Dataset Information

Is tuberculosis patients management improved in the integrated TB control model in West China? A survey in Guizhou Province, China.

ABSTRACT: BACKGROUND:Tuberculosis (TB) patient management (TPM) is crucial to improve patient compliance to treatment. The coverage of TPM delivered by TB dispensaries or Centers for Disease Control and Prevention (CDC) was not high under the previous CDC model of TB control in China. In the integrated TB control model in China, TB patient management (TPM) was mainly delivered by lay health workers (LHWs) in primary health care (PHC) sectors. This study aims to investigate TPM delivery in resource-limited western China and to identify factors affecting TPM delivery by LHWs under the integrated TB control model. METHODS:A stratified random sampling was used to select study sites. Pulmonary TB (PTB) patients ?15?years old from selected counties/districts in Guizhou Province were surveyed from August 2015 to May 2016. Structured questionnaires were used to collect data. A ?2 test and logistic regression were used to identify factors associated with self-administered treatment (non-TPM). RESULTS:In total, 638 PTB patients were included in the final analysis. Close to 30% of patients were ethnic minorities. More than 30% of patients were from counties with high TB burden, and 24.9% of patients had poor compliance to treatment. Only 37.1% of patients received TPM delivered by LHWs under the integrated TB control model throughout the treatment period. The main reasons for unwillingness to manage reported by patients included social stigma and no perceived need. Being ethnic minorities (OR?=?3.35) was a main factor associated with lower likelihood of receiving TPM, while living in areas with middle or high TB burden may increase the likelihood of receiving TPM (OR?=?0.17 and 0.25, respectively). Among current management approaches, more than 85% of patients chose phone reminder as their preferred TPM by LHWs. CONCLUSIONS:TPM under the integrated model in West China is still low and need further improvement, and the impeding factors of TPM need to be addressed. Strengthening patient-centered and community-based TPM and developing more feasible approaches of TPM delivery should be explored in future research in this region.

SUBMITTER: Pu J

PROVIDER: S-EPMC6604227 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Is tuberculosis patients management improved in the integrated TB control model in West China? A survey in Guizhou Province, China.

Pu Jie J Chen Wei W Jiang Wei-Xi WX Xing Wei W Liang Sheng-Xiang SX Wang Geng G Liu Shi-Li SL Wu Hao H Li Ying Y Tang Sheng-Lan SL

Infectious diseases of poverty 20190702 1

<h4>Background</h4>Tuberculosis (TB) patient management (TPM) is crucial to improve patient compliance to treatment. The coverage of TPM delivered by TB dispensaries or Centers for Disease Control and Prevention (CDC) was not high under the previous CDC model of TB control in China. In the integrated TB control model in China, TB patient management (TPM) was mainly delivered by lay health workers (LHWs) in primary health care (PHC) sectors. This study aims to investigate TPM delivery in resource ...[more]

PMID: 31262368

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Project description:Background:As antimicrobial resistance became an increasing threat to global public health, Clinical Pharmacist-led Consultation (CPC) for Infectious Diseases (ID) was developed in China. We conducted a survey among hospital pharmacies to investigate the present situation and potential determinants of CPC for ID in China's Guizhou Province. Methods:The study was conducted by sending the questionnaire to the directors of hospital pharmacy who were members of Guizhou Province Pharmaceutical Administration Collaboration Network (GPPACN) from April to May 2019. We implemented the Firth's logistic regression model to analyze the factors that influence the implementation of CPC. The acceptance rate of consultation suggestions (ARCS) and effective response rate after acceptance of pharmacists' suggestions (ERRAPS) were pooled by meta-analysis using a random effect model, respectively. A pairwise meta-analysis was performed to compare the effective response rate between patients whose treatment followed the pharmacists' suggestions and those whose treatment did not. Results:A total of 83 hospitals covering 9 regions in Guizhou Province were included in this survey. The results showed that 50 hospitals (60.24%) developed the CPC for ID. Staffing ID, respiratory, or general clinical pharmacist had a significantly positive effect on the implementation of CPC [adjusted odds ratios = 7.298, 95% CI (confidence interval): 2.232 to 23.858]. The pooled ARCS and ERRAPS for secondary hospitals were 97.59% (95% CI: 94.27 to 100.00%) and 88.36% (95% CI: 84.71 to 92.17%), respectively. Importantly, CPC improved the prognosis of ID patients [risk ratio (RR) = 6.49, 95% CI: 2.84 to 14.82] in these hospitals. Conclusion:CPC adoption is gradually increasing among hospitals and will be a promising intervention for ID treatment at grassroots medical institutions in Guizhou Province. Training more clinical pharmacists to specialize in ID, respiratory, or general diseases might be the most practical measure to promote the development of CPC for ID.

Project description:Stable and high-quality roosting-sites are crucial for the survival of migratory wading birds in winter. The black-necked crane (Grus nigricollis) is the only crane species that lives on the Tibetan plateau for its entire life. Every year, black-necked cranes routinely migrate to the wetlands on the southern lower plateau and roost at wetland sites. Currently, many roosting-sites are under threat from wetland degradation resulting from human disturbance, and changes in water depths and the landscape environment. To understand how the black-necked crane selects roosting-sites given these influencing factors, we conducted a study in the Caohai wetland in China by comparing and modeling the selection of roosting habitat. The vegetation factors mainly included the vegetation height of the swamp patch where the roosting-site was located (VHP) and the vegetation height in the roosting-site (VHR), and the geographic factors mainly included the height of the nearest hill (HNH) and the visible range (VR). These four factors were first considered by the black-necked cranes when choosing roosting-sites on the lakeshore. The roosting-site selection model of black-necked cranes was fitted as (P = e Logit(p) /(1 + e Logit(p)) Logit(p) = 1.243 + 8.397(VHP) -7.999(VHR) -4.105(HNH) + 1.584(VR)). In the Caohai wetland, black-necked cranes preferred roosting-sites away from human disturbances, such as villages/settlements and roads, and where the distance to main roads was > 1,300 m, the distance to villages/residential areas was > 650 m, the distance to rural/service roads was > 500 m, the relatively open area with surrounding hills had a relative height < 15 m, the visible range area was > 550,000 m2, and the shallow swamp area had a water depth of < 5 cm with a vegetation height of < 15 cm. Outside the area of the roosting-site, the surrounding vegetation height was 35 cm-60 cm. We believe that human disturbance, not energy savings or heat loss, was the main factor influencing crane roost site selection. We first gathered data about black-necked crane selection of roosting-sites in a highly complex wetland system. Based on our findings, we strongly recommend appropriately managing the habitat patches in the Caohai wetland, which will have implications for the conservation management of overwintering black-necked cranes in wetlands.

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Is tuberculosis patients management improved in the integrated TB control model in West China? A survey in Guizhou Province, China.

Publications

Is tuberculosis patients management improved in the integrated TB control model in West China? A survey in Guizhou Province, China.

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