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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

Strengthening community and primary health systems for tuberculosis. A consultation on childhood TB integration

UNICEF
2016

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An estimated one million children between the age of 0-14 fall ill with tuberculosis (TB) every year, over 67 million children are infected and might develop active disease at any time. In 2013, the WHO with key partners launched the Roadmap for Childhood TB, outlining ten key actions to improve outcomes for children affected by TB, including improved data, development of child-friendly tools for diagnosis and treatment, engagement of key stakeholders at all levels of the system, and the development of integrated family- and community-centred strategies to provide comprehensive and effective services at the community level. A consultation on childhood TB integration took place in New York on June 1 and 2, 2016 to stimulate further the dialogue. The meeting addressed 7 topics: perspectives on childhood TB; country discussions on integration; integrating childhood TB interventions into service delivery; an opportunity for TB risk assessment at the community level: TB/HIV adapted integrated community case management (iCCM); childhood TB integration at the national, district, and community level; and financing childhood TB integration 

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.”

Bridging the gaps between research, policy and practice in low- and middle-income countries : a survey of health care providers

GUINDON, G Emmanuel
et al
May 2010

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This article discusses the results of a survey to examine the gaps that continue to exist between research based evidence and clinical practice. Health care providers in 10 low- and middle-income countries were surveyed about their use of research-based evidence and examined factors that may facilitate or impede such use. The conclusion is that locally conducted or published research plays an important role in changing the professional practice of health care providers surveyed in low- and middle-income countries and increased investments in local research, or at least in locally adapted publications of research-based evidence from other settings, are therefore needed. Although access to the Internet was viewed as a significant factor in whether research-based evidence led to concrete changes in practice, few respondents reported having easy access to the Internet. Therefore, efforts to improve Internet access in clinical settings need to be accelerate

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

National partnership platforms on HIV and TB : a toolkit to strengthen civil society information, dialogue and advocacy

RAMAKANT, Bobby
et al
2009

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This toolkit aims to share the learning on national partnership programmes (NPP) so far, The examples, case studies, challenges and processes described are therefore a ‘work-in-progress’ rather than perfectly presented material. The toolkit also provides examples of successful initiatives using the NPP approach. A NPP is based on the principle that information is power, providing tools for information sharing, networking and dialogue. NPPs facilitate the process of consensus building, developing an informed common advocacy agenda and implementing effective country level advocacy on HIV and TB

eforums on HIV and TB : a toolkit for launching, moderating and managing a high quality eforum

KISTLER, Elizabeth
et al
2009

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This toolkit aims to provide organisations working in health and development with tools to launch, moderate and manage high-quality eForums that provide a safe space for civil society focused information sharing, networking and dialogue. It has the potential to be applied to a range of health and development issues. It is intended for international, regional and national civil society organisations recognising the power of information and the significance of a transparent, broad-based communication mechanism that enhances civil society responses to HIV and TB

Towards universal access : scaling up priority HIV/AIDS interventions in the health sector : progress report 2008

WORLD HEALTH ORGNAIZATION (WHO)
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
2008

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This report provides in-depth information on: treatment and care for people living with HIV; HIV testing and counselling; health sector interventions for HIV prevention; scaling up HIV services for women and children; strengthening health systems and health information; and towards universal access as the way forward

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

TB control in China

HEALTHLINK WORLDWIDE
February 2006

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This paper considers findings from EQUI-TB's work in China. Using a range of methods, researchers uncovered critical challenges facing TB control in China, including economic and social barriers, how to support vulnerable people including rural-to-urban migrants and delays in diagnosis and treatment

Footsteps issues 18-65

TEARFUND
2006

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Includes issues 18 - 65 of Footsteps, a newsletter with a Christian emphasis that is aimed at all health and development workers. It aims to share practical ideas and enthusiasm on all aspects of development that impact at community level, including health, sustainable agriculture, agro-forestry, literacy, the environment, and project management. Provides book reviews and resource guides

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.

 

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