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Clinical Features, Biochemical Parameters, and Treatment Adherence of Individuals Who Started the Treatment for Active Pulmonary Tuberculosis during the Pandemic Period.

ABSTRACT: This descriptive prospective study investigated the clinical features and treatment adherence of individuals who started the treatment for Pulmonary tuberculosis (TB) during the COVID-19 pandemic in São Luís. Thirty-six TB patients and thirty-five age/sex-matched individuals were recruited between January 2021 and January 2022. The clinical features, sociodemographic information, and serum were obtained at the diagnosis time. Adherence to treatment and adverse reactions were investigated monthly. The most common symptoms in TB patients were cough (91.6%) and fever (83.3%). All TB patients had elevated pre-therapy levels of CRP and reduced HDL: 88.9% presented hypocalcemia and 47.2% showed elevated ALP and GGT. TB patients showed higher levels of ALT, AST, ALP, GGT, CRP, amylase, and triglycerides than the comparison group (p < 0.05), while the calcium levels were reduced (p < 0.0001). TB patients with anti-SARS-CoV-2-IgG antibodies (seroprevalence of 66.7%) presented higher values of amylase and lower CRP levels (p < 0.05). Most patients (~70%) reported at least one adverse drug reaction, mainly pruritus and nausea. The treatment abandonment rate was 19.2%. In conclusion, TB patients showed elevated pre-therapy levels of CRP, low levels of HDL, and hypocalcemia. Liver and pancreatic functions were also compromised in several patients before the therapy. The treatment non-adherence rate observed was similar to other studies performed before the pandemic period.

SUBMITTER: Sales ACS

PROVIDER: S-EPMC10381187 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Clinical Features, Biochemical Parameters, and Treatment Adherence of Individuals Who Started the Treatment for Active Pulmonary Tuberculosis during the Pandemic Period.

Sales Amanda Caroline de Souza ACS Lopes Larissa Araújo LA Vale Maria Caroliny Dos Santos MCDS Costa Mayara Ferreira MF Lima João Victor de Souza JVS Silva João Gabriel Matos da JGMD Ferreira Bruna Sthefanny da Cunha BSDC Nascimento Victoria Alves do VAD Flor Saara Emanuele da Silva SEDS Sousa Elane Luiza Costa de ELC Paz Bruna Katarine Bezerra BKB Garcia Ricardo Amorim de Sousa RAS Sousa Eduardo Martins de EM Santos Alexsandro Ferreira Dos AFD Silva Luís Cláudio Nascimento da LCND Zagmignan Adrielle A

Journal of clinical medicine 20230722 14

This descriptive prospective study investigated the clinical features and treatment adherence of individuals who started the treatment for Pulmonary tuberculosis (TB) during the COVID-19 pandemic in São Luís. Thirty-six TB patients and thirty-five age/sex-matched individuals were recruited between January 2021 and January 2022. The clinical features, sociodemographic information, and serum were obtained at the diagnosis time. Adherence to treatment and adverse reactions were investigated monthly ...[more]

PMID: 37510958

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Project description:BackgroundDigital health technologies are widely used for disease management, with their computing platforms, software, and sensors being used for health care. These technologies are developed to manage chronic diseases and infectious bacterial diseases, including tuberculosis (TB).ObjectiveThis study aims to comprehensively review the literature on the use of digital health interventions (DHIs) for enhancing TB treatment adherence and identify major strategies for their adoption.MethodsWe conducted a literature search in the PubMed, Cochrane Library, Ovid Embase, and Scopus databases for relevant studies published between January 2012 and March 2022. Studies that focused on web-based or mobile phone-based interventions, medication adherence, digital health, randomized controlled trials, digital interventions, or mobile health and ubiquitous health technology for TB treatment and related health outcomes were included.ResultsWe identified 27 relevant studies and classified them according to the intervention method, a significant difference in treatment success, and health outcomes. The following interventions were emphasized: SMS text messaging interventions (8/27, 30%), medicine reminders (6/27, 22%), and web-based direct observation therapy (9/27, 33%). Digital health technology significantly promoted disease management among individuals and health care professionals. However, only a few studies addressed 2-way communication therapies, such as interactive SMS text messaging and feedback systems.ConclusionsThis scoping review classified studies on DHIs for patients with TB and demonstrated their potential for the self-management of TB. DHIs are still being developed, and evidence on the impact of digital technologies on enhancing TB treatment adherence remains limited. However, it is necessary to encourage patients' participation in TB treatment and self-management through bidirectional communication. We emphasize the importance of developing a communication system.

Project description:BACKGROUND:Non-adherence to tuberculosis treatment can lead to prolonged periods of infectiousness, relapse, emergence of drug-resistance, and increased morbidity and mortality. In this review, we assess whether patient education or counselling, or both, promotes adherence to tuberculosis treatment. OBJECTIVES:To evaluate the effects of patient education or counselling, or both, on treatment completion and cure in people requiring treatment for active or latent tuberculosis. SEARCH METHODS:Without language restriction, we searched for eligible studies in the Cochrane Infectious Diseases Group Specialized Register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and LILACS; checked reference lists of relevant articles; and contacted relevant researchers and organizations up to 24 November 2011. SELECTION CRITERIA:Randomized controlled trials examining the effects of education or counselling, or both, on treatment completion and cure in people with clinical tuberculosis; and treatment completion and clinical tuberculosis in people with latent disease. DATA COLLECTION AND ANALYSIS:We independently screened identified studies for eligibility, assessed methodological quality, and extracted data; with differences resolved by consensus. We expressed study results as risk ratios (RRs) with 95% confidence intervals (CI). MAIN RESULTS:We found three trials, with a total of 1437 participants, which examined the effects of different educational and counselling interventions on adherence to treatment for latent tuberculosis.All three trials reported the proportion of people who successfully completed treatment for latent tuberculosis. Overall, education or counselling interventions may increase successful treatment completion but the magnitude of benefit is likely to vary depending on the nature of the intervention, and the setting (data not pooled, 923 participants, three trials, low quality evidence).In a four-arm trial in children from Spain, counselling by nurses via telephone increased the proportion of children completing treatment from 65% to 94% (RR 1.44, 95% CI 1.21 to 1.72; 157 participants, one trial), and counselling by nurses through home visits increased completion to 95% (RR 1.46, 95% CI 1.23 to 1.74; 156 participants, one trial). Both of these interventions were superior to counselling by physicians at the tuberculosis clinic (RR 1.20, 95% CI 0.98 to 1.47; 159 participants, one trial).In the USA, a programme of peer counselling for adolescents failed to show an effect on treatment completion rates at six months (RR 1.01, 95% CI 0.90 to 1.13; 394 participants, one trial). In this trial treatment completion was around 75% even in the control group.In the third study, in prisoners from the USA, treatment completion was very low in the control group (12%), and although counselling significantly improved this, completion in the intervention group remained low at 24% (RR 1.94, 95% CI 1.03 to 3.68; 211 participants, one trial).None of these trials aimed to assess the effect of these interventions on the subsequent development of active tuberculosis, and we found no trials that assessed the effects of patient education or counselling on adherence to treatment for active tuberculosis. AUTHORS' CONCLUSIONS:Educational or counselling interventions may improve completion of treatment for latent tuberculosis. As would be expected, the magnitude of the benefit is likely to depend on the nature of the intervention, and the reasons for low completion rates in the specific setting.

Dataset Information

Clinical Features, Biochemical Parameters, and Treatment Adherence of Individuals Who Started the Treatment for Active Pulmonary Tuberculosis during the Pandemic Period.

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Clinical Features, Biochemical Parameters, and Treatment Adherence of Individuals Who Started the Treatment for Active Pulmonary Tuberculosis during the Pandemic Period.

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