Browsing by Author "Ali, Ibrahim(BSc, MSc)"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Drug Resistance Pattern of Mycobacterium Tuberculosis and its Association with Patients` Knowledge, Attitude and Practice towards Tuberculosis in Eastern Amhara Region
    (Addis Abeba University, 2011-03) Esmael, Ahmed; Desta, Kassue (BSc, MSc); Ali, Ibrahim(BSc, MSc); Agonafir, Mulualem(BSc. MSc)
    Background: Tuberculosis (TB) remains a serious public health problem, worsened by the emergence and spread of drug resistance particularly multi-drug resistance that threat global TB control. Data obtained from KAP survey is essential to plan, implement and evaluate Advocacy, Communication and Social Mobilization (ACSM)work. Objectives: The aim of this study was to assess the magnitude of drug resistance pattern of M.tuberculosis, knowledge, perception and practice of patients` towards TB in Eastern Amhara Region, North East Ethiopia. Methods: A cross sectional survey was conducted among new and re-treatment patients (age > 18 years old) from September 2010 to February 2011. A structure and pre-validate questionnaires was used to collect data. Primary isolation and DST were carried out on egg based LJ media using indirect proportion method. Chi-Square and multivariate logistic regression was used. Results: Out of 230 study participants for DST, 165 were new cases while 65 were previously treated cases. From these, 66.5% of isolates were sensitive and 4.4% resistance to four f irst line anti-tuberculosis drugs (HRSE) while the remaining 33.5% was resistance to at least for single drug. MDR-TB was detected in 6.5 % isolates, of which 4.4% were resistance to all four first line drugs. Overall resistance to S, R, H and E was found in 27 % (62), 10 % (23), 17.8 % (41), and 6.5 % (15) respectively. Mono resistance was found in 17.4 % (40) of all isolates Among new cases primary drug resistance for one or more drugs was observed in 23.6 % (39)cases. Primary MDR-TB was found in 3 (1.81%) cases. Similarly among previously treated cases resistance to any drug was found in 58.5 % (38) cases. MDR-TB in previously treated cases was found in 18.46 % (12) Cases; the highest being in failure cases 9.23% (6). More over the mean and median knowledge score of respondents about PTB was 6.81 and 7 respectively. Majority (53.6%) of study subjects had poor knowledge score, feels not well informed about TB and had several misconceptions that need to be clarified. Majority (66.6%)ofstudy subjects heard about TB for the first time from health workers. Of study participants, 79.9% mentioned that TB transmits by respiratory droplets through coughing and sneezing and prevents by covering mouth and nose (66.6%). The four common symptoms mentioned by respondents were cough (65.6%), weight loss (33.2%), cough > = 2 weeks (32.7%) and shortness of breath (29.4%). About half of respondent not knew current free cost of TB diagnosis and treatment. Majority of respondents also worried about the disease due to it might transmits to their family, might not be cure, social interact (fear of stigma) and unable to do work. Cost (69.9 %) and difficulties in transportation (54.5 %) mentioned as the main reason for their delaines t o seeking care. Previous drug exposure and 1 + bacterial load independently contribute for the development of drug resistance TB strains. Similarly Illiteracy, rural residence, non-previous history of contracting TB, experiencing self treatment option, and delayed frequency of visit were independent predictor of low knowledge score. Conclusion: Drug resistance TB particularly MDR-TB is an emerging problem in new and retreatment patients in our study area. Majority of respondents also had poor knowledge and several misconceptions that need to be clarified. Hence, it is essential to address the problems of drug resistance through establishing good TB control program including DOTS plus service and raise KAPs` of patients through establish proper IEC pathway to indicate the level of severity and to create proper awareness about its cause, transmission, prevention and availability of service.
  • No Thumbnail Available
    Item
    Evaluation of Same Day Diagnosis of TB Microscopy in Comparison to the Spotmorning-spot method and Knowledge, Attitude and Practice of Health Personnel towards the Use of the Same Day Diagnosis of TB in Selected Health Institution in Addis Ababa, Ethiopia.
    (Addis Abeba University, 2012-06) kebede, Sisay; Desta, Kassu(BSc,MSc); Ali, Ibrahim(BSc, MSc); Agonafir, Mulualem(BSc,MSc)
    Back ground: the need to collect serial sputum specimens over multiple patient visits results in a protected diagnostic process with rates of patients with high rates of patient dropout. Recent studies on SMS method of examination PTB reported that the first two specimens have high smear positivity in line with this WHO changed its policy to minimize the number of sputum specimens from three to two. Objective: The main objective of this study was to evaluate the same day diagnosis of TB microscopy in comparison to the spot-morning-spot methods and KAT of lab personnel, GP, HO and Nurse to wards the use of the same day diagnosis of TB in selected health institutions in Addis Ababa. Material and method: Across sectional study were conducted in 16 conveniently selected private clinics, governmental health centers, public hospitals and private hospitals, federal police and armed force hospital from September – December 2012.All patients who were avail themselves in the selected health institutions for the diagnosis of MTB and those health personal who were worked in each health facility. The diagnosis was performed using ZN sputum smear microscopy and light-emitting diodes fluorescent microscopy (LED-FM) technique. A structure and pre-validate questionnaires was used to collect data for KAP survey. Chi-square was used to assess the associations’ different variables of techniques and health personals KAP study. Result: A total of 209 participant enrolled, 43(21%) were identified culture positive,39 (18.7%) were detected by the same day approach and 40(19.1%) by the standard approach (p>0.05).on the other hand LED-FM and ZN microscopy were identified 39(18.1%) and 48(23%) respectively. Sensitivity was (88.4%) for ZN microscopy and (95.3%) for LED-FM, it was (99.4%) and (95.9%) for specificity. More over the mean and median knowledge, practice and attitude score of laboratory personal about the same day diagnosis was 4.07, 5.96, 7.67 and 5, 5, 8 respectively. Majority (61%),(73%) and (97%) of Laboratory personal had good knowledge, practice and positive attitude while the mean and median knowledge score was 4.7 and 4 respectively, but the mean and median attitude and practice was 6.65, 6.4 and 8.7 respectively .majority (57.7%),(63.4%) and (72.4%) of other health personal had poor knowledge, positive attitude and good practice respectively. using same day approach together with LED-FM would increase the smear detection rate, reduce work load, TAT, patient and health facility cost and transmission of TB. Hence, it is essential to address the advantages and dis advantages of the conventional approaches, LED-FM and same day diagnosis of TB to raise KAPs` of health personnel. Therefore it is necessary to give in-service and off service training for health personnel towards the use of LED-FM, conventional approach and the same day approach in the diagnosis of TB