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Investigation of physical and functional impairments experienced by people with active tuberculosis infection: A feasibility pilot study

Van ASWEGEN, Heleen
ROOS, Ronel
McCREE, Melanie
QUINN, Samantha
MER, Mervyn
August 2019

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Background: Tuberculosis (TB) remains a significant healthcare problem. Understanding physical and functional impairments that patients with active TB present with at the time of diagnosis and how these impairments change over time while they receive anti-TB therapy is important in developing appropriate rehabilitation programmes to optimise patients’ recovery.

 

Objectives: The aim of this study was to assess the acceptability, implementation and practicality of conducting a prospective, observational and longitudinal trial to describe physical and functional impairments of patients with active TB.

 

Method: A feasibility pilot study was performed. Patients with acute pulmonary TB admitted to an urban quaternary-level hospital were recruited. Physical (muscle architecture, mass and power, balance, and breathlessness) and functional (exercise capacity) outcomes were assessed in hospital, and at 6 weeks and 6 months post-discharge. Descriptive statistics were used to analyse the data.

 

Results: High dropout (n = 5; 41.7%) and mortality (n = 4; 33.3%) rates were observed. Limitations identified regarding study feasibility included participant recruitment rate, equipment availability and suitability of outcome measures. Participants’ mean age was 31.5 (9.1) years and the majority were human immunodeficiency virus (HIV) positive (n = 9; 75%). Non-significant changes in muscle architecture and power were observed over 6 months. Balance impairment was highlighted when vision was removed during testing. Some improvements in 6-minute walk test distance were observed between hospitalisation and 6 months.

 

Conclusion: Success of a longitudinal observational trial is dependent on securing adequate funding to address limitations observed related to equipment availability, staffing levels, participant recruitment from additional study sites and participant follow-up at community level. Participants’ physical and functional recovery during anti-TB therapy seems to be limited by neuromusculoskeletal factors.

 

 

African Journal of Disability, Vol 8, 2019

2015 global reference list of 100 core health indicators

WORLD HEALTH ORGANIZATION (WHO)
2015

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“The Global Reference List of 100 Core Health Indicators is a standard set of 100 indicators prioritized by the global community to provide concise information on the health situation and trends, including responses at national and global levels. It contains indicators of relevance to country, regional and global reporting across the spectrum of global health priorities relating to the post-2015 health goals of the Sustainable Development Goals (SDGs). These include the Millennium Development Goals (MDGs) agenda, new and emerging priorities such as noncommunicable diseases, universal health coverage and other issues in the post-2015 development agenda.”

Treatment of tuberculosis guidelines

WORLD HEALTH ORGANIZATION (WHO)
2010

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These guidelines aim ..."to help national tuberculosis (TB) control programmes in setting TB treatment policy to optimise patient cure: curing patients will prevent death, relapse, acquired drug resistance, and the spread of TB in the community. Their further purpose is to guide clinicians working in both public and private sectors." This new edition of the guidelines integrates the detection and treatment of both HIV infection and multi-drug resistant TB

The Millennium Development Goals report 2008

UNITED NATIONS (UN)
2008

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This UN Report summarizes progress towards the Millennium Development Goals between 2000 and 2008, for the world as a whole and for various country groupings. It also considers factors that may affect future progress towards achieving the goals by 2015

Achieving millennium development goals (4, 5 &6) in Africa south of Sahara : BCH Africa's strategic vision

Building Capacities for Better Health in Africa (BCH Africa)
2007

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This is document outlines BCH-Africa's strategic vision to help countries in sub-Saharan Africa to meet three of the millennium goals by 2015. These goals are: to help to reduce child mortality; improve maternal health; and combat HIV and AIDS, malaria and other diseases. The strategy sets out four main areas of focus: promoting social ownership of immunisation, to contribute to a rapid reduction in infant and maternal mortality; promoting national partnership and developing community skills to roll back malaria in Africa sustainably; developing individual and community skills to stop the spread of HIV and AIDS and tuberculosis; and using communication approaches that achieve long-lasting social changes to help control HIV, malaria and tuberculosis and resolve other health problems. Accompanying strategic priorities are: integrating health communication interventions; and building human resource capacity in community health promotion with a firm commitment to involving all the main actors and partners to create greater social ownership and sustainability

Civil society perspectives on TB policy in Bangladesh, Brazil, Nigeria, Tanzania, and Thailand

Public Health Watch, Open Society Institute
2006

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This publication contains an overview of the common themes and funding resulting from five country reports, and the five reports themselves. The World Health Organization has designated all five as TB-high burden countries. The research findings show a low level of awareness about TB, and TB and HIV co-infection; about how TB is transmitted and how it can be cured; and about the link between poverty and TB; as well as low media coverage of TB and a lack of strong communication strategies for national TB programmes. It also contains country-specific recommendations

Disease control priorities in developing countries. 2nd edition. Chapter 2. Intervention cost-effectiveness: overview of main messages.

LAXMINARAYAN, Ramanan
et al
2006

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Drawing from the collective knowledge and analytical work of the many experts who have contributed to this volume, this chapter provides a broader perspective on the relative efficiency and effect on health of a number of interventions than is possible in a single, condition-specific chapter. The objective is to provide information on the cost-effectiveness estimates for 319 interventions covering nearly every disease condition considered in the volume, and the resulting avertable burden of disease. This chapter provides broad conclusions on the economic efficiency of using these interventions to improve health.

 

Access to medicines in under-served markets : what are the implications of changes in intellectual property rights, trade and drug registration policy?

DFID HEALTH SYSTEMS RESOURCE CENTRE (HSRC)
September 2004

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This overview draws on seven studies commissioned by the UK's Department for International Development. After providing some background, it considers the implications of stronger intellectual property protection for access to medicines; the prospects for supply in emerging and under-served markets; and makes recommendations for increasing access

TB/HIV : a clinical manual

HARRIS, Anthony D
MAHER, Dermot
2004

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Developments since 1996, particularly in the TB/HIV field, have prompted a second edition of this popular manual which provides a pocket-sized guide to the clinical management of TB, particularly in patients suffering from co-infection with HIV. Designed for use by busy clinicians, the manual aims to promote the best possible diagnosis and treatment in low-income countries where the prevalence of TB and HIV infection is high, case loads are heavy, and laboratory support may be limited. With these needs in mind, the manual combines the latest scientific knowledge about TB and HIV with authoritative advice based on extensive field experience in several of the hardest hit countries. Throughout the manual, tables, flow charts, lists of do's and don'ts, questions and answers, and numerous practical tips are used to facilitate quick reference and correct decisions. Information ranges from advice on how to distinguish TB from other HIV-related pulmonary diseases to the simple reminder that in sub-Saharan Africa, anyone with TB is in a high risk group for HIV. Though primarily addressed to clinicians working at district hospitals in sub-Saharan Africa, the manual is also suitable for use in areas of Asia and South America where the problem of TB and HIV co-infection poses a growing clinical challenge

Palliative care in Sub-Saharan Africa : an appraisal

HARDING, Richard
HIGGINSON, Irene
2004

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This report was written from the belief that palliative care is, and will be for the forseeable future, an essential component in the continuum of managing HIV/AIDS in sub-Saharan Africa. There is now a wealth of experience in sub-Saharan Africa about the ways in which palliative care can be delivered both affordably and effectively. However, there remains a lack of properly documented evidence and research to demonstrate the importance of this work and promote its development. This report provides a review of existing evaluations of palliative care projects in sub-Saharan Africa with an emphasis on isolating the factors that lead to sustainability, local ownership and scaling up; the role of palliative care in the management of HIV/AIDS and how to integrate palliative care and Anti-Retroviral Therapy (ART); primary health based care projects in two countries, Kenya and Malawi, that could provide lessons for the implementation of palliative care; lessons from other parallel programmes which mirror palliative care delivery, for example, tuberculosis programmes, and primary care programmes with good links to local clinics and hospitals, and community mobilization and empowerment projects linked to health facilities. In this way it contributes to the effort of providing an evidence base to demonstrate the importance of palliative care and provides a source of reference for policy makers, practitioners, donors and researchers

A framework for conceptualising and reviewing vulnerability to malaria, TB and HIV

TOLHURST, R
THEOBALD, S
June 2003

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This policy brief aims to define vulnerability in the context of infectious disease and provide a framework for analysis. The framework can be used to identify factors that influence vulnerability to infectious disease, including vulnerability to exposure, infection, progression to disease, progression to severe disease, and the effects of disease. The paper identifies strategic areas for further research, the implications for policy makers and future directions for research, interventions and policy

A challenge to make more effective use of scarce resources | Liverpool School of Tropical Medicine : annual report 2002-2003

LSTM
2003

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This page contain information on the Malaria Knowledge Programme at the Liverpool School of Tropical Medicine. The page notes the work carried out by the VHA on developing a framework that can be used to identify cross-sectoral and multi-disciplinary approaches to vulnerability to malaria, TB and HIV. It shows that few resources are being put into developing appropriate, cheap and accurate tools for malaria diagnosis. Evidence shows that what is needed is effective district laboratory services. It also mentions the Gates Malaria Partnership, which has supported a radio project in the Gambia. It is called ‘Bolonghodala’ which means ‘By the Riverside’. It is a radio drama set in a fictional but typical rural village and combines stories about people’s lives with malaria prevention

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