S13-6.; DOI:10.5588/pha.14.0038
Davtyan K, Zachariah R, Davtyan H, Ramsay AR, Denisiuk O, et al.
Public Health Action. 21 October 2014; Volume 4 (Issue 2); S13-6.; DOI:10.5588/pha.14.0038
We assessed the performance of decentralised tuberculosis (TB) out-patient centres in tuberculosis (TB) case notification and treatment success in Armenia. An average threshold case notification of ⩾37/100 000 was seen in centres that had higher numbers of presumptive TB patients, where more TB was diagnosed by in-patient facilities and where TB contacts were examined. The number of doctors and/or TB specialists at centres did not influence case notification. Onsite smear microscopy was significantly associated with a treatment success rate of ⩾85% for new TB patients. Addressing specific characteristics of TB centres associated with lower case notification and treatment success and optimising their location may improve performance.
Journal Article > ResearchFull Text
Public Health Action. 1 September 2017; Volume 7 (Issue 3); DOI:10.5588/pha.17.0002
Goncharova O, Denisiuk O, Zachariah R, Davtyan K, Nabirova D, et al.
Public Health Action. 1 September 2017; Volume 7 (Issue 3); DOI:10.5588/pha.17.0002
Setting: Twenty-two first-line, two second-line and one tertiary health facility in Bishkek, the capital of Kyrgyzstan. Objectives: Among migrants, a marginalised population at risk for acquiring and transmitting tuberculosis (TB), we determined the proportion with TB among all registered TB cases. For those registered at primary-level facilities, we then reported on their demographic and clinical profiles and TB treatment outcomes. Design: This was a retrospective cohort analysis of 2012-2013 programme data. Results: Of 2153 TB patients registered in all health facilities, 969 (45%) were migrants, of whom 454 were registered in first-line facilities. Of these, 27% were cross-border migrants, 50% had infectious TB and 12% had drug-resistant TB. Treatment success was 74% for new cases and 44% for retreatment TB (the World Health Organization target is ⩾85%). Failure in new and retreatment TB patients was respectively 8% and 25%. Twenty-six individuals started on a first-line anti-tuberculosis regimen failed due to multidrug-resistant TB. Eight (25%) of 32 individuals on a retreatment TB regimen also failed. Loss to follow-up was 10% for new and 19% for retreatment TB. Conclusion: Migrants constituted almost half of all TB patients, drug resistance is prevalent and treatment outcomes unsatisfactory. Fostering inter-country collaboration and prioritising rapid TB diagnostics (Xpert® MTB/RIF) and innovative ways forward for improving treatment outcomes is urgent.
Journal Article > ResearchFull Text
Public Health Panor. 1 January 2016; Volume 1 (Issue 3); 252-259.
Davtyan K, Aghabekyan S, Davtyan H, Margaryan T, Zachariah R, et al.
Public Health Panor. 1 January 2016; Volume 1 (Issue 3); 252-259.
BACKGROUND AND OBJECTIVE
Adherence to treatment is an important factor for the successful treatment of tuberculosis (TB). Many countries have introduced incentive mechanisms to enhance adherence. Armenia provides social support packages of food
and hygiene kits to TB patients. We aimed to evaluate the importance of the social support programme among 500 randomly selected TB patients and their physicians.
METHODS
We used a mixed-methods approach(both qualitative and quantitative) with a retrospective descriptive study design.
For the qualitative part, 40 in-depth interviews were conducted with 20 TB patients and 20 TB physicians. For the quantitative study, medical records and face-to-face interviews with 500 randomly selected TB patients and their TB doctors served as the data sources.
RESULTS
Out of 500 patients, 490 (98%) reported receiving social packages during treatment and 470 (96%) were satisfied (based on the patient’s personal perception) with them. Most of the patients preferred monetary incentives (274 [57.8%]) instead of the currently provided food and hygiene kits. Treatment
success was positively associated with satisfaction with the social support provided (odds ratio [OR]=2.8, 95% confidence interval [CI]: 1.0; 7.6, P=0.04), treatment interruptions that did not last longer than a week (OR=4.1, 95% CI: 2.4; 7.1, P<0.01) and having “regular” TB (OR=3.0, 95% CI: 1.7; 5.3, P<0.01).
CONCLUSION
More flexible social support packages that better address patient needs would enhance treatment adherence, which would result in better treatment outcomes and programme improvement.
Adherence to treatment is an important factor for the successful treatment of tuberculosis (TB). Many countries have introduced incentive mechanisms to enhance adherence. Armenia provides social support packages of food
and hygiene kits to TB patients. We aimed to evaluate the importance of the social support programme among 500 randomly selected TB patients and their physicians.
METHODS
We used a mixed-methods approach(both qualitative and quantitative) with a retrospective descriptive study design.
For the qualitative part, 40 in-depth interviews were conducted with 20 TB patients and 20 TB physicians. For the quantitative study, medical records and face-to-face interviews with 500 randomly selected TB patients and their TB doctors served as the data sources.
RESULTS
Out of 500 patients, 490 (98%) reported receiving social packages during treatment and 470 (96%) were satisfied (based on the patient’s personal perception) with them. Most of the patients preferred monetary incentives (274 [57.8%]) instead of the currently provided food and hygiene kits. Treatment
success was positively associated with satisfaction with the social support provided (odds ratio [OR]=2.8, 95% confidence interval [CI]: 1.0; 7.6, P=0.04), treatment interruptions that did not last longer than a week (OR=4.1, 95% CI: 2.4; 7.1, P<0.01) and having “regular” TB (OR=3.0, 95% CI: 1.7; 5.3, P<0.01).
CONCLUSION
More flexible social support packages that better address patient needs would enhance treatment adherence, which would result in better treatment outcomes and programme improvement.
Journal Article > ResearchFull Text
J Infect Dev Ctries. 29 September 2021; Volume 15 (Issue 9.1); 3S-6S.; DOI:10.3855/jidc.15057
Davtyan H, Davtyan K, Harries AD, Reid AJ, Aslanyan G, et al.
J Infect Dev Ctries. 29 September 2021; Volume 15 (Issue 9.1); 3S-6S.; DOI:10.3855/jidc.15057
The Structured Operational Research and Training Initiative (SORT IT) model has contributed to building research capacity and has produced evidence for improving public health program performance in countries with limited research capacity. The model involves hands-on mentorship and consists of three modules/weeks. It is recognized to be an innovative research capacity building model. In a world changed by COVID-19, where bringing people together is not viable, an innovative, interactive, web-based, knowledge-transfer platform (e-SORT IT) for virtual implementation of SORT IT modules was created. The platform design imitated the residential course as closely as possible with the same lectures, plenary sessions, and breakout rooms. Despite the challenges, the platform performed well and even though participants and mentors were located in eight different time zones, the course was successful; 90% of participants achieved their milestones and 10 manuscripts were successfully completed. Participant evaluation revealed a satisfaction level that was nearly equivalent to the residential module. However, mentor evaluation indicated a number of shortcomings including capacity building, professional networking, communication, engagement, and contribution by participants, as well as overall module success. In conclusion, COVID-19 stimulated the creation of the e-SORT IT platform that provided a functional alternative to the residential version. Despite the limitations of reduced capacity building and networking, the e-SORT IT platform should be considered a success - it delivered the goods. This is an example of innovation and flexibility, two attributes that are sorely needed to maintain activities during the pandemic and beyond.
Journal Article > ResearchFull Text
Trop Med Infect Dis. 6 November 2020; Volume 5 (Issue 4); 167.; DOI:10.3390/tropicalmed5040167
Zachariah R, Rust S, Thekkur P, Khogali A, Kumar AMV, et al.
Trop Med Infect Dis. 6 November 2020; Volume 5 (Issue 4); 167.; DOI:10.3390/tropicalmed5040167
INTRODUCTION
Observational studies are often inadequately reported, making it difficult to assess their validity and generalizability and judge whether they can be included in systematic reviews. We assessed the publication characteristics and quality of reporting of observational studies generated by the Structured Operational Research and Training Initiative (SORT IT).
METHODS
A cross-sectional analysis of original publications from SORT IT courses. SORT IT is a global partnership-based initiative aimed at building sustainable capacity for conducting operational research according to country priorities and using the generated evidence for informed decision-making to improve public health. Reporting quality was independently assessed using an adapted version of ‘Strengthening the Reporting of Observational Studies in Epidemiology’ (STROBE) checklist.
RESULTS
In 392 publications, involving 72 countries, 50 journals, 28 publishers and 24 disease domains, low- and middle-income countries (LMICs) first authorship was seen in 370 (94%) and LMIC last authorship in 214 (55%). Publications involved LMIC-LMIC collaboration in 90% and high-income-country-LMIC collaboration in 87%. The majority (89%) of publications were in immediate open access journals. A total of 346 (88.3%) publications achieved a STROBE reporting quality score of >85% (excellent), 41 (10.4%) achieved a score of 76–85% (good) and 5 (1.3%) a score of 65–75% (fair).
CONCLUSION
The majority of publications from SORT IT adhere to STROBE guidelines, while also ensuring LMIC equity and collaborative partnerships. SORT IT is, thus, playing an important role in ensuring high-quality reporting of evidence for informed decision-making in public health.
Observational studies are often inadequately reported, making it difficult to assess their validity and generalizability and judge whether they can be included in systematic reviews. We assessed the publication characteristics and quality of reporting of observational studies generated by the Structured Operational Research and Training Initiative (SORT IT).
METHODS
A cross-sectional analysis of original publications from SORT IT courses. SORT IT is a global partnership-based initiative aimed at building sustainable capacity for conducting operational research according to country priorities and using the generated evidence for informed decision-making to improve public health. Reporting quality was independently assessed using an adapted version of ‘Strengthening the Reporting of Observational Studies in Epidemiology’ (STROBE) checklist.
RESULTS
In 392 publications, involving 72 countries, 50 journals, 28 publishers and 24 disease domains, low- and middle-income countries (LMICs) first authorship was seen in 370 (94%) and LMIC last authorship in 214 (55%). Publications involved LMIC-LMIC collaboration in 90% and high-income-country-LMIC collaboration in 87%. The majority (89%) of publications were in immediate open access journals. A total of 346 (88.3%) publications achieved a STROBE reporting quality score of >85% (excellent), 41 (10.4%) achieved a score of 76–85% (good) and 5 (1.3%) a score of 65–75% (fair).
CONCLUSION
The majority of publications from SORT IT adhere to STROBE guidelines, while also ensuring LMIC equity and collaborative partnerships. SORT IT is, thus, playing an important role in ensuring high-quality reporting of evidence for informed decision-making in public health.