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- Hurtig, Anna-Karin, et al.
(författare)
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Anti-tuberculosis treatment in private pharmacies, Kathmandu Valley, Nepal.
- 2000
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Ingår i: The International Journal of Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 4:8, s. 730-6
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Tidskriftsartikel (refereegranskat)abstract
- SETTING: Urban municipality of 150000 citizens in Kathmandu Valley, Nepal. OBJECTIVE: To determine 1) the perceptions among private pharmacists of characteristics of tuberculosis (TB) patients visiting private pharmacies in the area, 2) the sales of different anti-tuberculosis drugs, and 3) the interaction between private health providers and pharmacists. DESIGN: Between January and April 1998, semi-structured interviews were conducted with 98% (49/50) of the private drug-retailers in the area. RESULTS: Thirty-two (65%) pharmacies had sold anti-TB drugs during the last month. Forty-three (88%) said that most TB patients were of low socio-economic status and rarely bought drugs for more than a week at a time. Only eight (16%) reported that TB patients usually returned to buy the full course of drugs. Seventy-two per cent of total spending on anti-tuberculosis drugs was for different kinds of combinations of drugs. Nine per cent was spent on plain rifampicin, believed to be sold only to tuberculosis/leprosy patients. During the previous month, 5/13 (38%) of pharmacies with no doctors attached had sold anti-tuberculosis drugs compared with 27/38 (71%) of pharmacies with doctors attached to them (P < 0.05). CONCLUSION: The private sector offers an available and acceptable but non-affordable service for many TB patients. A substantial amount of anti-TB drugs are being sold in the private pharmacies. There is therefore a potential role for pharmacists to play in collaborative efforts between the private and public sector in TB control activities.
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| 2. |
- Lindström, Mai, et al.
(författare)
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Underdiagnosis of chronic obstructive pulmonary disease in Northern Sweden
- 2002
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Ingår i: The International Journal of Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 6:1, s. 76-84
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess underdiagnosis of chronic obstructive pulmonary disease. MATERIAL AND METHODS: Two cross-sectional studies of respiratory symptoms and diseases in two population samples of the same age living in the same areas in northern Sweden were performed 6 years apart. In 1986, 5698 (86%) out of 6610 subjects aged 35-36, 50-51 and 65-66 years responded to a postal questionnaire. In 1992 an identical study was performed, and 5617 subjects (87%) out of 6434 responded. Lung function measurements were performed in stratified samples. RESULTS: Of the subjects diagnosed with chronic bronchitis only 25% in 1986 and 23% in 1992 had been diagnosed prior to the study as having chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD). Chronic airflow limitation (CAL), used as a surrogate variable for COPD and defined as FEV1/VC <70% and FEV1 <80% of predicted value, was found in 171 subjects in 1986-1987 (12% of the examined subjects), and 166 subjects in 1993-1994 (11%). In 1986-1987, 26% of the subjects with CAL had been diagnosed as having chronic bronchitis or emphysema prior to the survey, while a diagnosis of either asthma, chronic bronchitis or emphysema, or use of asthma medicines, was found in 58%. The corresponding figures in 1993-1994 were 31% and 63%, respectively. The great majority of the subjects with CAL had recurrent wheeze, dyspnoea and chronic productive cough. CONCLUSION: Approximately 60% of the subjects with chronic airflow limitation had been diagnosed prior to the survey as having asthma, chronic bronchitis or emphysema, or were using asthma medicines. The results were similar in 1986-1987 and 1993-1994.
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| 3. |
- Pallasaho, Paula, et al.
(författare)
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Low socio-economic status is a risk factor for respiratory symptoms : a comparison between Finland, Sweden and Estonia
- 2004
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Ingår i: The International Journal of Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 8:11, s. 1292-300
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the relation of socio-economic status to respiratory symptoms common in asthma and chronic bronchitis, and to compare risk factors for these symptoms between three neighbouring countries. DESIGN: A postal survey was performed in 1996 as a part of comparative studies in Finland, Sweden and Estonia (the FinEsS studies). A random sample of 58,661 subjects aged 20-64 years were invited, of whom 44,483 participated. RESULTS: Respiratory symptoms were most prevalent among manual workers, who were at significantly increased risk for chronic respiratory symptoms. The same pattern of increased risk appeared when the analyses were made among non-smokers only: for recurrent wheeze, manual workers in industry yielded an OR of 1.91 (95%CI 1.62-2.24) and in the service sector an OR of 1.50 (95%CI 1.27-1.78). The corresponding figures for chronic productive cough were 1.45 (95%CI 1.22-1.71) and 1.20 (95%CI 1.02-1.42), respectively. Risk factor profiles for respiratory symptoms were similar in Finland, Sweden and Estonia, except for gender differences in Estonia.CONCLUSIONS: Belonging to the socio-economic group of manual workers correlated with an increased risk for chronic respiratory symptoms, independently of smoking habits, in each country. Women manual workers in industry suffered most from respiratory symptoms
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| 5. |
- Schön, Thomas, 1973-, et al.
(författare)
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Local production of nitric oxide in patients with tuberculosis
- 2004
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Ingår i: The International Journal of Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 8:9, s. 1134-1137
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Tidskriftsartikel (refereegranskat)abstract
- Nitric oxide (NO), produced by the inducible nitric oxide synthase (iNOS), is important in host defence against Mycobacterium tuberculosis in rodents, but the presence of high-output NO production in human tuberculosis has been controversial. We investigated iNOS and nitrotyrosine (Ntyr) expression in pleural (n = 7), pulmonary (n = 5) and lymph node biopsies (n = 5) from untreated, newly diagnosed tuberculosis patients. Many iNOS and Ntyr reactive macrophages were observed in granulomas, including Langhans giant cells, indicating high-output NO production at the primary site of disease in tuberculosis.
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| 9. |
- Eugen-Olsen, J, et al.
(författare)
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The serum level of soluble urokinase receptor is elevated in tuberculosis patients and predicts mortality during treatment: a community study from Guinea-Bissau
- 2002
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Ingår i: The International Journal of Tuberculosis and Lung Disease. - 1815-7920. ; 6:8, s. 686-692
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether the serum level of soluble urokinase plasminogen activator receptor (suPAR) carries prognostic information in individuals infected with Mycobacterium tuberculosis. DESIGN: suPAR was measured by ELISA in 262 individuals at the time of enrolment into a cohort based on suspicion of active tuberculosis and in 101 individuals after 8 months of follow-up. RESULTS: The suPAR levels were elevated in patients with active TB compared to TB-negative individuals (P < 0.001). suPAR levels were highest in patients positive for TB on direct microscopy (n = 84, median suPAR 3.17 ng/ml, P < 0.001), followed by patients negative on direct microscopy but culture positive (n = 35, median suPAR 2.41 ng/ml, P = 0.005) and by patients diagnosed on clinical grounds (n = 63, median suPAR 2.13 ng/ml, P = 0.06) compared to 64 TB-negative individuals (median suPAR 1.73 ng/ml). During the 8-month treatment period, 23 TB cases died. In a multivariate Cox model controlling for HIV status, age, sex, CD4 count and type of TB diagnosis, the mortality increase per ng suPAR was 1.25 (95%CI 1.12-1.40). After treatment, suPAR levels had decreased to the levels of TB-negative individuals. CONCLUSIONS: suPAR levels are elevated in TB patients and associated with mortality. Furthermore, suPAR may be a potential marker of treatment efficacy.
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