Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
- Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Cannon, Lesley-Ann https://orcid.org/0000-0002-7635-277X
- Date: 2022-02
- Subjects: Multidrug resistance , Tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26706 , vital:65958
- Description: Background Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. Methodology The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. Results There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. Conclusion MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
Exploring socio-economic factors influencing incidences and outcome of multidrug resistance tuberculosis among patients and facility staffs in Makana Sub-District, Eastern Cape
- Authors: Cannon, Lesley-Ann Lynnath
- Date: 2022-02
- Subjects: Multidrug resistance , Multidrug-resistant -- tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23471 , vital:57896
- Description: Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR-TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR-TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Authors: Cannon, Lesley-Ann Lynnath
- Date: 2022-02
- Subjects: Multidrug resistance , Multidrug-resistant -- tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23471 , vital:57896
- Description: Drug-resistant Tuberculosis (DR-TB) is one of the main causes of global public health crisis, due to the morbidity and mortality rates associated with the disease. This DR-TB is a complex illness having direct and indirect impact on finances, social functioning, and quality of life of infected individuals. Major research advances have been made in the diagnosis and treatment of DR-TB. However, minimal information exists on the socio-economic factors influencing the incidence and outcomes. This study aims to fill the gap by exploring the socio-economic factors from both the health care professional and patient perspective in particular settings to gain insights into developing context-specific strategies against the burden of DR-TB. The study applied a qualitative method to explore the socio-economic factors influencing MDR-TB through key-in-depth interviews (KIIs) and focus group discussions (FGDs). The study enrolled a total of thirty-two (32) consenting participants. The KIIs was conducted for ten (10) healthcare workers and nine (9) MDR-TB patients. Two focus group discussions were done involving seven (7) MDR-TB patients and six (6) MDR-TB patients, respectively. The study targeted healthcare workers working in the MDR-TB field and TB patients with the following: GeneXpert Rifampicin resistance and patient confirmed as MDR TB. Eligible participants were selected using a purposive sampling technique from the hospitals` routine data electronic records (EDR-WEB database) and hardcopy registers (drug-resistant TB register) on MDR-TB patients enrolled in care at the study site. Informed consent was obtained from all study participants after thoroughly explaining the purpose. No personal information of participants was used. All responses from respondents were coded during analysis for autonomy and the respondents were not identifiable in any published or unpublished work following this research. The interviews were transcribed, some translated into English, where necessary, and analysed until saturation was reached. Data was coded and analysed using both thematic and content analysis technique. There were 3 main themes identified in the study: social factors, economic factors, and other contributing factors. 7 sub- themes were recorded under social factors and 2 subthemes under economic factors. Two independent factors that were also considered to impact MDR-TB were the attitude of healthcare workers, as well as the current COVID-19 pandemic. MDR-TB is a major public health concern in the Makana Sub-district of the Eastern Cape. The findings of this study highlight the impact of socio- economic factors on the incidence, spread, defaulter rate and outcomes of MDR-TB. The social areas highlighted by the study participants as affecting the incidence and outcomes of MDR TB were housing and relocation, decreased immunity, stigma, patients’ attitude and lack of support, alcohol and other substance usage and prison/ incarceration. The economic factors identified by the participants were unemployment and job loss and health related expenses. Other factors are those factors contributing to the increased incidence and possible poor outcomes of MDR TB. Healthcare workers impact and attitude and the effects of the covid-19 pandemic were highlighted as additional factors influencing the incidence and outcomes of MDR TB. The management of MDR-TB requires rigorous efforts that should be directed at addressing the socio-economic factors. Therefore, future quantitative studies and important programmatic strategies should be considered to tackle the socio-economic challenges that contribute to the burden of MDR-TB infection in the Makana community. , Thesis (MPA) -- Faculty of Health Sciences, 2022
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Molecular characterization and antimicrobial resistance profiling of Salmonella species isolated from final effluent discharged from the Fort Hare Dairy Farm in Raymond Mhlaba Local Municipality
- Thinyane, Pindile https://orcid.org/0000-0001-8236-9407
- Authors: Thinyane, Pindile https://orcid.org/0000-0001-8236-9407
- Date: 2021-10
- Subjects: Salmonella typhimurium , Anti-infective agents , Multidrug resistance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22666 , vital:52618
- Description: The exposure of livestock to antimicrobials for treatment, prophylaxis, or development advancement can select for antimicrobial resistant organisms that can be transmitted to humans. Salmonella as a significant zoonotic microorganism can go about as a likely supply of antimicrobial resistant determinants. Salmonella is a zoonotic pathogen that causes food and waterborne infections. It affects wild and domestic animals, and humans, by causing a number of infections including Salmonellosis. Salmonella species infect humans through the consumption of contaminated meat, like beef, chicken, pork etc. This study aimed to determine the molecular characterization and antimicrobial resistance profile of Salmonella species isolated from effluent discharged from the Fort Hare Dairy Farm in Raymond Mhlaba Local Municipality. Polymerase chain reaction (PCR) was used for the molecular confirmation of the presumptive Salmonella isolates targeting both ompC gene and typh gene. Standard disc diffusion method was used for the antimicrobial susceptibility testing (AST) as recommended by the Clinical and Laboratory Standards Institute. The confirmed Salmonella isolates were tested against 12 test antimicrobial agents and were screened for antimicrobial resistance genes (ARGs) including blaTEM and amp for beta-lactams, and tetC for tetracycline. The research showed that the effluent discharge from this farm is contaminated with Salmonella. Presumptive Salmonella densities were ranging between 1,7 ×102 to 6,1×102 CFU/100ml, out of 83 presumptive isolates recovered, 61 were molecularly confirmed Salmonella typhimurium. The most prevalent Salmonella species found in this study was Salmonella typhimurium, which was more abundant in the final effluent discharges than in the water samples. This may be due to the contamination from farm animal faeces. The susceptibility against 12 different antibiotics by the recovered Salmonella typhimurium were examined, and Salmonella typhimurium isolates was notably resistant to azithromycin, ampicillin, amoxiclav, but less resistance were seen on doripenem , meropenem and ciprofloxacin but none of the isolates were resistant to norfloxacin. Antibiotic results obtained from this research suggest that Quinolones (Norfloxicin, Ciprofloxacin and Nalidixic acid), and Carbapenems (Meropenem and Doripenem.) were the most effective antibiotics against Salmonella. Forty-eight percent of isolates were found to be resistant to more than 3 antibiotics from different families thus considering them to be multidrug resistant. Resistant determinants ampC, blaTEM and tetC were detected on resistant isolates. Misuse and overuse of antibiotics on animal producing farms put human lives at risk as it promotes the emergency of multidrug resistant bacteria. Findings of this study revealed that animal producing farm pose a threat to the community as they harbour and promote the emergence of multidrug resistant Salmonella typhimurium. , Thesis (MSc) -- Faculty of Science and Agriculture, 2021
- Full Text:
- Authors: Thinyane, Pindile https://orcid.org/0000-0001-8236-9407
- Date: 2021-10
- Subjects: Salmonella typhimurium , Anti-infective agents , Multidrug resistance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22666 , vital:52618
- Description: The exposure of livestock to antimicrobials for treatment, prophylaxis, or development advancement can select for antimicrobial resistant organisms that can be transmitted to humans. Salmonella as a significant zoonotic microorganism can go about as a likely supply of antimicrobial resistant determinants. Salmonella is a zoonotic pathogen that causes food and waterborne infections. It affects wild and domestic animals, and humans, by causing a number of infections including Salmonellosis. Salmonella species infect humans through the consumption of contaminated meat, like beef, chicken, pork etc. This study aimed to determine the molecular characterization and antimicrobial resistance profile of Salmonella species isolated from effluent discharged from the Fort Hare Dairy Farm in Raymond Mhlaba Local Municipality. Polymerase chain reaction (PCR) was used for the molecular confirmation of the presumptive Salmonella isolates targeting both ompC gene and typh gene. Standard disc diffusion method was used for the antimicrobial susceptibility testing (AST) as recommended by the Clinical and Laboratory Standards Institute. The confirmed Salmonella isolates were tested against 12 test antimicrobial agents and were screened for antimicrobial resistance genes (ARGs) including blaTEM and amp for beta-lactams, and tetC for tetracycline. The research showed that the effluent discharge from this farm is contaminated with Salmonella. Presumptive Salmonella densities were ranging between 1,7 ×102 to 6,1×102 CFU/100ml, out of 83 presumptive isolates recovered, 61 were molecularly confirmed Salmonella typhimurium. The most prevalent Salmonella species found in this study was Salmonella typhimurium, which was more abundant in the final effluent discharges than in the water samples. This may be due to the contamination from farm animal faeces. The susceptibility against 12 different antibiotics by the recovered Salmonella typhimurium were examined, and Salmonella typhimurium isolates was notably resistant to azithromycin, ampicillin, amoxiclav, but less resistance were seen on doripenem , meropenem and ciprofloxacin but none of the isolates were resistant to norfloxacin. Antibiotic results obtained from this research suggest that Quinolones (Norfloxicin, Ciprofloxacin and Nalidixic acid), and Carbapenems (Meropenem and Doripenem.) were the most effective antibiotics against Salmonella. Forty-eight percent of isolates were found to be resistant to more than 3 antibiotics from different families thus considering them to be multidrug resistant. Resistant determinants ampC, blaTEM and tetC were detected on resistant isolates. Misuse and overuse of antibiotics on animal producing farms put human lives at risk as it promotes the emergency of multidrug resistant bacteria. Findings of this study revealed that animal producing farm pose a threat to the community as they harbour and promote the emergence of multidrug resistant Salmonella typhimurium. , Thesis (MSc) -- Faculty of Science and Agriculture, 2021
- Full Text:
Modelling the impact of risk factors affecting TB treatment
- Authors: Tsuro, Urgent
- Date: 2013
- Subjects: Diseases -- Risk factors , Tuberculosis -- Epidemiology , Multidrug resistance
- Language: English
- Type: Thesis , Masters , MSc (Biostatistics and Epidemiology)
- Identifier: vital:11787 , http://hdl.handle.net/10353/d1019782 , Diseases -- Risk factors , Tuberculosis -- Epidemiology , Multidrug resistance
- Description: The Tuberculosis infection rate has been generally escalating due to poor health conditions in the Gweru district of Zimbabwe. The study therefore seeks to identify the risk factors that affect TB treatment in the Gweru district. A cross sectional study was carried out in which a questionnaire was employed for data collection on 113 respondents. A binary logistic regression model was employed for data analysis. A total of 98 TB patients were interviewed: [50 respondents (44.0%) had Multi-drug resistant Tuberculosis and 63 respondents (56.0%) had general Tuberculosis). Before being enrolled into the study, an informed consent form was given to each of the participants. The data was then put into excel and later transferred to SPSS for analysis. Out of the 14 potential risk factors of TB treatment, only 6 variables (side effects, gender, alcohol use, HIV status, smoking during the treatment period and having been pre-exposed to TB drugs) were statistically significant in their association with treatment failure.
- Full Text:
- Authors: Tsuro, Urgent
- Date: 2013
- Subjects: Diseases -- Risk factors , Tuberculosis -- Epidemiology , Multidrug resistance
- Language: English
- Type: Thesis , Masters , MSc (Biostatistics and Epidemiology)
- Identifier: vital:11787 , http://hdl.handle.net/10353/d1019782 , Diseases -- Risk factors , Tuberculosis -- Epidemiology , Multidrug resistance
- Description: The Tuberculosis infection rate has been generally escalating due to poor health conditions in the Gweru district of Zimbabwe. The study therefore seeks to identify the risk factors that affect TB treatment in the Gweru district. A cross sectional study was carried out in which a questionnaire was employed for data collection on 113 respondents. A binary logistic regression model was employed for data analysis. A total of 98 TB patients were interviewed: [50 respondents (44.0%) had Multi-drug resistant Tuberculosis and 63 respondents (56.0%) had general Tuberculosis). Before being enrolled into the study, an informed consent form was given to each of the participants. The data was then put into excel and later transferred to SPSS for analysis. Out of the 14 potential risk factors of TB treatment, only 6 variables (side effects, gender, alcohol use, HIV status, smoking during the treatment period and having been pre-exposed to TB drugs) were statistically significant in their association with treatment failure.
- Full Text:
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