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Total Quality Management [TQM] in the Healthcare Industry – Challenges, Barriers and Implementation Developing a Framework for TQM Implementation in a Healthcare Setup
Issue:
Volume 4, Issue 4, July 2016
Pages:
271-278
Received:
1 June 2016
Accepted:
Published:
2 June 2016
Abstract: Quality management has become an important issue in healthcare organizations (hospitals) during the last couple of decades. The increased attention to quality is due to governmental regulations, influence of customers, and hospital management initiatives. Apparently, there are many difficulties in managing healthcare organizations in a competitive marketplace with a little support from official bodies especially in a developing country like India. The purpose of this paper is to provide a framework for implementing the total quality management concept that is compatible with the local culture of India. The SERVQUAL model and its application can help the healthcare facility in achieving satisfaction on both ends - employees’ satisfaction and customer satisfaction. In healthcare organizations, the traditional Indian culture, leadership style, and the mentality of the medical professionals are somehow the barriers to the adoption of the TQM. The suggested integrated framework model of the TQM can be of great help to the healthcare organizations to move out of the barriers and successfully implementing TQM concepts and practices.
Abstract: Quality management has become an important issue in healthcare organizations (hospitals) during the last couple of decades. The increased attention to quality is due to governmental regulations, influence of customers, and hospital management initiatives. Apparently, there are many difficulties in managing healthcare organizations in a competitive ...
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Effects of High Prevalence Anisakis in Fish Caught in the White Coast Médano, Falcon State, Venezuela on the Consuming Population
Issue:
Volume 4, Issue 4, July 2016
Pages:
279-283
Received:
27 April 2016
Accepted:
7 May 2016
Published:
6 June 2016
Abstract: In order to evaluate the effect of the high prevalence of parasites Anisakidae family, in fish caught in the fishing area Médano white, Falcon State, Venezuela; consumed by families of fishermen and villagers expended sector Pantano Abajo, municipality Miranda, Falcon state. The participatory diagnosis was made in the fishing area, in the consumer population and the dispenser Health Center (Ambulatory Urban) using unstructured interviews, surveys and review of medical records during the first half of 2013. An average of 1098 patient month has symptoms: asthma allergic diseases, diarrhea and vomiting, with percentages remains in a range that goes from 29.81% to 38.43%. 68% of fishermen dispense fish without sanitary permit. Fishermen and consumers are likely to be accidental hosts of the parasite, not having adequate prevention levels.
Abstract: In order to evaluate the effect of the high prevalence of parasites Anisakidae family, in fish caught in the fishing area Médano white, Falcon State, Venezuela; consumed by families of fishermen and villagers expended sector Pantano Abajo, municipality Miranda, Falcon state. The participatory diagnosis was made in the fishing area, in the consumer ...
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Attitudes of Primary Health Care (PHC) Gatekeepers Towards Patient Referral Policy, Machakos County, Kenya
Desire Aime Nshimirimana,
Wanja Mwaura-Tenambergen,
Donald Kokonya,
Maureen Adoyo
Issue:
Volume 4, Issue 4, July 2016
Pages:
284-288
Received:
16 May 2016
Accepted:
28 May 2016
Published:
13 June 2016
Abstract: Primary Health Care (PHC) serves as the foundation for building a working healthcare system that provide good health outcomes. The quality of PHC delivery and the decision to refer patients depends on some behavioural factors (knowledge, skills and behaviour) of primary care providers. The study was conducted at 100 PHC centres sampled using Taro Yamane formula, in Machakos County, Kenya, from March to May 2015. It involved 8 gender-based focus group discussions (FGDs) with patients and their caretakers. Qualitative and quantitative data were collected from emancipated children and adults aged 15-65 years excluding the disabled due to data integrity issues. The Statistical Package for Social Science (SPSS) version 20.0 and Atlas.ti 7 software were used for analysis. A questionnaire return rate of 83% was achieved of whom 84.3% were nurses (p<0.001) and 15.7% were diploma holders in clinical medicine (clinical officers). The health workers were young (P<0.001) and married (p<0.001). About 62% of the respondents reported to know about PHC gatekeeper system and 38% don’t know about PHC gatekeeper system. The gate keepers at a majority rate 86.7% reported to have participated in workshops of which at least 40.3% participated in at least one workshop per year, means that the majority of gatekeepers don’t fill the required continuing professional development (CPD) to renew their licenses. Bad behavior, poor communication, don’t care attitude, long waiting time and no courtesy were mentioned by patients by 60% of respondents as the main contributing factors to non-compliance of patients with the national patient referral policy. Attitudes (knowledge, skills and behaviour) are crucial in primary care gatekeeper policy implementation. It has been made clear that nurses acquire enough knowledge from college to take care of patients but still need more practical knowledge and experience to increase their performance. This study recommends an innovative plan using incentive driven model and performance rewards in the implementation process.
Abstract: Primary Health Care (PHC) serves as the foundation for building a working healthcare system that provide good health outcomes. The quality of PHC delivery and the decision to refer patients depends on some behavioural factors (knowledge, skills and behaviour) of primary care providers. The study was conducted at 100 PHC centres sampled using Taro Y...
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Challenges of Cervical Cancer Screening Among Women of Reproductive Age in Kisii Town, Kisii County, Kenya
Robert M. Kei,
Julius K. M’Ndegwa,
Taratisio Ndwiga,
Faith Masika
Issue:
Volume 4, Issue 4, July 2016
Pages:
289-296
Received:
17 May 2016
Accepted:
3 June 2016
Published:
17 June 2016
Abstract: Introduction: Cervical cancer is a preventable non communicable disease of public health importance. It is the most common genital cancer and one of the leading causes of death among female population. Cervical cancer is a prevalent yet preventable cause of death among Kenyan women. The main objective of this study was to assess the knowledge, practice and barriers towards screening for premalignant cervical lesions among women aged 15 years and above years in Kisii Town, Kisii County. Methods: A descriptive cross-sectional study design was used and the sample population was selected among women in Kisii town. Data was collected using a structured interviewer-administered questionnaire. This instrument was pretested in a neighboring town to ascertain validity. Random sampling was used, in order to give every woman in Kisii Town opportunity to be included in the study. The sample size of 151 respondents was realized using Fisher et al, (1998). formula. Data Analysis: The SPSS version 20.0 was used to analyze the data which was presented in prose, figures and tables. Chi-square test was used to measure the strength of associations between the various variables where a p-value of = or <0.05 was considered to be statistically significant. Results: Knowledge on cervical cancer and screening was very low among women in Kisii Town, because 20.5% knew about vaginal bleeding and 15% knew about having multiple sexual partners as a risk factor. There is relationship between the level of education and belief on the cure for cancer (P = 0.000), those who are more educated believed that cervical cancer can be cured at early stages while those with less education believed that cancer cannot be cured. Conclusion and Recommendation: Knowledge on cervical cancer and screening was low, hence poor practice on screening among women. Main barriers for not screening were ignorance and fear of positive results. It may be recommended that cancer screening machines should be purchased by County government and distributed to town health facilities at subsidized charge for screening. Also, awareness creation including counseling should be intensified in order to promote screening compliance.
Abstract: Introduction: Cervical cancer is a preventable non communicable disease of public health importance. It is the most common genital cancer and one of the leading causes of death among female population. Cervical cancer is a prevalent yet preventable cause of death among Kenyan women. The main objective of this study was to assess the knowledge, prac...
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Sanitation Practice of Slum Communities in Addis Ababa, Ethiopia
Abdissa Aga,
Walelegn Worku
Issue:
Volume 4, Issue 4, July 2016
Pages:
297-304
Received:
16 May 2016
Accepted:
6 June 2016
Published:
23 June 2016
Abstract: Globally, an estimated 2.5 billion people lack access to improved sanitation which is more than 35% of the world’s population and about 1billion people, 15% of the world population do not have access to any kind of sanitation facility and exercise open defecation. A total of 16% of population living in urban Ethiopia do not have access to any kind of sanitation facility and exercise open defecation, of which the huge proportion lives in the slum areas. Objectives: To assess the level of practice and associated factors towards sanitation in the urban slum communities of Addis Ababa, Ethiopia. Methods: A community based cross-sectional study design was conducted on January 2015 in Addis Ketema, Lideta, Kirkos, and Gulelle sub cities of Addis Ababa. Using stratified sampling 636 sample households was selected and data was collected from 624 household, which is 98.1% of estimated sample size. Results: Practice of sanitation was 43.89% and it gets higher in households found in Lideta [AOR=3.37, 95% CI=1.12-10.15, p<0.031], Kirkos [AOR= 4.97, 95% CI=1.76-14.04, p<0.002], and Gullele [AOR= 10.16, 95% CI=3.61-28.58, p<0.000] sub cities; and who own previous latrines [AOR= 6.26, 95% CI=3.01-13.01, p<0.000]. It gets lower in households who share latrine with other neighboring households [AOR= 0.08, 95% CI=0.03-0.17, p<0.000], those who own simple pit latrines [AOR= 0.02, 95% CI=0.05-0.74, p<0.016], those who didn’t receive support during the construction of their latrine, [AOR=0.004, 95% CI=0.001– 0.014, p<0.000], and those whose annual income is between 55,001 ETB and 65,000 ETB [AOR=0.15, 95% CI= 0.02– 0.88, p<0.036]. The level of practice of sanitation in the study population is low. Latrine sharing habit, not hiring sanitation facility builder/ skilled mason, and need for subsidy and support during latrine construction were found to be the main factors contributing for this low practice. Establishing well organized and responsible body at each level of administration that will incept and execute awareness and promotion activities to improve the practice of sanitation should be done using different promotion approaches.
Abstract: Globally, an estimated 2.5 billion people lack access to improved sanitation which is more than 35% of the world’s population and about 1billion people, 15% of the world population do not have access to any kind of sanitation facility and exercise open defecation. A total of 16% of population living in urban Ethiopia do not have access to any kind ...
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Expectations About Counseling for a Mental Illness Among Primary School Teacher Trainees in Kenya
Eunice Jemalel Nyavanga,
Maurice Barasa
Issue:
Volume 4, Issue 4, July 2016
Pages:
305-311
Received:
31 May 2016
Accepted:
12 June 2016
Published:
23 June 2016
Abstract: The objective of this study is to determine and document expectations about counseling for a mental illness among public primary teacher trainees in Kenya. Self-administered demographic questionnaire and opinions about mental illness scale brief form (EAC-BF) were presented to the participants. The EAC-BF consisted of three factors of personal commitment, facilitative conditions and counselor expertise. The ethical protocol was followed from getting authority from the Ethics Board to informed consent from the participants. Out of the 2925 questionnaires presented, 2777 were returned fully filled, a return rate of 94.34%. Summative scores indicated moderate (between 2.34 and 4.67) towards negative expectations about counseling, with significant differences in year of study, gender, marital status, or ever taught before coming to college. There was a correlation between all the EAC factors. This study found more negative expectations about counseling for a mental illness and recommended on an intervention to improve expectations towards counseling.
Abstract: The objective of this study is to determine and document expectations about counseling for a mental illness among public primary teacher trainees in Kenya. Self-administered demographic questionnaire and opinions about mental illness scale brief form (EAC-BF) were presented to the participants. The EAC-BF consisted of three factors of personal comm...
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Co-operation, a Solution to Health Service Provision Problems in Tanzania: Case of the Co-operated Health Care Facilities in Dodoma Region
Mshana Zainabu M.,
Sinda Hussein S.,
Lung’wecha Daudi M.
Issue:
Volume 4, Issue 4, July 2016
Pages:
312-320
Received:
3 June 2016
Accepted:
18 June 2016
Published:
29 June 2016
Abstract: The co-operation between Government (GVT) and Faith-Based Organizations (FBOs) in health services provision (HSP) is vital in Tanzania. However, to benefit from such co-operation it requires adoption of the procedures that will overcome the persisting problems of health services provision. The study on the evaluationof the solution to health services provision problems in Tanzania was conducted in Dodoma region. Basically; it analysed the status, problems, reasons for problems and solution of health services provision problems in Dodoma urban and Kondoa districts by targeting GVT and FBOs co-operated health care facilities. Cross-sectional research design was used during the study. Sample size was 394. This was obtained purposively followed by simple random sampling techniques. Both descriptive and inferential statistical analyses were used to analyse the data obtained through questionnaire survey, interview, focus group discussion and participant observation. The sudy identified that the co-operation between the GVT and FBOs in health services provision is important. However, it will be achieved if and only if the moderate status of health services provision in the region will follow various procedures including; analysis of the root causes of the moderate status of health services provision, analysis of the environmental conditions facing GVT and FBOs co-operated health care facilities and, the implementation capability of the GVT and FBOs co-operated health care facilities in Dodoma urban and Kondoa districts. The study recommended that, the Government of Tanzania in co-operation with Faith-Based Organizations should ensure; strong leadership and management team, improvement of infrastructure and working facilities, good management of health plan, availability of essential drugs with reasonable costs and the availability of human resources.
Abstract: The co-operation between Government (GVT) and Faith-Based Organizations (FBOs) in health services provision (HSP) is vital in Tanzania. However, to benefit from such co-operation it requires adoption of the procedures that will overcome the persisting problems of health services provision. The study on the evaluationof the solution to health servic...
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Evaluation of the Relationship Between Socio-economic Environment and Oro-dental Health of Children in Diourbel Health District in Senegal
Faye Daouda,
Kanoute Aida,
Lo Cheikh Mbacke
Issue:
Volume 4, Issue 4, July 2016
Pages:
321-325
Received:
9 June 2016
Accepted:
18 June 2016
Published:
29 June 2016
Abstract: The objective of this paper was to evaluate the socio economic environment influence on oral health of children in the sanitary district of Diourbel to formulate recommendations for its improvement by conducting a descriptive cross-section study. Data were registered and analyzed using Epi Info 6.04 d release. A logistic regression analysis was used to identify factors associated with dependant variables. On a theoretical target of 1600 children, 1237 have been examined: 508 in urban area and 729 in rural area. The children of the rural area were significantly younger, more scholarized, and from poorer families. They were statistically sicker than those of the urban area. Oro-dental affections were more frequent among the children of age less than nine years, no scholarized, and living in poor families. The oro-dental affections prevalence is linked to the socioeconomic environment. This confirms the correlation between bad health and poverty in one hand, and between good health and development in other hand. In the WHO international classification of the diseases, the most important death factor is extreme poverty. It exercises its harmful influence at all the stages of human life, since the conception to the death. Unfortunately, most of the world inhabitants are located facing the double threatens of poverty and in equity, and the double blight of suffering and disease. Oral Pathology represents a real public health problem, more frequent in rural areas. Thus, a multisectoral strategy with a longitudinal follow-up is needed to improve the oral health of children.
Abstract: The objective of this paper was to evaluate the socio economic environment influence on oral health of children in the sanitary district of Diourbel to formulate recommendations for its improvement by conducting a descriptive cross-section study. Data were registered and analyzed using Epi Info 6.04 d release. A logistic regression analysis was use...
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A Critical Look at 2015 Acute Flaccid Paralysis (AFP) Surveillance Core Indicators of Bauchi State, Nigeria
Jalal-Eddeen Abubakar Saleh,
Rui Gama Vaz,
Fiona Braka,
Khaled Abdelrahim,
Adamu Ibrahim Ningi
Issue:
Volume 4, Issue 4, July 2016
Pages:
326-329
Received:
8 May 2016
Accepted:
17 May 2016
Published:
4 July 2016
Abstract: Background: Poliomyelitis, a disease that predominantly affects children under the age of five years, is a highly infectious viral disease transmitted through the faeco-oral route. The disease could result in irreversible paralysis in 1:200 infections and has a case fatality rate of 5-10% especially when the respiratory muscles become immobilized. The Global Polio Eradication Initiatives (GPEI) is a partnership between international organizations and governments of countries and other stakeholders aimed at polio eradication across the globe through the use of strategies such as improved AFP surveillance, strengthening routine immunizations, and supplemental immunization activities. Importantly, the use of polio vaccine in multiple times on a child confers lifelong immunity against the disease. Study Design: Retrospective study Methods: Quantitative cross-sectional study of AFP cases reported across the 20 local government areas (LGA) of Bauchi State, northeastern Nigeria. The data was collected between 1st January 2015 and 31st December 2015. Results: Although all the 20(100%) LGAs met the non-polio AFP rate (NPAFP) of reporting at least 1 case per annum and stool adequacy, only 10(50%) LGAs met the minimum accepted NPENT rate of 10% with the remaining 10(50%) LGAs falling short of the minimum acceptable rate. Thus, the cumulative NPENT rate for Bauchi State stood at 10.3%. Conclusion: The 2015 AFP surveillance results from Bauchi State clearly support the remarkable progress made by Nigeria. However, there is need for future studies to establish reasons behind the remaining 10 (50%) of the LGAs in Bauchi failing short of meeting the minimum NPENT rate of 10.
Abstract: Background: Poliomyelitis, a disease that predominantly affects children under the age of five years, is a highly infectious viral disease transmitted through the faeco-oral route. The disease could result in irreversible paralysis in 1:200 infections and has a case fatality rate of 5-10% especially when the respiratory muscles become immobilized. ...
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Determinants of Risky Sexual Behaviour Among Preparatory School Students in Gurage Zone, SNNPR, Ethiopia (A Cross-Sectional School Based Study)
Tadesse Gossaye Birru,
Mitikie Molla,
Yemane Berhane,
Amenu Wesen,
Tesfaye Chuko
Issue:
Volume 4, Issue 4, July 2016
Pages:
330-341
Received:
21 May 2016
Accepted:
8 June 2016
Published:
4 July 2016
Abstract: Background: There is growing evidence suggesting that young people in school are practicing risky sexual behavior. Ethiopian young people age 10 – 24 years have emerged as the segments of the population most vulnerable to a broad spectrum of serious sexual health problems including STI/HIV, unwanted pregnancy and unsafe abortion. Objectives: To identify factors determining risky sexual behavior among preparatory school students. Methods: A cross-sectional quantitative study design was employed among preparatory school students in Gurage zone (SNNPR) from May to June 2009. The study participants were selected using multistage sampling. A structured self administered questionnaire was used to collect data from the participants. Results: A total of 418 participants with a response rate of 97.6% were enrolled in the study. A significant proportion of the participants 108(25.8%) were sexually initiated. About 66.6% of them were sexually active in the last one year. The overall condom use at first sexual debut was only 39.8%. Out of 108 sexually active students, 58(53.7%) had had multiple sexual practice. About 62% of the participants who practiced sex had history of sexually transmitted infection. Female students who engaged in sexual practice, 17(44.7%) encountered unwanted pregnancy and 16(94%) of them committed unsafe abortion, of which 4(25%) committed more than two abortion. Multivariate analysis showed age, poor parental attachment and substance use were significantly associated with risky sexual behavior of young students in school. Conclusion: The study has revealed that young people in preparatory schools, despite having good knowledge about their sexual health and its unwanted consequences, a significant proportion of them were found to be sexually at risk. Institutionalization of youth friendly service, condom promotion, open and regular discussion with main actor, and wide rage further studies seem to be compulsory.
Abstract: Background: There is growing evidence suggesting that young people in school are practicing risky sexual behavior. Ethiopian young people age 10 – 24 years have emerged as the segments of the population most vulnerable to a broad spectrum of serious sexual health problems including STI/HIV, unwanted pregnancy and unsafe abortion. Objectives: To ide...
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Factors Behind Low NPENT Rate in Bauchi State in 2015
Jalal-Eddeen Abubakar Saleh,
Rui Gama Vaz,
Fiona Braka,
Khaled Abdelrahim,
Adamu Ibrahim Ningi,
Isa Mohammed Bello
Issue:
Volume 4, Issue 4, July 2016
Pages:
342-345
Received:
5 June 2016
Accepted:
13 June 2016
Published:
4 July 2016
Abstract: The need for a country or region to achieve certification as polio-free requires spending at least 3 consecutive years without a reported case of polio. Meeting the acute flaccid paralysis (AFP) core surveillance indicators forms an important requirement during the stipulated period towards achieving certification. In addition to meeting the AFP core indicators, non-polio enteroviruses (NPENT) rate is key in evaluating whether the reported AFP meets the minimum required to be tag as true AFP. This cross-sectional quantitative study distributed questionnaires to 20 disease surveillance and notification officers (DSNOs) on the AFP surveillance network of Bauchi State, Nigeria. The responses were collated and analyzed accordingly. The result shows that although 20 (100%) DSNOs/assistant DSNOs were involved in the process of stool collection only 12 (60%) participated in the process for all cases reported in their respective LGAs in 2015. Additionally, while 9 (45%) of the respondents admit that specimen are batched in Bauchi prior transporting to Gombe, 18 (90%) of the responses shows that specimen are batched in Gombe for onward delivery to the national polio laboratory in Ibadan. Thus, the low NPENT rate (10.3%) recorded in Bauchi in 2015 could be attributed to factors that include batching of specimens before the final analysis in national polio laboratory, failure of DSNOs/assistant DSNOs to fully participate in the process of stool collection of reported AFP cases. Thus, there is need to avoid batching of stool specimen at all levels to avoid compromising outcome of the final analysis.
Abstract: The need for a country or region to achieve certification as polio-free requires spending at least 3 consecutive years without a reported case of polio. Meeting the acute flaccid paralysis (AFP) core surveillance indicators forms an important requirement during the stipulated period towards achieving certification. In addition to meeting the AFP co...
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Coverage of Iodized Salt and Associated Factors at Household Level in Goba Town, Bale Zone, South East Ethiopia, 2015
Abdurrahman Kalu Tololu,
Fentie Ambaw Getahun,
Dereje Birhanu Abitew
Issue:
Volume 4, Issue 4, July 2016
Pages:
346-351
Received:
28 September 2015
Accepted:
27 October 2015
Published:
11 July 2016
Abstract: Background: Iodine Deficiency Disorder is one of the biggest worldwide public health problems of today. Fortification of salt with iodine is recognized as the most simple and cost effective strategy to achieve recommended daily intake of iodine. Hence this study wanted to assess coverage of adequately iodized salt & associated factors at household level in Goba town. Methods: Community based cross-sectional survey conducted among 598 households using concurrent qualitative & quantitative method in Goba town, South East Ethiopia from August 1-30, 2013. Data were collected by trained diploma nurses supervised by BSC nurses. Interviewer administered questionnaire & rapid field test kits were used to collect the data. Data were cleaned, coded & entered in to EPI Info and exported to SPSS for analysis. Data were summarized in tables & charts. Variables having p value ≤ 0.2 in univariate analysis were entered into multivariate logistic regression to test association between the outcome and predictable variables at p value ≤ 0.05. Results: From a total of 596 households included in the study, only 30% of the households were covered by adequately iodized salt. Regarding the associated factors, about coverage of adequately iodized salt, not exposing to sunlight, purchasing from supermarkets or big shops & perceived cheap were found to be statistically significant with AOR (95% CI) = 2.20 (1.31, 3.60), 1.91 (1.10, 3.34), 1.70 (1.10, 2.0) respectively. Conclusion: Coverage of adequately iodized salt at household level was low (30%) in Goba town. The main associated factors were not exposing to sun light, purchased from big shop or supermarket & perceived cheap. Households’ should be educated about proper handling of iodized salt at household level.
Abstract: Background: Iodine Deficiency Disorder is one of the biggest worldwide public health problems of today. Fortification of salt with iodine is recognized as the most simple and cost effective strategy to achieve recommended daily intake of iodine. Hence this study wanted to assess coverage of adequately iodized salt & associated factors at household ...
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FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment
Useni Sani,
Gidado Mustapha,
Onazi Jumoke,
Eneogu Rupert,
Chukwueme Nkemdilim,
Ubochioma Emperor,
Akang Gabriel,
Obot Valerie,
Omoniyi Amos
Issue:
Volume 4, Issue 4, July 2016
Pages:
352-358
Received:
1 March 2016
Accepted:
18 March 2016
Published:
28 July 2016
Abstract: FAST stands for Finding, Actively, Separating, and Treating. FAST focus health care workers on the most important administrative Tuberculosis (TB) transmission control intervention: effective TB treatment reduces TB spread rapidly, even before sputum smear and culture turn negative. General outpatient department (GOPD) and inpatient clinics in most public and some private health institutions are overcrowded with long waiting times to access health care services. This has led to an increasing importance to ensure effective TB prevention and control especially in settings were Presumptive TB cases, confirmed TB cases and People living with HIV (PLHIV) are seen. This study is aimed at describing the process of FAST implementation and its effect on reduction of time to diagnosis of TB and enrolment for care at tertiary Health care facilities. A prospective study in 12 facilities of 6 states with high TB and HIV burden; adapted guidelines, standard operating procedures (SOPs) and training materials for FAST strategy; trained pool of facilitators; field tested tools; advocacy visits to health facilities; collected base line data that preceded facility level sensitization of FAST implementation. Diagnosis of TB and DR-TB was in line with the national guidelines with the use of Acid Fast Bacilli (AFB) light microscopy and GeneXpert MTB/RIF technology. Follow-up evaluations were conducted monthly by State Tuberculosis and Leprosy Control Program (STBLCP) and quarterly by National TBL Control Program (NTBLCP). Data was analyzed using Stata 13 version 1 for paired t-test (mean comparison test). Average time to diagnosis of susceptible TB using 3 sputa samples reduced from a baseline of 2.9 days in April 2014 to 1.9 days by end of September 2014. Time to treatment of susceptible TB cases diagnosed either by AFB microscopy or Xpert reduced from a baseline of 3.9 days to 1.1 days. Similarly, average time for DR-TB cases diagnosed (including patients receiving their results) reduced from 2.3 days to 1 day. Proportion of TB cases diagnosed and started on treatment increased by up to 14-56% range among different facilities. Integrating FAST into health care delivery improves early diagnosis and enrolment to care at minimal cost; facilitate TB infection control in clinic waiting areas especially in low income countries like Nigeria. FAST also has additional advantage of increasing TB case notification.
Abstract: FAST stands for Finding, Actively, Separating, and Treating. FAST focus health care workers on the most important administrative Tuberculosis (TB) transmission control intervention: effective TB treatment reduces TB spread rapidly, even before sputum smear and culture turn negative. General outpatient department (GOPD) and inpatient clinics in most...
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Isolation, Identification and Determination of the Prevalence of Mycobacterium tuberculosis Complex among People Living with HIV in Kisumu County, Kenya
Maryanne Betsy Usagi,
Gilbert Abura Odilla,
John Muthini Maingi,
Anthony Kebira
Issue:
Volume 4, Issue 4, July 2016
Pages:
359-365
Received:
15 June 2016
Accepted:
12 July 2016
Published:
28 July 2016
Abstract: Mycobacterium tuberculosis complex are important pathogens to man and causative agents of tuberculosis. Tuberculosis is one of the diseases that continue to be a public health concern in the world. Earlier, tuberculosis was considered controlled, but with emergence of HIV and AIDS, the disease has been exacerbated, with the highest incidences being in sub-Saharan Africa. Kenya ranks 15th and 5th in the World and Africa respectively. The World Health Organization indicates that there were 300 TB cases per 100,000 people in 2011. Information on the identity of the Mycobacterium tuberculosis complex and the prevalence of pulmonary tuberculosis in HIV positive patients seeking treatment in Kisumu County is limited. In this study, we isolated and identified the Mycobacterium tuberculosis complex and also determined the prevalence of tuberculosis in HIV patients seeking treatment in Kisumu County. A cross-sectional study was conducted between December 2013 and June 2014. The study engaged, 379 HIV positive patients suspected of TB infection who gave sputum samples. The sputum samples were then decontaminated, concentrated, liquefied and neutralized before being cultured in liquid media using MGIT 960 tubes. The culture positive MGIT tubes were sub cultured in Brain Heart Infusion Agar (BHIA) before microscopic examination of the culture using ZN smear for Acid Fast Bacilli and identified using Genotype MTBC. In the study, 130 (34.3%) of the 379 suspected TB patients were diagnosed positive for pulmonary TB by MGIT culture. A significantly greater number of males were diagnosed with pulmonary tuberculosis compared to females (57.7% and 42.3% respectively; χ 2 = 1.0342, df = 1 P < 0.05). Further, the study revealed that TB prevalence decreased steadily with age, with the youths being at greater risk of becoming active patients. In the age category of 26-35 years, prevalence was 36.92% while, for age category above 55 years it was 6.15%. Based on the results, the etiological agent of tuberculosis in Kisumu County is Mycobacterium tuberculosis, the prevalence of infection was higher in males than in females and the prevalence rate to infection was highest among the youth. There is need for rapid and accurate diagnosis of active TB particularly in HIV-positive patients. Also, TB awareness and control programme should mainly be directed towards the youths by the all the stakeholders in the Public Health sector.
Abstract: Mycobacterium tuberculosis complex are important pathogens to man and causative agents of tuberculosis. Tuberculosis is one of the diseases that continue to be a public health concern in the world. Earlier, tuberculosis was considered controlled, but with emergence of HIV and AIDS, the disease has been exacerbated, with the highest incidences being...
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