ABSTRACT
Objective: To estimate the predictors of death during intensive phase of Multidrug resistant tuberculosis treatment according to the weight of patients at the time of diagnosed. Methods: A retrospective study was conducted at three public hospitals in the Lahore, Punjab region, namely Jinnah Hospital, Mayo Hospital and Gulab Devi Hospital on 1,496 patients receiving treatment for MDR-TB from January 2018 to December 2020. Data were collected from electronically nominating and recording system of the hospitals. Data were fitted to Cox proportional hazards regression model with 95% confidence interval (CI) to evaluate the associations between predictors of death and weight of MDR-TB patients during the intensive phase of treatment. Results: This analysis revealed a MDR-TB mortality rate of 30% and the mortality rate due to MDR-TB during the intensive phase of treatment was 23%. The variables related to increased mortality among underweight patients were age more than 60 years (HR: 0.398, 95% CI: 0.314-0.504) , diabetes (HR: 1.496, 95% CI: 1.165-1.921), current smoking (HR: 0.465, 95% CI: 0.222-0.973), history of MDR-TB (HR: 0.701, 95% CI: 0.512-0.959) and culture positive at the time of diagnosed (HR: 0.499, 95% CI: 0.379-0.659) during the intensive phase of treatment. Conclusion: The high mortality rate among the underweight MDR-TB patients during the intensive phase of the treatment requires the nutritional support for malnourishment and ensured a close follow-up of the elderly patients with co-morbidities as well as family history of Tuberculosis.
ABSTRACT
OBJECTIVES: To determine the prevalence and risk factors of hepatitis C virus among injecting drugs users, furthermore different genotypes of HCV infection and their effect on viral load were also found and subsequently most prevalent subtype was predicted. METHODS: All samples were processed for Anti-HCV antibody detection through ELISA by using third generation ELISA Kit. The Anti-HCV positive serum samples were stored for RT-PCR to estimate the viral load and genotypes of HCV for study. Injecting drug users selected from in and around Lahore Metropolitan from July 2012 to August 2013 was included. The data analysis was completed by using SPSS version 16. A p-value of < 0.05 was considered to be significant. RESULTS: A total of 241 Injecting drug users were enrolled and screened for Anti HCV in the study. Prevalence of HCV infection in IDUs from Lahore was found to be 36.09%. Education (p=0.000), low socioeconomic status (p=0.011), Blood transfusion (0.003), any tattoo on the body (p=0.002), use of injectable drugs with reused syringes (p=0.000) and sharing of syringes (p=0.001) in groups was significantly associated with HCV infection. Some utensils were also significantly associated with HCV status. The most common subtype of HCV genotype was 3a (n=65) followed by 2a (n=15) and 1a (n=6). CONCLUSION: The study reveals that IDUs with reused syringes status and sharing of syringes in group had more chances to get HCV infection. The viral load in IDUs infected with different subtypes of genotype was significantly associated.
