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Survival and health status of DOTS tuberculosis patients in rural Lao PDR.

Barennes H, Keophithoun T, Nguyen TH, Strobel M, Odermatt P - BMC Infect. Dis. (2010)

Bottom Line: Low compliance was associated with poor accessibility to health care (p = 0.01) and symptomatic improvement (p = 0.02).Additionally, it showed that follow-up of TB patients is feasible although the patients lived in very remote area of Laos.Follow-up should be strengthened as it can improve patient compliance, and allow contact tracing, detection of new cases and collection of accurate treatment outcome information.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR. hubert.barennes@auf.org

ABSTRACT

Background: Contact tracing of tuberculosis (TB) patients is rarely performed in low-income countries. Our objective was to assess the outcome of and compliance with directly observed treatment (DOTS) of TB patients over a 3 year period in rural Lao PDR.

Methods: We performed a retrospective cohort study in which we enrolled TB patients who started DOTS treatment at Attapeu Provincial Hospital. We traced, through hospital records, all patients in their residential village. We conducted a standardized questionnaire with all TB patients and performed physical and anthropometric examinations as well as evaluations of compliance through counting of treatment pills at home and at the health facilities.

Results: Of 172 enrolled TB patients (sex ratio female/male: 0.52, mean age: 46.9 years ± 16.9), 26 (15.1%) died. These had a lower weight at the start (34.6 vs. 40.8 kg, p < 0.001) and were less compliant (91.6% vs. 19.2%, p < 0.001) than survivors. Low compliance was associated with poor accessibility to health care (p = 0.01) and symptomatic improvement (p = 0.02). Survivors had persistently poor health status. They were underweight (54.7%), and still had clinical symptoms (53.5%), including dyspnoea (28.8%) and haemoptysis (9.5%).

Conclusion: Our study suggests a lower rate of survival than expected from official statistics. Additionally, it showed that follow-up of TB patients is feasible although the patients lived in very remote area of Laos. Follow-up should be strengthened as it can improve patient compliance, and allow contact tracing, detection of new cases and collection of accurate treatment outcome information.

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Related in: MedlinePlus

Flow chart of tuberculosis patients through the follow up in southern Lao PDR. * Misclassified in hospital statistics
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Figure 1: Flow chart of tuberculosis patients through the follow up in southern Lao PDR. * Misclassified in hospital statistics

Mentions: Of the 172 TB patients, 159 patients had pulmonary TB (92.4%, Figure 1). All patients were visited at home, and the mean duration of treatment at the time of the home visit was 6 months. Table 1 and Table 2 present the main characteristics of the patients when hospitalized and during the home visits, respectively. All patients were rice farmers, living in 80 different remote villages of the province, where transportation means were scarce.


Survival and health status of DOTS tuberculosis patients in rural Lao PDR.

Barennes H, Keophithoun T, Nguyen TH, Strobel M, Odermatt P - BMC Infect. Dis. (2010)

Flow chart of tuberculosis patients through the follow up in southern Lao PDR. * Misclassified in hospital statistics
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2944351&req=5

Figure 1: Flow chart of tuberculosis patients through the follow up in southern Lao PDR. * Misclassified in hospital statistics
Mentions: Of the 172 TB patients, 159 patients had pulmonary TB (92.4%, Figure 1). All patients were visited at home, and the mean duration of treatment at the time of the home visit was 6 months. Table 1 and Table 2 present the main characteristics of the patients when hospitalized and during the home visits, respectively. All patients were rice farmers, living in 80 different remote villages of the province, where transportation means were scarce.

Bottom Line: Low compliance was associated with poor accessibility to health care (p = 0.01) and symptomatic improvement (p = 0.02).Additionally, it showed that follow-up of TB patients is feasible although the patients lived in very remote area of Laos.Follow-up should be strengthened as it can improve patient compliance, and allow contact tracing, detection of new cases and collection of accurate treatment outcome information.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR. hubert.barennes@auf.org

ABSTRACT

Background: Contact tracing of tuberculosis (TB) patients is rarely performed in low-income countries. Our objective was to assess the outcome of and compliance with directly observed treatment (DOTS) of TB patients over a 3 year period in rural Lao PDR.

Methods: We performed a retrospective cohort study in which we enrolled TB patients who started DOTS treatment at Attapeu Provincial Hospital. We traced, through hospital records, all patients in their residential village. We conducted a standardized questionnaire with all TB patients and performed physical and anthropometric examinations as well as evaluations of compliance through counting of treatment pills at home and at the health facilities.

Results: Of 172 enrolled TB patients (sex ratio female/male: 0.52, mean age: 46.9 years ± 16.9), 26 (15.1%) died. These had a lower weight at the start (34.6 vs. 40.8 kg, p < 0.001) and were less compliant (91.6% vs. 19.2%, p < 0.001) than survivors. Low compliance was associated with poor accessibility to health care (p = 0.01) and symptomatic improvement (p = 0.02). Survivors had persistently poor health status. They were underweight (54.7%), and still had clinical symptoms (53.5%), including dyspnoea (28.8%) and haemoptysis (9.5%).

Conclusion: Our study suggests a lower rate of survival than expected from official statistics. Additionally, it showed that follow-up of TB patients is feasible although the patients lived in very remote area of Laos. Follow-up should be strengthened as it can improve patient compliance, and allow contact tracing, detection of new cases and collection of accurate treatment outcome information.

Show MeSH
Related in: MedlinePlus