Determining the risk factors associated with delayed sputum conversion at the end of the intensive phase among tuberculosis patients

Background: In pulmonary tuberculosis (PTB), the sputum conversion rate at 2 months is frequently used to evaluate treatment outcomes and effectiveness of a TB control programme. Aims: The study aimed to estimate the rate of delayed sputum conversion and explore its predicting factors at the end of the intensive phase among smear-positive PTB (PTB +ve) patients. Methods: A 3-year retrospective study was conducted in the government hospital in Pulau Pinang from 2016 to 2018. During the study, a standardized, data collection form was used to collect data from the patient record. Patients aged over 18 years were recruited. Multivariable logistic regression analysis was used to identify significant independent variables associated with delayed sputum conversion. Results: A total 1128 of PTB patients were recorded visiting the TB clinic, 736 (65.2%) were diagnosed as PTB +ve; of these, 606 (82.3%) PTB +ve had a record of sputum conversion at the end of the intensive phase. Age ≥ 50 years, blue-collar jobs, smoking, heavy bacillary load, relapsed and treatment interrupted were significantly (P < 0.05) associated with delayed sputum conversion. Delayed sputum conversion rate at the end of the intensive phase was 30.5%. Conclusion: The rate of sputum smear conversion in the intensive phase of treatment was independently associated with high sputum smear grading at diagnosis, relapsed and treatment interrupted categories, old age and blue-collar occupations.

Misinformation, Perceptions Towards COVID-19 and Willingness to be Vaccinated: A Population-Based Survey in Yemen

BackgroundSince the beginning of the COVID-19 outbreak, many pharmaceutical companies were racing to develop a safe and effective COVID-19 vaccine. Simultaneously, rumors and misinformation about COVID-19 were and still widely spreading. Therefore, this study aimed to investigate the prevalence of COVID-19 misinformation among the Yemeni population and its association with vaccine acceptance and perceptions. MethodsA cross-sectional online survey was conducted in four major cities in Yemen. The constructed questionnaire consisted of four main sections (sociodemographic data, misinformation, perceptions (perceived susceptibility, severity and worry), and vaccination acceptance evaluation). Subject recruitment and data collection were conducted online utilizing social websites and using the snowball sampling technique. Descriptive and inferential analyses were performed using SPSS version 27. ResultsThe total number of respondents was 484. Over 60% of them were male and had a university education, more than half had less than 100$ monthly income and were Khat chewers, while only 18% were smokers. Misinformation prevalence ranged from 8.9% to 38.9%, depending on the statement being asked. Men, university education, higher income, employment, and living in urban areas were associated with a lower misinformation level (p <0.05). Statistically significant association (p <0.05) between university education, living in urban areas, and being employed with perceived susceptibility were observed. The acceptance rate was 61.2% for free vaccines, but it decreased to 43% if they had to purchase it. Females, respondents with lower monthly income, and those who believed that pharmaceutical companies made the virus for financial gains were more likely to reject the vaccination (p <0.05). ConclusionThe study revealed that the acceptance rate to take a vaccine was suboptimal and significantly affected by gender, misinformation, cost, and income. Furthermore, being female, Nonuniversity educated, low-income, and living in rural areas were associated with higher susceptibility to misinformation about COVID-19. These findings show a clear link between misinformation susceptibility and willingness to vaccinate. Focused awareness campaigns to decrease misinformation and emphasize the vaccinations safety and efficacy might be fundamental before initiating any mass vaccination in Yemen.

Quality Of Life Among Patients Undergoing Haemodialysis In Jakarta, Indonesia

@#Haemodialysis is a continuous treatment provided to patients with chronic kidney disease as a replacement for renal function. It is important to assess the quality of life among these patients. The aim of this study was to evaluate quality of life among patients on haemodialysis using an Indonesian version of the KDQoL-SF24 questionnaire. This is a cohort observational study that included 145 haemodialysis patients in a haemodialysis centre in Jakarta, Indonesia. A translated and validated version of the KDQoL-SF24 was used in this survey. The participants in this study had lower mean scores than the standard form in the following 6 components: burden of kidney disease (44.22±33.23), cognitive function (74.94±20.32), sleep (57.07±24.15), patient satisfaction (60.11±18.56), role-physical (26.21±44.01), emotional well-being (69.19±24.25) and role-emotional (40.69±49.18). A significant relationship was found between sexual function, physical functioning, role emotional and age among haemodialysis patients (P <0.05). Based on the overall health rating from the KDQoL-SF24, the mean and standard deviation for the 21- to 30-year-old age group was lower than the standard form. The burden of kidney disease, cognitive function, sleep, patient satisfaction, role-physical, emotional well-being and role-emotional component scores were low for haemodialysis patients in Indonesia compared to the standard form. Additionally, age significantly affected sexual function, physical functioning and role-emotional.

Infective Endocarditis and Chronic Kidney Disease: How to Deal with Complications

Infective endocarditis (IE) is the one of the most important causes of increased mortality and morbidity among haemodialysis patients. The reason for this increasing prevalence of infection among these patients is the use of haemodialysis catheters during dialysis, as these patients are highly susceptible to infections that are easily transmitted via blood access points. The present case was a geriatric end stage renal disease (ESRD) patient who was readmitted to the hospital two days after her scheduled haemodialysis session with symptoms of nosocomial endocarditis. Her concurrent medical complications were hypertension, non-insulin dependent diabetes mellitus, and ischemic heart disease. Based on her previous medical history and current examination, the patient was suspected to have IE due to catheter related infection. The goal of therapy is to manage the comorbidities and infection by provision of appropriate treatment based on close monitoring of the patient condition.