ABSTRACT
Background: Tuberculosis (TB) is one of the most infectious diseases if not treated properly it may lead to mortality. The directly observed treatment, short course (DOTS) therapy is the choice of the treatment of TB. Objectives: The objectives of the study were (1) to determine the factors influencing compliance of persons with TB to DOTS, (2) to evaluate the effectiveness of an awareness program on knowledge and compliance to DOTS among persons with TB, (3) to find the association between pre-test level of knowledge with selected sociodemographic variables, and (4) to find the association between pre-test level of compliance to DOTS with selected sociodemographic variables. Materials and Methods: An evaluative approach with one group pre-test and post-test design was used as a research design in the study. 50 participants were selected as a sample using purposive sampling technique. The data were collected using structured knowledge questionnaire and compliance checklist through interview schedule Results: The study result showed that the mean post-test knowledge score (17.32 ± 1.58) was higher than the mean pre-test knowledge score (10.80 ± 2.05) and “t” value is 27.22 at P < 0.05. Similarly, the mean post-test compliance score (8.92 + 0.72) was higher than the mean pre-test compliance score (6.00 ± 1.05) and “t” value is 9.369 at P < 0.05. The sociodemographic variable such as age and educational status was significantly associated with pre-test knowledge score (χ² = 5.993, P < 0.05, and χ² = 11.49, P < 0.05), respectively, and gender was significantly associated with pre-test compliance score (χ² = 4.482, P < 0.05). The main reason for noncompliance to DOTS therapy was difficult to take multiple drugs for a long period and data showed that family support (29.55%) was highly influencing to comply with DOTS therapy. Conclusion: The awareness program was highly effective in increasing knowledge among TB person and compliance to DOTS therapy. Therefore, the knowledge and compliance of the TB person to DOTS therapy can be further improved by providing on-going awareness programs.
ABSTRACT
Objective: To determine the efficacy of a short course of antibiotics (<4 days) in comparison to a longer course (≥4 days) for the treatment of acute otitis media in children. Data sources: Electronic databases, hand search of reviews, bibliographies of books, abstracts and proceedings of international conferences. Review Methods: Randomized controlled trials of the empiric treatment of acute otitis media comparing antibiotic regimens of <4 days versus ≥4 days in children between four weeks to eighteen years of age were included. The trials were grouped by pharmacokinetic behavior of short-course antibiotics into short-acting antibiotics, parenteral ceftriaxone, and long-acting azithromycin. Results: We reviewed 35 trials, which provided 38 analytic components. Overall, there was no evidence of an increased risk of treatment failure until one month with a short-course of antibiotics (RR=1.06, 95% CI 0.95 to 1.17, P=0.298). Use of short-acting oral antibiotic in shortcourse was associated with a significantly increased risk of treatment failure (RR=2.27, 95% CI: 1.04 to 4.99). There was a slightly increased risk of treatment failure with parenteral ceftriaxone (RR=1.13, 95% CI 0.99 to 1.30). The risk of adverse effects was significantly lower with short-course regimens (RR=0.58, 95% CI: 0.48 to 0.70). Conclusion: There is no evidence of an increased risk of treatment failure with short course of antibiotics for acute otitis media. Among the short-course regimens, azithromycin use was associated with a lower risk of treatment failure while short-acting oral antibiotics and parenteral ceftriaxone may be associated with a higher risk of treatment failure.