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      Knowledge and attitudes towards ambulatory treatment of tuberculоsis in Kazakhstan

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          Abstract

          Background

          Ambulatory based treatment of tuberculosis has been recently introduced in Kazakhstan. We sought to assess the attitudes of the general population, TB patients and their household members towards ambulatory TB treatment and identify how knowledge of TB is associated with these attitudes.

          Methods

          New pulmonary TB cases and their household and community controls were recruited from three regions of Kazakhstan in 2012–2014. 1083 participants completed audio computer-assisted self interviews to assess their knowledge of TB and attitudes towards ambulatory care. Mixed effects logistic regression models were used to identify factors associated with attitudes toward ambulatory TB treatment.

          Results

          The proportion of people who considered ambulatory TB treatment as appropriate was very low (24.9%). Positive attitudes towards ambulatory TB treatment were significantly associated with region of residence, higher level of education, family support and experience with TB. The association between sufficient tuberculosis knowledge and favorable attitude toward ambulatory treatment was stronger among community controls compared to TB patients and their family members .

          Conclusions

          This study provides insight into attitudes toward ambulatory TB treatment among different groups and the specific influence of TB knowledge on these attitudes. Our findings can inform the process of integration of new TB treatment strategies and the development of appropriate education and advocacy programs in the general population.

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          Most cited references14

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          Social determinants of therapy failure and multi drug resistance among people with tuberculosis: A review.

          Social determinants influence health and the development of tuberculosis (TB). However, a paucity of data is available considering the relationship of social determinants influencing therapy failure and multi drug resistance (MDR). We conducted a review investigating the relationship of common social determinants on therapy failure and MDR in people with TB.
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            Community-based treatment for multidrug-resistant tuberculosis in rural KwaZulu-Natal, South Africa.

            Hlabisa health sub-district, KwaZulu-Natal, South Africa. To describe the establishment of a community-based multidrug-resistant tuberculosis (MDR-TB) treatment programme embedded in the district TB control programme and to evaluate whether early outcomes are comparable to those in the traditional hospital-based model of care. Cases who initiated community-based MDR-TB treatment (CM) between March and December 2008 were compared with patients who initiated MDR-TB treatment under the traditional hospital-based model of care (TM) between January 2001 and February 2008. Time to initiation of treatment and time to sputum smear and culture conversion were compared for the two groups in Kaplan-Meier survival curves using the Mantel-Cox log-rank test. Overall, 50 CM cases and 57 TM cases were included; 39 of the 50 CM cases (78.0%) were human immunodeficiency virus positive. The median time to initiation of treatment was 84 days for CM and 106.5 days for TM (P = 0.002). Median time to sputum smear conversion was shorter for CM than TM (59 vs. 92 days, P = 0.055), as was time to sputum culture conversion (85 vs. 119 days, P = 0.002). Community-based treatment for MDR-TB can be implemented within the existing TB control programme in rural South Africa and should be scaled up where resources allow.
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              Emergence of extensive drug resistance during treatment for multidrug-resistant tuberculosis.

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                Author and article information

                Contributors
                mdarisheva@gmail.com
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                22 June 2020
                22 June 2020
                2020
                : 20
                : 563
                Affiliations
                [1 ]Columbia University Global Health Research Center of Central Asia, Almaty, Kazakhstan
                [2 ]GRID grid.265850.c, ISNI 0000 0001 2151 7947, School of Public Health, Department of Epidemiology and Biostatistics, , University at Albany, ; Albany, NY USA
                [3 ]GRID grid.443453.1, ISNI 0000 0004 0387 8740, Kazakh National Medical University, ; Almaty, Kazakhstan
                [4 ]GRID grid.21729.3f, ISNI 0000000419368729, Department of Epidemiology, , Columbia University Mailman School of Public Health, ; New York, NY USA
                [5 ]GRID grid.21729.3f, ISNI 0000000419368729, Columbia University School of Social Work, ; 1255 Amsterdam Avenue, New York, NY USA
                Article
                5413
                10.1186/s12913-020-05413-0
                7310255
                9962982f-35c2-4dec-ada5-5c193d07f7ce
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 27 January 2020
                : 9 June 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004561, Ministry of Education and Science of the Republic of Kazakhstan;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Health & Social care
                tuberculosis,tb treatment,kazakhstan,tb attitude,tb knowledge
                Health & Social care
                tuberculosis, tb treatment, kazakhstan, tb attitude, tb knowledge

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