Journal Article > ResearchFull Text
Int J Environ Res Public Health. 30 August 2022; Volume 19 (Issue 17); 10823.; DOI:10.3390/ijerph191710823
Agyarkwa MAk, Azaglo GSK, Kokofu HK, Appah-Sampong EK, Nerquaye-Tetteh EN, et al.
Int J Environ Res Public Health. 30 August 2022; Volume 19 (Issue 17); 10823.; DOI:10.3390/ijerph191710823
Antimicrobial resistant (AMR) bacteria in effluents from seafood processing facilities can contribute to the spread of AMR in the natural environment. In this study conducted in Tema, Ghana, a total of 38 effluent samples from two seafood processing facilities were collected during 2021 and 2022, as part of a pilot surveillance project to ascertain the bacterial load, bacterial species and their resistance to 15 antibiotics belonging to the WHO AWaRe group of antibiotics. The bacterial load in the effluent samples ranged from 13–1800 most probable number (MPN)/100 mL. We identified the following bacterial species: E. coli in 31 (82%) samples, K. pneumoniae in 15 (39%) samples, Proteus spp. in 6 (16%) samples, P. aeruginosa in 2 (5%) samples and A. baumannii in 2 (5%) samples. The highest levels of antibiotic resistance (100%) were recorded for ampicillin and cefuroxime among Enterobacteriaceae. The WHO priority pathogens—E. coli (resistant to cefotaxime, ceftazidime and carbapenem) and K.pneumoniae (resistant to ceftriaxone)—were found in 5 (13%) effluent samples. These findings highlight the need for enhanced surveillance to identify the source of AMR and multi-drug resistant bacteria and an adoption of best practices to eliminate these bacteria in the ecosystem of the seafood processing facilities.
Journal Article > ResearchFull Text
Public Health Action. 21 September 2013; Volume 3 (Issue 3); 243-6.; DOI:10.5588/pha.13.0051
Siddiquea BN, Islam MS, Bam TS, Satyanarayana S, Enarson D, et al.
Public Health Action. 21 September 2013; Volume 3 (Issue 3); 243-6.; DOI:10.5588/pha.13.0051
SETTING
BRAC, a non-governmental organisation, implemented a modified smoking cessation programme for tuberculosis (TB) patients based on International Union Against Tuberculosis and Lung Disease (The Union) guidelines in 17 peri-urban centres of Dhaka, Bangladesh.
OBJECTIVE
To determine whether a modified version of The Union's smoking cessation intervention was effective in promoting cessation among TB patients and determinants associated with quitting smoking.
DESIGN
Cohort study of routinely collected data.
RESULTS
A total of 3134 TB patients were registered from May 2011 to April 2012. Of these, 615 (20%) were current smokers, with a mean age of 38 years (±13.8). On treatment completion, 562 patients were analysed, with 53 (9%) lost to follow-up or dead, while 82% of smokers had quit. Patients with extra-pulmonary TB were less likely to quit than those with pulmonary TB. Patients with high-intensity dependence were less likely to quit than those with low-intensity dependence.
CONCLUSION
This study suggests that a simplified smoking cessation intervention can be effective in promoting smoking cessation among TB patients in Bangladesh. This is encouraging for other low-resource settings; the Bangladesh National Tuberculosis Control Programme should consider nationwide scaling up and integration of this smoking cessation plan.
BRAC, a non-governmental organisation, implemented a modified smoking cessation programme for tuberculosis (TB) patients based on International Union Against Tuberculosis and Lung Disease (The Union) guidelines in 17 peri-urban centres of Dhaka, Bangladesh.
OBJECTIVE
To determine whether a modified version of The Union's smoking cessation intervention was effective in promoting cessation among TB patients and determinants associated with quitting smoking.
DESIGN
Cohort study of routinely collected data.
RESULTS
A total of 3134 TB patients were registered from May 2011 to April 2012. Of these, 615 (20%) were current smokers, with a mean age of 38 years (±13.8). On treatment completion, 562 patients were analysed, with 53 (9%) lost to follow-up or dead, while 82% of smokers had quit. Patients with extra-pulmonary TB were less likely to quit than those with pulmonary TB. Patients with high-intensity dependence were less likely to quit than those with low-intensity dependence.
CONCLUSION
This study suggests that a simplified smoking cessation intervention can be effective in promoting smoking cessation among TB patients in Bangladesh. This is encouraging for other low-resource settings; the Bangladesh National Tuberculosis Control Programme should consider nationwide scaling up and integration of this smoking cessation plan.
Journal Article > ResearchFull Text
Int J Tuberc Lung Dis. 6 September 2011; Volume 15 (Issue 11); DOI:10.5588/ijtld.11.0503
Harries AD, Lin YD, Satyanarayana S, Lonnroth K, Li L, et al.
Int J Tuberc Lung Dis. 6 September 2011; Volume 15 (Issue 11); DOI:10.5588/ijtld.11.0503
The prevalence of diabetes mellitus is increasing at a dramatic rate, and countries in Asia, particularly India and China, will bear the brunt of this epidemic. Persons with diabetes have a significantly increased risk of active tuberculosis (TB), which is two to three times higher than in persons without diabetes. In this article, we argue that the epidemiological interactions and the effects on clinical presentation and treatment resulting from the interaction between diabetes and TB are similar to those observed for human immunodeficiency virus (HIV) and TB. The lessons learned from approaches to reduce the dual burden of HIV and TB, and especially the modes of screening for the two diseases, can be adapted and applied to the screening, diagnosis, treatment and prevention of diabetes and TB. The new World Health Organization (WHO) and The Union Collaborative Framework for care and control of TB and diabetes has many similarities to the WHO Policy on Collaborative Activities to reduce the dual burden of TB and HIV, and aims to guide policy makers and implementers on how to move forward and combat this looming dual epidemic. The response to the growing HIV-associated TB epidemic in the 1980s and 1990s was slow and uncoordinated, despite clearly articulated warnings about the scale of the forthcoming problem. We must not make the same mistake with diabetes and TB. The Framework provides a template for action, and it is now up to donors, policy makers and implementers to apply the recommendations in the field and to 'learn by doing'.
Journal Article > ResearchFull Text
Glob Health Action. 1 February 2018; Volume 11 (Issue 1); DOI:10.1080/16549716.2018.1445467
Sagili KD, Satyanarayana S, Chadha SS, Wilson NC, Kumar AMV, et al.
Glob Health Action. 1 February 2018; Volume 11 (Issue 1); DOI:10.1080/16549716.2018.1445467
BACKGROUND:
The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices.
OBJECTIVES:
To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice.
METHODS:
From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project's core activities and outcomes.
RESULTS:
In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice.
CONCLUSIONS:
OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects.
The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices.
OBJECTIVES:
To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice.
METHODS:
From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project's core activities and outcomes.
RESULTS:
In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice.
CONCLUSIONS:
OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects.
Journal Article > ResearchFull Text
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 138-41.; DOI:10.5588/pha.12.0034
Ram S, Kishore K, Batio I, Bissell K, Zachariah R, et al.
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 138-41.; DOI:10.5588/pha.12.0034
SETTING
All tuberculosis (TB) diagnostic and treatment centres in Fiji.
OBJECTIVES
To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services.
METHODS
A retrospective review of routine programme data reconciling TB laboratory and treatment registers.
RESULTS
A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001).
CONCLUSION
This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
All tuberculosis (TB) diagnostic and treatment centres in Fiji.
OBJECTIVES
To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services.
METHODS
A retrospective review of routine programme data reconciling TB laboratory and treatment registers.
RESULTS
A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001).
CONCLUSION
This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
Journal Article > Short ReportFull Text
Public Health Action. 21 March 2012; Volume 2 (Issue 1); DOI:10.5588/pha.12.0001
Edginton ME, Enarson D, Zachariah R, Reid AJ, Satyanarayana S, et al.
Public Health Action. 21 March 2012; Volume 2 (Issue 1); DOI:10.5588/pha.12.0001
Journal Article > ResearchFull Text
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 90-92.; DOI:10.5588/pha.12.0082
Basnet R, Shrestha BR, Nagaraja BS, Basnet B, Satyanarayana S, et al.
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 90-92.; DOI:10.5588/pha.12.0082
This study assessed the characteristics of beneficiaries of a government-led policy of exemption for payment being provided in a regional hospital in Nepal. In January and February 2012, 9547 patients sought services at the out-patient clinic, the majority (83%) of whom were from the same district although this was a referral hospital for 15 districts. Only 10.8% received exemption from payment; 66% of the individuals aged >60 years and eligible for exemption were missed. These shortcomings highlight intrinsic weaknesses in the current implementing mechanisms for payment exemption, which may not be providing financial protection. This hampers efforts towards achieving universal health coverage.
Journal Article > CommentaryFull Text
Public Health Action. 21 June 2014; Volume 4 (Issue 2); DOI:10.5588/pha.14.0012
Kumar AMV, Satyanarayana S, Wilson N, Chadha SS, Gupta D, et al.
Public Health Action. 21 June 2014; Volume 4 (Issue 2); DOI:10.5588/pha.14.0012
Journal Article > ResearchFull Text
PLOS One. 17 June 2015; Volume 10 (Issue 6); DOI:10.1371/journal.pone.0129166
Vogt F, Tayler-Smith K, Bernasconi A, Makondo E, Taziwa F, et al.
PLOS One. 17 June 2015; Volume 10 (Issue 6); DOI:10.1371/journal.pone.0129166
CD4 cell count measurement remains an important diagnostic tool for HIV care in developing countries. Insufficient laboratory capacity in rural Sub-Saharan Africa is frequently mentioned but data on the impact at an individual patient level are lacking. Urban-rural discrepancies in CD4 testing have not been quantified to date. Such evidence is crucial for public health planning and to justify new yet more expensive diagnostic procedures that could circumvent access constraints in rural areas.
Journal Article > ResearchFull Text
PLOS One. 17 January 2012; Volume 7 (Issue 1); E30281.; DOI:10.2147/HIV.S20993
Kondapaka KK, Prasad SV, Satyanarayana S, Kandi S, Zachariah R, et al.
PLOS One. 17 January 2012; Volume 7 (Issue 1); E30281.; DOI:10.2147/HIV.S20993
SETTING
A tertiary health care facility (Government General and Chest hospital) in Hyderabad, India.
OBJECTIVESE
To assess a) the extent of compliance of specialists to standardized national (RNTCP) tuberculosis management guidelines and b) if patients on discharge from hospital were being appropriately linked up with peripheral health facilities for continuation of anti-Tuberculosis (TB) treatment.
METHODS
A descriptive study using routine programme data and involving all TB patients admitted to inpatient care from 1st January to 30th June, 2010.
RESULTS AND CONCLUSIONS
There were a total of 3120 patients admitted of whom, 1218 (39%) required anti-TB treatment. Of these 1104 (98%) were treated with one of the RNTCP recommended regimens, while 28 (2%) were treated with non-RNTCP regimens. The latter included individually tailored MDR-TB treatment regimens for 19 patients and adhoc regimens for nine patients. A total of 957 (86%) patients were eventually discharged from the hospital of whom 921 (96%) had a referral form filled for continuing treatment at a peripheral health facility. Formal feedback from peripheral health facilities on continuation of TB treatment was received for 682 (74%) patients. In a tertiary health facility with specialists the great majority of TB patients are managed in line with national guidelines. However a number of short-comings were revealed and measures to rectify these are discussed.
A tertiary health care facility (Government General and Chest hospital) in Hyderabad, India.
OBJECTIVESE
To assess a) the extent of compliance of specialists to standardized national (RNTCP) tuberculosis management guidelines and b) if patients on discharge from hospital were being appropriately linked up with peripheral health facilities for continuation of anti-Tuberculosis (TB) treatment.
METHODS
A descriptive study using routine programme data and involving all TB patients admitted to inpatient care from 1st January to 30th June, 2010.
RESULTS AND CONCLUSIONS
There were a total of 3120 patients admitted of whom, 1218 (39%) required anti-TB treatment. Of these 1104 (98%) were treated with one of the RNTCP recommended regimens, while 28 (2%) were treated with non-RNTCP regimens. The latter included individually tailored MDR-TB treatment regimens for 19 patients and adhoc regimens for nine patients. A total of 957 (86%) patients were eventually discharged from the hospital of whom 921 (96%) had a referral form filled for continuing treatment at a peripheral health facility. Formal feedback from peripheral health facilities on continuation of TB treatment was received for 682 (74%) patients. In a tertiary health facility with specialists the great majority of TB patients are managed in line with national guidelines. However a number of short-comings were revealed and measures to rectify these are discussed.