Epidemiological Factors and Preventable Tuberculosis Transmission in a Hospital Setting in Malaysia
American Journal of Pulmonary and Respiratory Medicine
Volume 2, Issue 2, June 2017, Pages: 28-32
Received: Mar. 5, 2017;
Accepted: Apr. 5, 2017;
Published: May 3, 2017
Views 1664 Downloads 110
Thana Sehgaran Shanmugam, Environmental Health Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
Nyanamalar Sivapalan, Perdana University-Royal College of Surgeons in Ireland, Perdana University, Serdang, Malaysia
Nirmalatiban Parthiban, Perdana University-Royal College of Surgeons in Ireland, Perdana University, Serdang, Malaysia
Tha Shanmuga Sundari Thana Sehgaran, Faculty of Medicine, Melaka Manipal Medical University, Melaka, Malaysia
Puvanewari Subramanian, Krian District Health Department, Perak Health Department, Perak, Malaysia
Tuberculosis (TB) is a public health challenge in Malaysia. Delay in diagnosing and treating TB patients are associated with TB transmission. These treatment delays can be reduced by identifying and managing the contributing epidemiological factors. This study measured the magnitude of the delays in TB treatment in terms of patient delay, medical visit delay and treatment initiation delay. In addition, it aims to identify epidemiological factors contributing to these delays, the disease severity and positive sputum smear outcome. This is a cross sectional study of TB patients in a district hospital and the outcomes were computed in terms of percentage, survival curve, odds ratio and confidence interval. The patient delay, medical visit delay and initiation of treatment delay are 73%, 53% and 14% respectively. Patient delay is reduced to 50% after 28 days and is eliminated after 1120 days. Malay patients and patients without family history of TB have higher risk of experiencing all three delays. Non-Malays, males, patients with family history of TB and patients with TB contact have been related to higher risk of severe form of TB and positive smear. TB transmission can be reduced by managing the epidemiological factors identified in TB control measures.
Thana Sehgaran Shanmugam,
Tha Shanmuga Sundari Thana Sehgaran,
Epidemiological Factors and Preventable Tuberculosis Transmission in a Hospital Setting in Malaysia, American Journal of Pulmonary and Respiratory Medicine.
Vol. 2, No. 2,
2017, pp. 28-32.
World Health Organization. Global tuberculosis report2014.
Ministry of Health, Planning Division, Health Informatics Centre. Health Facts 2014.
World Health Organization. 10facts about tuberculosis,2012 Http://www.who.int/features/factfiles/tuberculosis/en/index.html Accessed November 2012.
TBSymposium http://www.jknselangor.moh.gov.my/documents/pdf/sharingDoc/Health Conference/SYMPOSIUM/TB_Transforming.pdf.
Ministry of Health. Annual report 2012.
Liam CK, Tang BG. Delay in the diagnosis and treatment of pulmonary tuberculosis in patients attending a university teaching hospital. Int J Tubercl Lung Dis.1997; 1(4):326-32.
Rundi C, Fielding K, Godfrey-FP, Rodrigues LC, Mangtani P. Delays in seeking treatment for symptomatic tuberculosisin Sabah, East Malaysia: factors for patient delay. Int J Tubercl Lung Dis. 2011; 15(9):1231–1238.
Saldana AL,Abid AM, McCarthyAN, Hunter BN, Inglis AR, Anders K. Factors affecting delay in initiation of treatment oftuberculosis in the Thames Valley, UK. The Royal Society for Public HealthElsevier 2013; 127:172-177.
Long NH, Johansson E, Lönnroth K, Eriksson B, Winkvist A, and. Diwan VK. Longer delays in tuberculosis diagnosis among women in Vietnam.. Int J Tuberc Lung Dis. 1999; 3(5):388–393.
Hui-PL, Chung-YD and Pesus C. Diagnosis and treatment delay among pulmonary tuberculosis patients identified using the Taiwan reporting enquiry system, 2002–2006. BMC Public Health. 2009; 9:55.
Xu X. Liu JH, Cao SY, Zhao Y, Dong XX, Liang Y, Lu ZX. Delays in care seeking, diagnosis and treatment among pulmonary tuberculosis patients in Shenzhen, China. Int J Tuberc Lung Dis. 2013; 17(5):615–620.
Chang CT, Esterman A. Diagnotic delay among pulmonary tuberculosis patients in Sarawak, Malaysia: a cross sectional study. Rural and Remote Health 2007; 7:667.
VirenfeldtJ, RudolfF, CamaraC, FurtadoA, GomesV, AabyP, PetersenE, WejseC, Treatment delay affects clinical severity of tuberculosis: a longitudinal cohort study. BMJ Open 2014; 4(6):e004818.
Kumaravel I, Sharath BN, Ramya A, Anil GJ, and Jaya PT, Deepak T. TB Treatment Delays in Odisha, India: Is It Expected Even after These Many Years of RNTCP Implementation? PLoS ONE 2015; 10(4):e0125465.
Finnie RK, Khoza LB, Van DBB, Mabunda T, and Abotchie P, Mullen PD. Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub-Saharan African countries with high burdens of TB and HIV. Trop Med Int Health. 2011; 16(4):394-411.
World Health Organization 2013. Definitions and reporting framework for tuberculosis – 2013 revision (updated December 2014).
Anand PK. Does Co-Suffering by Ischemic Heart Disease and Tuberculosis Exist in Community Endemic for These Diseases? International Journal of Tropical Disease & Health. 2015; 5(1):1-10.
Mills EJ, Beyrer C, Birungi J, Dybul MR. Engaging men in prevention and care for HIV/AIDs in Africa. PloS Med. 2012; 9(2):e1001167.
Kigozi IM, Dobkin LM, Martin JN, Geng EH, Muyindike W, Emenyonu NI, Bangsberg DR, Hahn JA: Late-disease stage at presentation to an HIV clinic in the era of free antiretroviral therapy in sub-Saharan Africa. J Acquir Immune Defic Syndr. 2009; 52(2):280-289.
Anteneh A, Wondu T. Total Delay in treatment among smear positive pulmonary tuberculosis Patients in five primary health centers, Southern Ethiopia. ePLOS ONE: 2014; 9(7):e102884.
Gagliotti C, Resi D, Moro M L. Delay in the treatment of pulmonary TB in a changing demographic scenario. Int J Tubercl Lung Dis. 2006; 10(3):305–309.
Muhammad ANS, Irum NA, Syed KAS, Mirza IS, Zahid SM, Sabira T, Imran HK and Azra K. Delay in diagnosis of tuberculosis in Rawalpindi, Pakistan. BMC Research Notes.2011; 4:165.