Objectives: To examine changes in the screening, diagnosis, treatment and management of drug-resistant tuberculosis (DRTB) patients, and investigate the impacts of DRTB-related policies on patients of different demographic and socioeconomic characteristics.
Design: A retrospective cohort study using registry data, plus a survey on DRTB-related policies.
Setting: All prefecture-level Centres for Disease Control in Zhejiang Province, China.
Main Outcome Measures: Alongside the care cascade, we examined: (1) reported number of presumptive DRTB patients; (2) percentage of presumptive patients with drug susceptibility testing (DST) records; (3) percentage of DRTB/rifampicin-resistant (RR) patients registered; (4) percentage of RR/multidrug-resistant TB (MDRTB) patients that received anti-DRTB treatment; and (5) percentage of RR/MDRTB patients cured/completed treatment among those treated. Multivariate logistic regressions were conducted to explore the impacts of DRTB policies after adjusting for other factors.
Results: The number of reported presumptive DRTB patients and the percentage with DST records largely increased during 2015-2018, and the percentage of registered patients who received anti-DRTB treatment also increased from 59.0% to 86.5%. Patients under the policies of equipping GeneXpert plus expanded criteria for DST had a higher likelihood of being registered compared with no GeneXpert (adjusted OR (aOR)=2.57, 95% CI: 1.20 to 5.51), while for treatment initiation the association was only significant when further expanding the registration criteria (aOR=2.38, 95% CI: 1.19 to 4.79). Patients with registered residence inside Zhejiang were more likely to be registered (aOR=1.96, 95% CI: 1.52 to 2.52), treated (aOR=3.83, 95% CI: 2.78 to 5.28) and complete treatment (aOR=1.92, 95% CI: 1.03 to 3.59) compared with those outside.
Conclusion: The policy changes on DST and registration have effectively improved DRTB case finding and care. Nevertheless, challenges remain in servicing vulnerable groups such as migrants and improving equity in the access to TB care. Future policies should provide comprehensive support for migrants to complete treatment at their current place of residence.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047997 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2020-047023 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Comparison of Different Machine Learning Classifiers in Predicting Xerostomia and Sticky Saliva due to Head and Neck Radiotherapy using a Multi-objective, Multimodal Radiomics Model.
Biomed Phys Eng Express
January 2025
Radiation Oncology, Emory University, Emory Midtown Hospital, Atlanta, Georgia, 30322, UNITED STATES.
Although radiotherapy techniques are the primary treatment for head and neck cancer (HNC), they are still associated with substantial toxicity, and side effect. Machine learning (ML) based radiomics models for predicting toxicity mostly rely on features extracted from pre-treatment imaging data. This study aims to compare different models in predicting radiation-induced xerostomia and sticky saliva in both early and late stage of HNC patients using CT and MRI image features along with demographics and dosimetric information.
View Article and Find Full Text PDFThe influence of sociodemographic and health factors on adherence to home-based rehabilitation after fast-track total knee arthroplasty: secondary analysis of a randomized controlled trial.
Disabil Rehabil
January 2025
Clinic Institute of Medical and Surgical Specialties (ICEMEQ), Hospital Clinic of Barcelona, Barcelona, Spain.
Purpose: Adherence to home rehabilitation following total knee arthroplasty (TKA) is essential to reach optimal functional outcomes, especially in fast-track procedures. The aim of this study is to identify which sociodemographic and health factors significantly affect adherence in this context.
Methods: This is a secondary analysis of a randomized controlled trial with 52 patients.
EEG-derived brainwave patterns for depression diagnosis via hybrid machine learning and deep learning frameworks.
Appl Neuropsychol Adult
January 2025
Faculty Xavier Institute of Engineering, Mahim, India.
In the fields of engineering, science, technology, and medicine, artificial intelligence (AI) has made significant advancements. In particular, the application of AI techniques in medicine, such as machine learning (ML) and deep learning (DL), is rapidly growing and offers great potential for aiding physicians in the early diagnosis of illnesses. Depression, one of the most prevalent and debilitating mental illnesses, is projected to become the leading cause of disability worldwide by 2040.
View Article and Find Full Text PDFHand-Assisted Laparoscopic Surgery (HALS) as an Alternative to Unplanned Laparoscopic Conversion to Open Surgery (LCOS) in Colectomies for Acute Diverticulitis.
Surg Innov
January 2025
Morristown Medical Center, Department of Surgery, Morristown, NJ, USA.
Background: In difficult colorectal cases, surgeons may opt for a hand-assisted laparoscopic (HALS) colectomy or attempt a laparoscopic surgery that may require an unplanned conversion to open (LCOS). We aimed to compare the clinical outcomes of these 2 types of surgeries.
Methods: Colectomies for acute diverticulitis with a HALS or LCOS surgery were selected from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) 2022 Targeted Colectomy Database.
The natural history of cytologically low-risk indeterminate thyroid nodules.
J Clin Endocrinol Metab
January 2025
Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
Background: Thyroid nodules classified cytologically as low-risk indeterminate lesions (TIR3A) on fine-needle aspiration biopsy (FNAB) present a clinical challenge due to their uncertain malignancy risk. This single-center study aimed to evaluate the natural history of TIR3A nodules.
Materials And Methods: FNABs performed between July 2017 and December 2019 were retrospectively retrieved and patients with TIR3A nodules were evaluated at baseline and throughout a follow-up based on ultrasound (US) parameters and clinical data.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!