Background:Tuberculosis (TB) remains a significant health issue, particularly among children in TB-endemic regions. Micronutrient deficiencies, such as zinc and selenium, may influence TB treatment outcomes. However, the relationship between these micronutrients and TB outcomes in children is not well-established in Indonesia. This study aimed to investigate the mean difference of zinc and selenium levels on TB treatment outcomes in children receiving treatment in Padang, Indonesia. Materials and Methods:A cross-sectional study was conducted at the district level hospitals in Padang City, Indonesia, from April to October 2024. The study included children aged 1-14 years diagnosed with TB and receiving treatment. Serum zinc and selenium levels were measured using Chemiluminescent Immunoassay (ECLIA). The treatment outcomes were categorized as success (cured and completed treatment) or failure (death, treatment failure, or default). Results:Zinc levels were significantly lower in the failure group (71.61±8.18 ng/mL) compared to the success group (79.72±8.12 ng/mL) (P<0.05). Similarly, selenium levels were lower in the failure group (89.56±23.47 ng/mL) compared to the success group (115.09±17.86 ng/mL) (P<0.05). Conclusion:The study found a significant association between lower zinc and selenium levels and unsuccessful TB treatment outcomes in children. These findings suggest that addressing micronutrient deficiencies may play an important role in improving TB treatment outcomes in pediatric populations. Further research is needed to explore potential interventions to improve micronutrient status in TB patients.
Background:COVID-19 has aggravated antimicrobial use owing to limited treatment options, raising concerns about antimicrobial resistance, which was previously estimated to potentially cause 10 million global deaths within 30 years. This study evaluated the potential impact of the COVID-19 pandemic on antibiotic resistance in referral hospitals. Material and Methods:A cross-sectional study at Kilimanjaro Christian Medical Centre analyzed clinical bacterial samples from pre-COVID-19 (2018) and during COVID-19 (2020, 2023). Two hundred isolates from 2018 and 2020, and 121 samples from 2023, were examined. Bacterial isolates were identified using API 20E for Enterobacteriaceae (bioMérieux) and standard biochemical tests, while antimicrobial susceptibility was assessed using the disc diffusion method. Results:During the COVID-19 pandemic, antibiotic resistance among bacteria has increased significantly. Resistance to ampicillin 113 (95.8%, p=0.018), ceftriaxone 102 (74.5%, p=0.043), and ciprofloxacin 119 (68.8%, p=0.003) increased. Conversely, resistance to chloramphenicol 19 (16.1%, p=0.021) and amoxicillin-clavulanic acid decreased to 62 (52.5 %, p = 0.007). Klebsiella pneumoniae showed decreased resistance to chloramphenicol 11(20.8%, p=0.004) and amoxicillin-clavulanic acid 27(50.9%, p=0.034). Acinetobacter species also showed a significant increase in ceftriaxone resistance 18(94.7%, p=0.018). Among the 233 isolates, ESBL-producing bacteria were identified in 101 (43.4%), and Klebsiella pneumoniae and Escherichia coli showed the highest frequencies at 40 (39.6%) and 54 (53.5%), respectively. Conclusion:During COVID-19, ampicillin, ciprofloxacin, and ceftriaxone resistance significantly increased, whereas restricted antibiotics, such as meropenem, showed lower resistance. The extensive and uncontrolled use of antibiotics during the pandemic has aggravated antimicrobial resistance, necessitating intensified and coordinated efforts to combat it.
Background:Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by persistent hyperglycemia, oxidative stress, and systemic inflammation. Diurnal intermittent fasting (DIF), a fasting pattern synchronized with circadian rhythms, has been proposed as a potential strategy to alleviate metabolic disturbances, but evidence from controlled animal studies remains limited. Materials and Methods:This experimental study employed a post-test-only control group design using thirty-six male Wistar rats. T2DM was induced by streptozotocin (65 mg/kg) and nicotinamide (230 mg/kg). Animals were randomized into four groups: diabetic control (G1), and three DIF-treated groups fasting two (G2), three (G3), and six (G4) days per week. Blood glucose was measured weekly. On day 28, serum levels of superoxide dismutase (SOD) and interleukin-6 (IL-6) were analyzed using enzyme-linked immunosorbent assay (ELISA). Results:DIF significantly reduced blood glucose levels in all intervention groups compared to the control (p < 0.05). The G4 group showed the highest SOD activity and the greatest IL-6 reduction (p < 0.05). However, there was no significant glucose difference between G3 and G4, suggesting a plateau in glycemic improvement. Conclusion:DIF improves glycemic control, enhances antioxidant defense through increased SOD activity, and reduces systemic inflammation via IL-6 suppression in a T2DM rat model. These findings support the potential of DIF as a complementary therapeutic approach for T2DM, although further research is needed to determine the optimal fasting regimen and its applicability in humans.
Background:The plant species identified as Uvaria chamae, a member of Annonaceae has exhibited notable anti-trypanosomal effect in in-vivo studies, demonstrating potential therapeutic benefits in animal models. However, a comprehensive toxicity profile is essential to assess the safety of U. chamae for potential therapeutic applications. This study investigated the toxicity of U. chamae leaves (n-hexane fraction) in order to identify any potential adverse effects and establish a safer dosage threshold for prolonged use. Methods:The n-hexane partitioned fraction obtained from U. chamae leaves was subjected to acute and sub-chronic toxicity evaluations. The short-term toxicity assessment followed established procedures. For the sub-chronic study, a total of 30 animals received the fraction continuously for 35 days. Biochemical analyses were performed on serum and liver homogenates to assess key parameters, including Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT), Triglycerides (TRIG) and Total cholesterol (TC). Also, histopathological examinations were performed on selected tissue samples. Results:The acute toxicity assessment showed an LD50 value exceeding 5000 mg/kg. For the repeated dose toxicity study, results showed statistically significant effect (p < 0.05) variations in AST and ALT levels within both liver and serum homogenates in relation to dosage. Additionally, histopathological analysis identified morphological alterations that distinct are from the control group and consistent with those typically observed in damaged tissues. Conclusion:At high doses, the n-hexane fraction of U. chamae showed no acute toxicity. However, prolonged use caused notable biochemical and morphological changes. A dose below 200 mg/kg is recommended for extended use.
Background:The variations in behavioral health issues by sex and age among adolescents in Indonesia have not been comprehensively explored. This study aimed to describe age and gender based differences in alcohol consumption, tobacco and substance use, reproductive health knowledge, and awareness of sexually transmitted disease (STD) prevention among high school students in Bukittinggi, Indonesia. Materials and Methods:This study employed a school-based cross-sectional design conducted in Bukittinggi Municipality, West Sumatra Province, Indonesia, with a sample size of 254 secondary school students. We used multi-stage stratified clustered sampling technique to select the students, and asked the students to complete self-administered questionnaires during class on a regular school day. Data analysis was performed using descriptive statistics, and the Chi-square test. Results:The study revealed that while the majority had never used alcohol, tobacco, electronic cigarettes, and substances, there were still some former drinkers and smokers, as well as current smokers and electronic cigarette users, especially among males aged 14-15 years. A small percentage also reported using analgesics and energy drinks. The participants generally received education about AIDS or HIV at school, but there were some misconceptions and stigmatizing attitudes toward HIV-positive individuals. Health education regarding birth control was not universal. Awareness of safe sex or STD prevention methods varied by age and gender, with varying levels of knowledge about abstinence and condom use. Conclusion:We found slight variations among male and female students. The study findings suggested the need for sex-specific targeted interventions to improve behavioral health issues.
Background:Traditional Practitioners (TPs) serve as primary healthcare providers in Rwanda, offering culturally relevant healing methods. Despite their importance, there's a lack of understanding regarding their infection prevention and control (IPC) practices. Materials and Methods:The study conducted in-depth interviews with Traditional Practitioners (TPs) in four Rwandan districts. Results:Four main themes emerged from 50 interviews in this study. 1) Many day-to-day traditional medicine procedures pose risks of infection to Traditional Practitioners. 2) TPs' concepts and understanding of infection are often basic and not evidence based. 3) TPs' beliefs and attitudes toward infection prevention and control may not prioritize patient-centered care. 4) TPs employ various IPC measures, including some scientifically questionable or incorrect practices. Discussion:Challenges such as lack of formal medical training and resources hinder effective IPC practices among Traditional Practitioners (TPs). Addressing the gaps in IPC practices among Traditional Practitioners (TPs) is crucial for promoting patient safety and public health in Rwanda. Improving IPC knowledge and practices, providing comprehensive training, and institutionalizing traditional medicine are recommended. Additionally, more research is needed to support the effectiveness and safety of traditional healing practices.
Background:Mortality in COVID-19 patients is often the result of multiple overlapping clinical complications rather than a single cause. Understanding these patterns is essential for improving clinical outcomes and supporting accurate forensic evaluation. Aim:This study aimed to identify the clinical conditions contributing to death in COVID-19 patients and to assess the association between the number of co-occurring conditions and patient outcomes. Methods:A retrospective observational study was conducted on 100 confirmed COVID-19 patients admitted to a national referral hospital in Indonesia. Data on demographic characteristics, comorbidities, clinical severity, and outcomes were collected from medical records. Clinical causes of death were recorded and categorized by the number of co-occurring conditions. Unadjusted and adjusted odds ratios (ORs) for mortality were calculated using logistic regression, adjusting for age, sex, BMI, comorbidities, and disease severity. Results:The most frequently documented clinical conditions contributing to death were acute respiratory distress syndrome (68%), respiratory failure (55%), and septic shock (34%). Among patients, 30% had one condition, 45% had two, and 25% had three or more. Compared to patients with a single condition, those with two conditions had an adjusted OR of 2.41 (95% CI: 1.16-4.41), and those with three or more conditions had an adjusted OR of 19.4 (95% CI: 10.73-32.23). Conclusion:Mortality in COVID-19 is significantly associated with the number of co-occurring clinical conditions. Early detection and integrated management of overlapping complications are essential for reducing fatal outcomes and improving diagnostic accuracy in clinical and forensic settings.
Background –:Contact tracing information as one of the measures of COVID-19 control had been met with some barriers and facilitators. This study was set to identify barriers and facilitators to providing COVID-19 contact tracing information among adult Nigerians. Materials and Methods –:The study was a prospective web-based cross-sectional descriptive design. Multi-stage sampling technique was used to select 1015 adult Nigerians within 18-70 years age band. Data were collected through Google forms and analyzed with the aids of Statistical Package for Social Sciences version 22. Results –:The majority (91.1%) of the respondents indicated that they will provide contact tracing information if they were confirmed or suspected to have COVID-19. The most identified facilitator to providing Covid-19 contact tracing information by the majority (90.7%) of the participants was to help stop the spread of COVID-19. More than average (58.9%) of participants did not trust the authorities; this was the most identified barrier to providing COVID-19 contact tracing information. The intent to provide contact tracing information was significantly associated with being a healthcare professional (p = .007) and place of residence (p = .044). Conclusion –:This study has identified facilitators and barriers to providing COVID-19 contact information. Despite the progress in management of COVID-19, the future is not predictive; therefore, providing contact tracing information will remain relevant in planning strategic and specific interventions for controlling infectious diseases. Government should make more effort to improve public trust on confidentiality of information and governance in general.
Background:Numerous microorganisms are linked to acute respiratory infections, with increasing focus on viruses as significant pathogens, particularly following the emergence of severe acute respiratory infections. we aimed to evaluate the prevalence of respiratory viruses in patients with acute respiratory infections in different regions of Morocco. Materials and Methods:Our study was conducted in accordance with the methodological criteria of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). We systematically reviewed studies having using databases of PubMed, Scopus, ScienceDirect, and Web of Science between 2000 and 2023. The protocol of the review was registered in the PROSPERO register (CRD42023372751). Twenty-three studies were included in the review. Results:The prevalence of pandemic influenza A(H1N1)2009 varied widely, ranging from 8% to 96%, with almost all studies reporting proportions exceeding 30%. Seasonal influenza had a prevalence ranging from 0.88% to 17%. Among children, four studies examined Respiratory Syncytial Virus prevalence, estimating rates between 18% and 36.47%. Additionally, four studies assessed Respiratory Syncytial Virus prevalence across all age groups, reporting rates from 12% to 53.8%. Three studies found Rhinovirus prevalence in children exceeding 50%, while six studies investigating populations of all ages reported rates from 5.8% to 38%. Conclusions:This review suggests that Pandemic and Seasonal Influenza, Respiratory Syncytial Virus and Rhinovirus have a considerable prevalence in the samples studied in the different cities of the Kingdom of Morocco.
Background:Staphylococcus aureus is a microorganism associated with nosocomial infections, characterized by its high pathogenicity and antibiotic resistance, posing a critical risk in hospital environments. This study aimed to determine its presence, antibiotic susceptibility, and the detection of virulence, adhesion, and regulatory genes on hospital surfaces using phenotypic and molecular methods. Materials and Methods:A total of 200 surface samples were collected from a secondary-level hospital, including clinical wards, ICU, and emergency areas. S. aureus was isolated using phenotypic techniques (mannitol, coagulase, DNase) and genotypic methods (detection of nucA and femB). Antimicrobial susceptibility was evaluated using the Kirby-Bauer method. Polymerase Chain Reaction (PCR) was employed to identify resistance and virulence genes. Results:S. aureus was detected in 7.5% of the samples analyzed, with higher prevalence in Clinic I and Emergency areas. The most contaminated surfaces included door handles, tables, and keyboards, identified as critical transmission points. Among the isolated strains, 66.6% were resistant to penicillin, while 100% were sensitive to methicillin and vancomycin. Virulence genes (tst, sea) were present in 26.6% and 13.3% of the strains, respectively. Regarding regulatory genes, agrI (73.3%) was the most common, followed by agrIII. For adhesion factors, icaD and icaC were the most frequently detected genes. Conclusion:These findings highlight the pathogenic potential of S. aureus and its ability to persist on inert surfaces, representing a significant risk for infection transmission.
Background:Saudi Arabia had high rates of bacterial meningitis in the late 90s. Children are at highest risk of this devastating disease with poor outcomes. Objective:The study aims to evaluate the prevalence, causative pathogens, and antibiotic resistance patterns in pediatric bacterial meningitis cases at a tertiary hospital in Riyadh, Saudi Arabia. Materials and Methods:Single-center retrospective chart review and cross-sectional methodology was conducted at King Saud University Medical City (KSUMC) from 2015 to 2023. Result:Reviewing 8 years of CSF culture results only yielded 37 cases. This is only 0.5% of total hospital admissions over 8 years. The majority of cases were for children under the age of 2 years (82%). Gender of cases was almost equal and there was no seasonal variation. The most common organisms were gram-positive (14, 38%) including Group B streptococcus (GBS) (4, 11%), Streptococcus pneumoniae (4, 11%). Gram-negative organisms caused 8 cases (22%) by 5 different organisms. There was no Haemophilus influenza type B or meningococcus found in any of the CSF cultures. The single sample of Staphylococcus aureus was methicillin-resistant Staphylococcus aureus (MRSA) and three gram-negative organisms were multidrug resistant. Conclusion:Saudi Arabia provides an example of the success of a mass vaccination program to curb the burden of pediatric bacterial meningitis. Future efforts should focus on antibiotic stewardship, mass screening of GBS, and adopting additional strains for the pneumococcus vaccine. Further research is needed to address the rising number of gram-negative organisms causing pediatric bacterial meningitis in Saudi Arabia and globally.
Background:Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by Insulin resistance, hyperglycemia, and systemic inflammation. Coffea canephora var. robusta contains bioactive compounds with potential antihyperglycemic and anti-inflammatory effects. This study aimed to evaluate the metabolic and inflammatory effects of its ethanolic extract in a rat model of T2DM. Materials and Methods:Forty-four male Wistar rats were randomized into 11 groups, including normal, diabetic controls, and treatment groups receiving ethanolic or ethyl acetate extracts (100-400 mg/kgBW). T2DM was induced using a high-fat diet and streptozotocin ± nicotinamide. Outcomes measured were fasting blood glucose (FBG), glucose-lowering percentage (%GL), fasting insulin resistance index (FIRI), quantitative insulin sensitivity check index (QUICKI), and TNF-α levels. Results:The 400 mg/kgBW ethanolic extract group showed a significant reduction in FBG (p = 0.017), percentage of glucose lowering (p = 0.000), TNF-α levels (p = 0.000), and body weight (p = 0.000) compared to diabetic controls, indicating improved metabolic regulation. Conclusion:The ethanolic extract of C. canephora improves glycemic control, enhances insulin sensitivity, and reduces inflammation in T2DM rats, supporting its potential for future clinical validation.
Background:The Efficiency of viral replication in cells depends on the capability of supporting virus replication by the cells. We characterized the effectiveness of Dengue Virus Serotype 1 (DENV-1) replication in various cell lines and various multiplicity of infection (MOI) starting from 2 FFU/cell up to 0,3125 FFU/cell. Materials and Method:We used HepG2 and Huh-7 human hepatocyte cell lines and in addition, we also used non-human kidney cells (Vero cells). DENV-1 strain IDS 11/2010 was isolated from DF patients and previously propagated in Huh7 and Vero cells as DENV-1-adapted Huh-7 and DENV-1-adapted Vero cells, respectively. Huh7 cells, Hep G2 cells, and Vero cells were infected with DENV-1 at various MOI and incubated for 48 hours at 370C with 5% CO2. DENV-infected cells were determined by indirect immuno-peroxidase staining using 3,3'-Diaminobenzidine (DAB). DENV-1 infected cells as foci were counted under inverted light microscopy and were used to determine the virus titer. Results:The virus was adapted to Huh-7 and Vero cells, with results showing that Vero cells exhibited the highest replication efficiency, evidenced by significant viral titers. Among human hepatocyte cell lines, DENV-1 demonstrated greater replication in Huh-7 cells than in HepG2 cells. Notably, no foci formation was observed in HepG2 cells after 48 hours of infection. Conclusion:These findings underscore the suitability of Vero and Huh-7 cells as optimal environments for DENV-1 replication, offering valuable insights for enhancing laboratory diagnostics and advancing antiviral strategies and vaccine development against DENV-1.
Background:The prevalence of anemia in children suffering from urinary tract infections with positive hematuria is very high. UTI is confirmed by a complete urine examination including macroscopic, chemical and microscopic examinations. Chemical examination can be carried out using the dipstick method, while urine microscopy involves looking at the image of the urine sediment. One of the parameters on the dipstick is blood. Examination with a reagent strip (dipstick) function to detect erythrocytes, free hemoglobin and myoglobin. So, the presence of erythrocytes, myoglobin or hemoglobin in the urine will give a positive result on the urine blood dipstick parameters, which means hematuria occurs. Materials and Methods:This is a cross-sectional analytical observational method, namely by comparing the results of blood urine examination using the dipstick method, with the results of the erythrocyte index and hemoglobin levels on the incidence of anemia in UTI patients. Results:The results of the blood urine dipstick examination obtained the highest positive value of 3. The average values for Hb, MCV, MCH, MCHC were respectively 10.9 g/dL, 83.3 fL, 28.5 pg, and 34.24%. Conclusion:The results of the Pearson correlation test obtained a degree of relationship of -0.363 which indicates a weak correlation. Blood urine is negatively related to the incidence of anemia (Hb levels), so that the higher the positive blood urine value, the lower the Hb value.
Background:Under-five pneumonia remains a critical health issue in Indonesia. Identifying risk factors using spatial models is crucial for developing effective disease-prevention strategies. This study aimed to identify risk factors and create a spatial model for under-five pneumonia distribution based on regional vulnerability. Materials and Methods:This study used a mixed-method approach that integrated mathematical models and GIS to identify risk factors using generalized Poisson regression (GPR) and developed a GIS-based spatial model with inverse distance weighted (IDW) and natural break methods. Results:The GPR model revealed significant associations between under-five pneumonia and population density (β = 0.004, Z-score = 6.118), rainfall (β = 0.002, Z-score = 6.031), malnutrition (β = 1.786, Z-score = 3.696), and health facilities (β = 0.073, Z-score = 13.527). Protective factors included exclusive breastfeeding (β = -0.004, Z-score = -2.874), healthy homes (β = -0.021, Z-score = -9.532), and under-five health service coverage (β = -0.003, Z-score = -2.225). Spatial modeling classified regions into high-risk (5 subdistricts), medium-risk (11 subdistricts), and low-risk (3 subdistricts). Conclusion:This study identified key risk factors and mapped spatial vulnerability for under-five pneumonia. Targeted, integrated interventions in high-risk areas are essential to reduce pneumonia incidence below 12 cases per 1,000 children under five by 2030, aligning with global health goals.
Background:Leptospirosis is a health concern with a high mortality rate. As of 2022, 9.8% of Indonesians are vulnerable to leptospirosis, and Kebumen Regency has been recognized as an endemic area since 2012. This study aims to identify the determinants and map the incidence of leptospirosis in Kebumen, Indonesia, in 2023. Material and Methods:This study used a 1:1 sample of 53 cases and 53 controls in a case-control study design. Each group was sampled using a purposive sampling technique. Cases were defined as individuals seeking care at a health center or hospital and identified as leptospirosis patients in 2023, while controls were individuals living nearest to the cases. Data analysis for this study involved the use of a logistic regression model. Results:Individuals with a history of wounds have 40.20 times higher odds of experiencing leptospirosis. Men have 2.58 times higher odds of experiencing leptospirosis, while poor use of personal protective equipment (PPE) increases the odds by 2.27. Leptospirosis risk is elevated in areas where rats and standing water are prevalent, as these factors are typically found nearby. Furthermore, pets at risk are commonly found in high-risk areas. Conclusion:History of wounds, sex, and use of PPE are factors that can predict the incidence of leptospirosis. Environmental determinant mapping is observed in high-density, geographically proximate locations.
Background:Dengue cases in Indonesia remain a significant public health concern, with incidence rates increasing over the years. The school environment, including lighting, humidity, temperature, and ventilation, plays a crucial role in the spread of Dengue Hemorrhagic Fever (DHF). This study aims to analyze the relationship between school environmental conditions and DHF incidence. Materials and Methods:This was an analytical observational study with a cross-sectional design. The sample consisted of 157 individuals selected using simple random sampling. Data collection was conducted from August to October 2023 using a validated questionnaire assessing school environmental conditions and DHF incidence. Statistical analysis was performed using chi-square and logistic regression tests with a significance level of p < 0.05. Results:School environmental factors significantly associated with DHF incidence included lighting (p = 0.008, PR = 1.82), humidity (p = 0.008, PR = 1.75), temperature (p = 0.045, PR = 1.498), and screen ventilation (p = 0.000, PR = 2.26). Logistic regression analysis identified humidity (OR = 7.16; 95% CI, 2.09-38.37) and ventilation (OR = 18.12; 95% CI, 3.36-56.70) as the most influential factors. Conclusion:The incidence of DHF is closely related to school environmental conditions. Preventive measures focusing on environmental cleanliness and improved ventilation could significantly reduce the risk of dengue transmission among school children.
Background:Tuberculosis is one of the tropical diseases which still exist in the tropical country specifically Indonesia. This study aims to investigate the recent epidemiology of tuberculosis before and during the pandemic of COVID-19. Materials and Methods:Data were collected from East Java Health Profile 2019 and 2020 which was provided by East Java Health Officer. Data were extracted and analyzed by statistical software SPSS and QGIS Application for the geographical map interpretation. Results:This study shows that the total cases of tuberculosis in 2019 was 606,985 cases, while in 2020 was decreased to 384,752 cases. The incidence rate of tuberculosis in 2019 was 224.98 per 100,000 populations, while in 2020 was 134.58 per 100,000 populations. The province with the highest amount of tuberculosis in 2019 was West Java with 143,935 cases, and also in 2020 with 90,905 cases. The province with the lowest number of tuberculosis was North Kalimantan with 2,113 cases, while in 2020 were 985 cases. The highest incidence rate of tuberculosis in 2019 was found in Jakarta which was 443,47 per 100,000 population, while in 2020 was found in Papua which was 279.92 per 100,000 population. The lowest incidence rate in 2019 was found in Bali Province which was 102.72 per 100,000 population, while in 2020 was 67.43 per 100,000 population. Conclusion:There was a decrease in TB cases before the COVID-19 pandemic (2019) compared to during the COVID-19 pandemic (2020).
Background:Tuberculosis (TB) remains a significant public health issue globally, with patient adherence to treatment being critical for successful outcomes.This study aimed to investigate the roles of family support and motivation in influencing adherence to TB treatment in Indonesia. Materials and Methods:A cross-sectional study was conducted among patients at four health centers in Padang Municipality, Indonesia, between January and November 2024. A total of 125 respondents diagnosed with drug-sensitive TB and in the second stage of treatment participated. Data were collected through structured interviews using validated questionnaires, assessing family support, motivation, and treatment adherence. Structural Equation Modeling (SEM) was used to analyze the relationships between variables. Results:The findings revealed significant relationships between family support and motivation (β = 0.931, t-value = 47.016, P<0.001), family support and adherence to TB treatment (β = 0.229, t-value = 2.743, P=0.006), and motivation and adherence to TB treatment (β = 0.775, t-value = 9.334, P<0.001). Conclusion:Family support and motivation play crucial roles in enhancing patient adherence to TB treatment. Strategies to strengthen family involvement and patient motivation should be integrated into TB control programs to improve treatment outcomes. Further research is recommended to explore additional factors influencing adherence in different contexts.
Background:Other microbial infections in pulmonary tuberculosis (TB) patients pose significant challenges, complicating treatment outcomes and potentially increasing mortality rates. This study aims to characterize the bacterial and fungal infections profiles in pulmonary TB patients. Materials and Methods:A retrospective cross-sectional analysis was conducted at Adam Malik Hospital in Medan, Indonesia, from June 2020 to May 2022, involving inpatients diagnosed with drug-sensitive or drug-resistant TB. The data was analyzed from total sampling subjects based on medical records. Results:From 125 pulmonary TB patients, 64% had drug-sensitive TB (DS-TB) and 36% had drug-resistant TB (DR-TB), with the majority being male and underweight. Microbial analysis showed 33.6% (n=42) of the subjects exhibited bacterial growth, 8.8% (n=11) had fungal growth and 30.4% (n=38) had mixed infection. Of 80 DS-TB patients, 80% had bacterial and fungal infections compared to 60% of 45 DR-TB patients, with Klebsiella pneumoniae and Candida albicans as the most common microbes. %<Microbial growth patterns were significantly different between DS-TB and DR-TB patients, with 38.8% (n=31) of DS-TB patients displaying mixed bacterial and fungal growth, in contrast to only 15.6% (n=7) of DR-TB patients. There were no significant differences in antibiotic resistance; however, antifungal sensitivity testing revealed a significant difference in response between DS-TB and DR-TB patients, particularly to Flucytosine, Fluconazole, and Micafungin. Conclusions:There is a considerable presence of bacterial and fungal infections, with Klebsiella pneumoniae and Candida albicans being the most prevalent. The antifungal sensitivity testing suggesting a need for personalized antifungal treatment strategies between DS-TB and DR-TB patients.
