Academic literature on the topic 'Tuberculosis Treatment Nepal'
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Journal articles on the topic "Tuberculosis Treatment Nepal"
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Marahatta, SB, and BJ Karki. "Tuberculosis in Nepal: Diagnosis and Treatment Barriers." Journal of Manmohan Memorial Institute of Health Sciences 2 (September 26, 2016): 1–2. http://dx.doi.org/10.3126/jmmihs.v2i0.15784.
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Adhikari, Nilaramba, L. R. Joshi, B. Subedi, D. Acharya, M. Adhikari, P. Thapa, R. Sultana, and K. B. Karki. "Tuberculosis in Nepal: Situation, Challenges and Ways Forward." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 17, no. 1 (July 26, 2019): 34–40. http://dx.doi.org/10.3126/saarctb.v17i1.25026.
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Introduction: Globally, tuberculosis is a major public health problem. Moreover, the emergence of drug resistant forms of TB has threatened TB prevention and treatment efforts. Despite the long history of tuberculosis prevention efforts, tuberculosis still ranks among the top ten causes of deaths in Nepal. Furthermore, Nepal being land locked with two high TB burden countries i.e. India and China, it has added difficulties to National Tuberculosis program. Hence this study aims to review the situation of National Tuberculosis Program in Nepal and explore the possible challenges and ways forward for NTP to strengthen the TB diagnostics and treatment services in Nepal.
Methods: This study is based on the review of available literatures and data sources related to tuberculosis prevention, care and control. Secondary data published by National Tuberculosis Program in the annual report for the year 2015, 2016 and 2017 were considered for the situation analysis of tuberculosis in Nepal. We used different platforms like Google scholar, PubMed to search relevant literatures.
Results: This has been a huge gap between WHO TB estimates and TB cases notification by the national system. It was 22% in 2015, 27% in 2016 and 29% in 2017. However National Tuberculosis Program has maintained treatment success rate consistently above 90%. Tuberculosis program has yet not achieved universal HIV testing, although HIV testing among TB patients has increased rapidly. Similarly, only 75%, 1994 received DST out of 2601 retreatment TB cases have received DST in 2017 despite guideline suggest mandatory drug susceptibility testing for retreatment TB cases.
Conclusion: Case notification has reduced gradually. It is difficult to achieve the target envisioned by NSP 2016-21 if the current case notification trend persists. NTP needs to expand service sites ensuring minimum quality standards as well as scale up targeted intervention addressing human right issues to identify the missing TB cases. NTP needs to regulate the quality of diagnosis and treatment TB services offered by private sector.
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Agarwal, Neha, Prajowl Shrestha, and Ramesh Chokhani. "Allergic BronchoPulmonary Aspergillosis in Nepal." Journal of Nepal Medical Association 52, no. 196 (December 31, 2014): 1020–23. http://dx.doi.org/10.31729/jnma.2806.
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Allergic BronchoPulmonary Aspergillosis is clinically under recognized and often misdiagnosed in Nepal. A total of 15 cases of ABPA were enrolled in this case series. Cases were followed up after the 3 months of start of treatment and clinical responses were assessed. The mean age of the patients was 33.06 ± 9.2 yrs. 80% were male. 26.6% patients were empirically on antitubercular treatment at the time of presentation. 40% patients were misdiagnosed and already treated as pulmonary Tuberculosis. 10 patients were previously treated as cases of refractory asthma. Majority of patients had significant eosinophillia and raised total serum IgE. All patients required treatment with bronchodilator and systemic steroid. 80% patients underwent remission with the treatment. Pulmonary Tuberculosis and refractory bronchial asthma are common condition that leads to the misdiagnosis of this disease.
Keywords: ABPA; bronchial asthma; central bronchiectasis; eosinophil count; serum IgE.
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Arora, Sunita, Gursharan Singh Narang, and Prabhjot Kaur Dhillon. "Neurological Worsening in a Child of Miliary Tuberculosis with Neuro-Tuberculosis on Anti Tubercular Treatment." Journal of Nepal Paediatric Society 35, no. 2 (January 20, 2016): 185–88. http://dx.doi.org/10.3126/jnps.v35i2.10406.
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A seven and half year old male child presenting with pyrexia of unknown origin was diagnosed to be a case of miliary tuberculosis. Neuroimaging revealed multiple discrete ring as well as nodular enhancing lesions indicative of tuberculomas. After the initial response to ATT along with systemic steroids the child again presented with severe headache along with vomiting towards the end of intensive phase. Repeat neuroimaging showed appearance of new lesions with perilesional edema. Child was started again on systemic steroids and Streptomycin was added to the anti tubercular regimen, to which the child responded well.J Nepal Paediatr Soc 2015;35(2):185-188
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Shrestha, S., GB Pradhan, K. Bhoomi, BL Shrestha, and CL Bhattachan. "Abdominal Tuberculosis in Nepal Medical College Teaching Hospital, Kathmandu." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 5, no. 1 (May 7, 2010): 39–42. http://dx.doi.org/10.3126/saarctb.v5i1.3083.
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Abdominal Tuberculosis is a common extra pulmonary manifestation of tuberculosis. The wide spectrum of presentation makes abdominal tuberculosis difficult to diagnose and treat. Retrospective review of cases with abdominal tuberculosis presenting to the Surgery Department of Nepal Medical College Teaching Hospital from January 2002- June 2007 was done to describe our experience of abdominal tuberculosis over a 5 year period. We found total 32 patients with abdominal tuberculosis, among which 13 had concurrent pulmonary tuberculosis. The most common clinical presentation, i.e. a triad of abdominal pain, fever and weight loss was present in 13 who had symptoms of pulmonary tuberculosis presented to physicians and the remaining 19 presented acutely to surgeons with symptoms of pain and obstruction. Chest X ray, abdominal ultrasound and barium meal follow through done to find associated abnormalities. Diagnostic Laparoscopy was performed in 10 and 3 patients with peritonitis underwent emergency laparotomy which revealed multiple ileal perforations in 2 cases and one had multiple strictures with small bowel perforation. Diagnosis of tuberculosis, attended at surgeons was confirmed by demonstrating caseating granulomas in histology and Acid Fast Bacilli Positive, culture for M. tuberculosis from peritoneal fluid. All patients were started anti tuberculosis treatment. Abdominal tuberculosis is a relatively common finding and should always be considered in the differential diagnosis of abdominal pain, fever and weight loss. Key Words: Tuberculosis; abdominal tuberculosis; Acid Fast Bacilli; ileocaecal disease DOI: 10.3126/saarctb.v5i1.3083 SAARC J. Tuber. Lung Dis. HIV/AIDS 2008 Vol.5(1) 39-42
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Kumar, MK, P. Kumar, and A. Singh. "Anti-Tubercular Treatment of Tuberculous Meningitis Cause Paradoxical Multiple Neurotuberculoma." Journal of Nepal Paediatric Society 34, no. 3 (April 8, 2015): 236–38. http://dx.doi.org/10.3126/jnps.v34i3.10752.
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Tuberculosis is the most common cause of infectious disease related mortality worldwide. Paradoxical reactions to antituberculous treatment have created difficulties in the management of extrapulmonary tuberculosis, particularly central nervous system tuberculosis. We report a three years baby with tuberculous meningitis, who was treated outside with anti-tuberculous drugs without steroid one month back and presented in our emergency as status epilepticus. This case emphasizes the importance of addition of steroid along with anti-tubercular drugs in the treatment of central nervous system tuberculosis. J Nepal Paediatr Soc 2014;34(3):236-238 DOI: http://dx.doi.org/10.3126/jnps.v34i3.10752
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Kumar. Shrestha, Sailesh, Ratna Bhattarai, Lok Raj Joshi, Suvesh Kumar Shrestha, Rajendra Basnet, Anil Thapa, and Kedar Narsingh Kc. "1361. Knowledge, Attitude, and Practices on Drug-Resistant Tuberculosis Infection Control Among Healthcare Workers in Nepal: A Cross-Sectional Study." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S493. http://dx.doi.org/10.1093/ofid/ofz360.1225.
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Abstract Background Healthcare centers are important sites for tuberculosis transmission, particularly in low-income settings where the burden of tuberculosis is high and infection control practices are often inadequate. This study aims to assess the knowledge, attitude, and practices of drug-resistant tuberculosis infection control among the healthcare workers under the National Tuberculosis Control Program in Nepal. Methods In this descriptive cross-sectional survey, we studied the healthcare workers from all the functioning drug-resistant tuberculosis treatment centers across Nepal between March 1, 2018 and March 15, 2018. Nepal Health Research Council provided ethical clearance. Trained enumerators obtained informed consent and conducted face-to-face interviews with a pretested questionnaire to collect data on the basic characteristics of healthcare workers, their self-reported knowledge, attitude, and practice on tuberculosis infection control. We assigned a score of one to the correct response and zero to the incorrect or no response and calculated a composite score in each of the knowledge, attitude, and practice domains. We ascertained the healthcare workers as having good knowledge, appropriate attitude, and optimal practices when the composite score was at least 50%. We summarized the numerical variables with median and interquartile range (IQR) and the categorical variables with proportions. Results A total of 95 out of 102 healthcare workers from 11 drug-resistant tuberculosis treatment centers participated in the study. There were 46 male and 49 female respondents. The median age was 33 years (IQR 26–42). The majority of them (53, 56%) were mid-level paramedics. The median work experience in drug-resistant tuberculosis was 2 years (IQR 1–5). We found 91 (96%) respondents had a good knowledge of tuberculosis infection control with the median knowledge score of 14 (IQR 12–14), 49 (52%) respondents had an appropriate attitude with the median attitude score of 5 (IQR 4–6) and 35 (37%) respondents had optimal practices with the median practice score of 5 (IQR 4–7). Conclusion Healthcare workers at the drug-resistant tuberculosis treatment centers in Nepal had good knowledge of tuberculosis infection control but it did not translate into an appropriate attitude or optimal practices. Disclosures All authors: No reported disclosures.
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Thapa, Astha, Agnimshwor Dahal, Saroj Yadav, Keshav Raj Sigdel, Sudeep Adhikari, Sulav Khanal, Buddha Basnyat, and Roman Dhital. "Case Report: Acute isoniazid intoxication after intentional ingestion." Wellcome Open Research 7 (August 22, 2022): 219. http://dx.doi.org/10.12688/wellcomeopenres.18068.1.
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Isoniazid is an anti-tuberculosis medication that is extensively used for treatment and prevention of tuberculosis. Acute isoniazid poisoning is characterized by a clinical triad of recurrent seizures, raised anion gap metabolic acidosis and coma. The seizures are unresponsive to standard anticonvulsant drugs, instead requiring pyridoxine administered in a dose equal to the amount of isoniazid consumed. Due to the high incidence of tuberculosis in low-income countries like Nepal, isoniazid intoxication should be considered in any patient who present with such unresponsive seizures and coma. We report a case of a 31 years old woman from Nepal, who intentionally ingested 12 grams of isoniazid and presented with generalized tonic-clonic seizures. She was successfully managed with 10 grams of pyridoxine along with other supportive management, including sodium bicarbonate for metabolic acidosis and mechanical ventilation. Doctors working in low-income countries, like Nepal, where tuberculosis is endemic, should be well acquainted with presentations and management of isoniazid intoxication.
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Kumar, Gaurav, N. Jha, SR Niraula, DK Yadav, S. Bhattarai, and PK Pokharel. "Gender Based Barriers In Accessing Tuberculosis Treatment: A Qualitative Study From Eastern Nepal." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 10, no. 2 (January 28, 2014): 15–20. http://dx.doi.org/10.3126/saarctb.v10i2.9708.
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Introduction: Previous studies have demonstrated longer length of delays in diagnosis and treatment among men and women, especially among women experiencing longer duration of delay in accessing tuberculosis treatment. So, the study was conducted to explore responsible factors among men and women affecting longer duration in accessing tuberculosis treatment. Methodology: Qualitative approach with FGD sessions among people from community, DOTS providers and pulmonary tuberculosis patients were conducted separately in between March 2012 to May 2012. Results: The perception of fear, hiding symptoms, social stigmas and traditional beliefs were common among women. The study revealed that social and cultural barrier, ignorance of symptoms, home remedies, fear of stigma, access to health centre from rural areas, poor knowledge of TB signs and symptoms, beliefs on traditional healers were the common reason for the longer delays in diagnosis. Conclusions: The fi ndings suggested that knowledge, information, perception regarding TB among men and women were lacking, especially among females. This warrants awareness for early diagnosis and control of disease. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(2); 15-20 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9708
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Ghimire, H. B., H. S. Rimal, and P. Parajuli. "Treatment Outcome of Drug Resistance Tuberculosis From a Centre of Eastern Region, Nepal." Birat Journal of Health Sciences 1, no. 1 (March 31, 2017): 20–26. http://dx.doi.org/10.3126/bjhs.v1i1.17092.
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Introduction Drug resistance tuberculosis (DRTB) has become major problem worldwide with difficulty in treatment. Objective The study is conducted to find the incidence and outcomes of DRTB in one of the eastern tuberculosis treatment centre of Nepal.Methodology We collected all the cases of DRTB being treated from national anti-tuberculosis association of Biratnagar, Nepal. There were altogether 154 patients, who had sputum culture with resistance of at least one anti tubercular drug (ATD), included in this study.Results Of 154 total patients, 36 patients were resistant to rifampicin only, 84 patients were resistant to isoniazid and rifampicin, 18 patients were resistant to isoniazid, rifampicin and ethambutol and 16 patients were resistant to isoniazid, rifampicin and either streptomycin or fluoroquinolone. There was overall 71% cure rate in case of drug resistance tuberculosis. There was only statistical difference between cured and died patients in case of sputum conversion time with earlier sputum conversion in cured patients. Similarly, patients who were previously treated with category 2 ATD had only resistance to ethambutol or streptomycin or fluoroquinolone besides resistance to isoniazid and rifampicin compared to new patients and patients treated with category 1 regimen; as these groups were not found to be resistant to first three drugs.Conclusion There was overall 71% cure rate in case of drug resistance tuberculosis. Earlier sputum conversion was seen in cured patients compared to those who died during the treatment. Multiple drugs were resistant in patients previously treated with category 2 Anti-tubercular drugs.Birat Journal of Health Sciences 2016 1(1): 20-26
Dissertations / Theses on the topic "Tuberculosis Treatment Nepal"
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Baral, Sushil Chandra. "Understanding tuberculosis treatment completion in urban areas of Nepal." Thesis, University of Leeds, 2011. http://etheses.whiterose.ac.uk/2108/.
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Non-completion of tuberculosis (TB) treatment has been a major topic of debate ever since combined drug therapy started to be used. It has threatened global TB control and posed a challenge to many National TB Programmes (NTPs) especially in developing countries where the burden of TB is highest and the poor are worst hit. As a means of controlling TB, WHO advocated a strategy branded as DOTS, which includes direct observation of treatment (DOT). Many countries have implemented DOTS, so DOT has become a central component of NTPs’ TB control strategy. DOTS as a comprehensive package was shown to be successful in many countries: however, this success over-credited the direct observation component, which led to a focus on the concept of TB treatment completion. The Nepal NTP implemented DOTS in the late 1990s and has achieved high treatment success rates under DOTS, but has not been exempted from the debate. There have been many studies which have identified the need to minimise non-completion as vital to controlling TB: however, few have considered how non-completion could be tackled through establishing locally feasible patient-centred care within existing TB control procedures. The overall aim of my study was, therefore, to gain a better understanding of experiences and issues faced by People Living with TB (PLTB) during the course of TB treatment under DOTS and identify appropriate ways of addressing the issues identified in the context of the NTP in urban setting in Kathmandu, Nepal.. The study used a qualitative research approach to investigate why and how different factors hindered or facilitated successful completion of TB treatment in an urban TB control setting in Nepal. The study used semi-structured qualitative interviews (49), focus group discussions (6) and observation techniques to generate data and a content analysis approach to analyse the data. Study respondents were PLTB; family members of PLTB; health care providers, NTP officials and community members. My study shows that, as defined by the NTP, successful completion of TB treatment was not straightforward for PLTBs. PLTBs underwent TB treatment in very difficult circumstances, as various obstacles to successful TB treatment completion complicated the treatment process and thus made PLTBs and their families further vulnerable. Obstacles arising from causes related to the health system had a greater impact on PLTBs and their families than obstacles arising from causes related to the PLTBs.
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Hari, Bahadur Kunwar Boonyong Keiwkarnka. "Factors related patient compliance with "Directly Observed Treatment Short Course" in Pokhara urban Kaski, Nepal /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd376/4737958.pdf.
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Bhattacharya, Baishali. "Evaluation of Directly Observed Therapy in Pulmonary Tuberculosis Patients in Nepal: Treatment Outcome and Patient Compliance." TopSCHOLAR®, 2001. http://digitalcommons.wku.edu/theses/678.
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Tuberculosis is the leading cause of infectious disease in Nepal. An estimated 60% of the adult population aged between 15-45 years is infected with tuberculosis, and 45% of the total population is infected. Ten percent of people infected with TB progress to active disease. To combat tuberculosis, Directly Observed Therapy (DOT) was adopted in Nepal in 1996. DOT was administered at four national demonstration sites in 1996 and expanded over time so that 56% of the population to date have been covered by DOT. This study aimed to evaluate DOT in pulmonary TB patients in Nepal in terms of patient outcome and compliance. DOT was compared against a conventional treatment program or self-administered therapy (SAT), which served as the control group. The project was a retrospective nonconcurrant cohort study. Patients were sputum positive pulmonary TB patients aged over 15 years from Bhaktapur district in Nepal, who had undergone DOT or SAT between 1996 and 1998. Medical records of all the patients were sent to the National TB Center in Thimi, Nepal. A total of 261 patients (DOT, 161 patients and SAT, 100 patients) were included in the study. The two groups were similar in terms of age, ethnicity, and religion status. The cure rate was 86.3% for DOT, which was significantly higher than the 75.0% for the SAT group (p<0.05). The compliance rate was also higher for DOT at 90.2% versus 81.8% for the SAT group (p<0.05). The mean treatment length was 6.8 months for the SAT group and 7.4 months for the DOT group (p<0.05). Higher rates of treatment compliance and cure rate were achieved in the DOT group versus the SAT group. Thus, DOT is advocated as a means of ensuring greater TB program success.