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
Public Health Panor. 1 March 2016; Volume 2 (Issue 1); 104-109.
Kulzhabaeva A, Nabirova D, Usenbaev N, Denisiuk O, Zachariah R
Public Health Panor. 1 March 2016; Volume 2 (Issue 1); 104-109.
The performance of the tuberculosis (TB) programme should be judged on the basis of detected TB cases recorded in the laboratory register and not just those placed on treatment and recorded in the TB treatment register. We examined the performance of the TB programme in this regard in Kyrgyzstan in 2012. This retrospective cohort study included all sputum smear-positive pulmonary TB cases registered in the TB laboratory register (584 persons). Data variables on geographical region, TB diagnosis, TB treatment and outcomes were sourced from various registers. We analysed (1) initial lost to follow-up (LTfu) between urban and rural areas; (2) time of starting treatment after diagnosis; (3) treat-
ment outcomes of laboratory-registered and treatment-registered patients. Of 584 patients diagnosed with new smear-positive pulmonary TB in two cities and eight rural districts, 59 (10%) were not traced in the patient TB treatment register and considered as initial LTfu. rural areas had significantly higher initial LTfu (13%) compared with urban areas (8%). The mean time to initiating treatment among those who were entered
in the TB register was 14 days (range 8–28 days). When all TB cases included in the laboratory register were used as the denominator, the overall treatment success rate reduced from 75% to 67% (a drop of 8%). Reporting on TB programme outcomes without including initial LTfu tends to exaggerate TB programme performance. Concerted efforts are needed to limit initial LTfu and accelerate progress towards ending TB as a
public health problem.
ment outcomes of laboratory-registered and treatment-registered patients. Of 584 patients diagnosed with new smear-positive pulmonary TB in two cities and eight rural districts, 59 (10%) were not traced in the patient TB treatment register and considered as initial LTfu. rural areas had significantly higher initial LTfu (13%) compared with urban areas (8%). The mean time to initiating treatment among those who were entered
in the TB register was 14 days (range 8–28 days). When all TB cases included in the laboratory register were used as the denominator, the overall treatment success rate reduced from 75% to 67% (a drop of 8%). Reporting on TB programme outcomes without including initial LTfu tends to exaggerate TB programme performance. Concerted efforts are needed to limit initial LTfu and accelerate progress towards ending TB as a
public health problem.