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Socioeconomic Determinants and Patient Profiles

Discussion

Why people lost to follow up treatment

The characteristic features of people such as lifestyles, perspectives regarding illness, thoughts, eating habits and nutrition, education, family background and regular habits are strongly associated with the occurrence of TB in people. From the database, it is seen that more than 77% of the patients selected from Sanatorium Hospital in Luanda did not have their own house (Romanowski et al., 2019). More than 34% of the patient did not receive a basic level of education. As mentioned by basic education is important for people to understand the reason and outcomes of any disease, which help them to develop the self-management ability to combat the impact of this disease on their health (World Health Organization, 2019). According to the outcome of the current study, Twenty-eight (51.8%) interviewed persons were patients who were lost to follow up of treatment, 9 (16.6%) were patients with a recent diagnosis of TB, 2 (3.7%) were patients experts, 5 (9.3%) were family of patients who had been lost of FU 5 (9.3%) were parents of children who Lost to FU TB treatment and 5 (9.3%) were health professionals.

In the context of social demographics factors, there have been several critical variables identified in the field of Tuberculosis treatment (Khan et al., 2020). In which researcher has selected 38 references in which 36 files seem appropriate to carry out a systematic investigation. In this regards, patients in the 7 files were addressed that the lack of support influenced the patients to leave the treatment of Tuberculosis. In addition to that, the poverty has been termed as key element that influences the inappropriate health and medical care. As per the study objectives, researcher has focused on the 29 patient’s files in which the poverty was being termed as key element that influenced people for not completing the treatment of the Tuberculosis. However, in recent years people in different nations are again infected by TB, which not only impacts ion their physical; health but also their mental and spiritual health (van Kampen, et al., 2018). The main cause of TB is considered as the health and socio-economic inequality among people.

What happened after loss to follow up treatment

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According to outcome of the study, 25 references has determined that 24 death cases were found as a result of the quitting the treatment. In this context, death is being termed as an important impact of the leaving the treatment. In addition to that, the assessment of 49 files has disclosed that the cases related to 49 patients were become worsen so as the inappropriate treatment of the Tuberculosis is essential to manage the emergence of death and occurrence of critical symptoms (Conradie et al., 2020). People who skip their main meals on a regular wise, eat poor quality foods that are lack protein and vitamins and keep on starvation frequently are more likely to be infected by different infectious and contagious disease such as TB.

Evidence suggests that abandonment of TB treatment is strongly associated with unorganized and unhealthily lifestyles such as unhealthy food consumption, skipping of meals, late rising, insufficient sleep, lack of sufficient protein and carbs intake, lack of exercise, skipping medicines and developing unhealthy habits such as alcoholism and smoking (Villa, et al, 2019). The clinical intervention shows that unhealthy eating, starvation and high consumption of alcohol, drugs and cigarettes, damage the function of body systems such as the pancreas, lungs and intestine. As per the outcome of the study, 29 patient’s files in which the poverty was being termed as key element that influenced people for not completing the treatment of the Tuberculosis. In similar way, the relocation and distance are being termed as key factors in which 2 files were selected these factors. It may have a significant impact on the treatment of the Tuberculosis. The abandonment of TB treatment impacts the body system of patients adversely. As compared to the cured person, the patients in the given database who abandoned the treatment are highly vulnerable to develop other health condition such as respiratory illness, cardiovascular illness and pulmonary issues (Romanowski et al., 2019).

This is because the hormonal changes that occurred during the TB treatment process make the body unable to redeem the previous internal state that the body had before taking the treatment process. Due to these hormonal changes in the body, TB patients who abandon the treatment develop several issues in their normal body functions. Evidence suggests the most common outcomes of abandonment of TB treatment are the impaired respiratory system in patients that cause severe breathing issues and episodic shortness of breath (Anastasopoulou et al., 2019). As per the findings of study, the relationship between adverse events related to drugs and lost to follow up TB treatment in which researcher has addressed the 12 case files from the 12 references. This is because the patients were found inappropriate process during the treatment of Tuberculosis and it influenced them to abandon the treatment of Tuberculosis. In addition to that, the religious belief has been reported as key driver for abandoning the treatment because the researcher has considered 5 references in which all 5 files were reported the positive responses about the issues aligned with religious beliefs. Therefore, it can be stated that different religious factors could leave the adverse impact on the efficiency the treatment processes of the Tuberculosis.

What patients recommended

From the database, it is clear that, out of the patients with TB who are selected for this study, only 63 individuals were been reported to three times meals and systematic eating habits. The database assessment of the patients had shown that there are many patients (1.8%) who used to skip their breakfast and dinner on regular wise, many patients used to take only diner (0.9%) and some used to take only breakfast and dinner but no lunch (47%). By analyzing the results of this nutritional assessment, it is clear that the majority of the people do not have a systematic and healthy eating habit which impacts severely on their immunes system and resistance power to disease thereby making them more vulnerable to the TB infection. (Mirzayev et al., 2021)

While evaluating the health condition of the patients, the majority of the people lack proper jobs therefore are unable to arrange the three times meals for their families. In this context, they decide to spend the money on arranging foods and drinks of their family rather than spending on their TB treatment. Moreover, the majority of 22 files were reported that the appropriate education and training to patients could support the patients in managing the appropriate treatment of the Tuberculosis. In addition to that, the evaluation of 7 files has helped to recommended that patients wanted a significant improvement in the attitude of medical practitioners that could be emerged the key approach to improve the treatment quality in the context of Tuberculosis. In similar way, government agencies should increase the access to health care facilities among poor citizens so as they could find the appropriate treatment of the Tuberculosis (World Health Organization, 2018). In addition to that, 13 files were supported to identify and recommended that the appropriate patient tracking and supervision would be emerged as the great tool for offering the high quality treatment in the case of Tuberculosis treatment.

The outcome of results, the young people who abandon TB treatment for their financial problem suffer from severe depression due to the thought of getting vulnerable to mortality and comorbidity. As per the outcome of the literature, people above 65 years who abandon TB treatment are highly vulnerable to a different health condition such as pulmonary illness, cardiovascular disease and lung cancer. Therefore, it is recommended to the patients of TB to maintain healthy lifestyle, education and income that are playing a critical role in managing the disease and getting the treatment (Lange, et al., 2019). Moreover, it is recommended that proper treatment and knowledge of the intervention tools and techniques is having positive impact on the health and wellbeing of the people in both rural and urban areas. The local and nation governments needs to focus on different aspects that highlighted in the study and outcome that suggest the actual factors that influence the health of the people. However, in the digital era people are getting information through social media and health care departments of country to protect and manage the healthy life style. The clinical intervention shows that unhealthy eating, starvation and high consumption of alcohol, drugs and cigarettes, damage the function of body systems such as the pancreas, lungs and intestine. On the other hand, lower-income people who reside in deprived communities have a lack of access to governmental, societal, economic healthcare facilities that make them vulnerable to infectious diseases such as TB. Therefore, the education plays a critical role in assessing the appropriate treatment in managing the health conditions. In the context of Tuberculosis, the education level plays a critical role in the timely treatment of Tuberculosis (Alghamdi, et al., 2019).

Conclusion

There are different types of disease and health issues are having direct or indirect impact on the physical and mental health of the individual. The study has focused on factors that influence the risk of TB and affect the health of the people. The major outcome of study have suggested that there are many strategies for controlling and preventing tuberculosis but the most known are: Screening people with symptoms and signs of tuberculosis in the community, treating positive cases with anti-tuberculosis drugs which are recommended by health professionals, management of positive cases of tuberculosis, notification of cases to the National Tuberculosis Control Programme, educating, informing and communicating people in the community about issues that increase incidence, prevalence and mortality rate of tuberculosis in the community such as lack of hygiene, alcohol abuse, smoking habits, poor alimentation and irregular on eating frequency which means eating once on the day.

The hectic lifestyle, bad eating habits, lack of knowledge related to the precaution and intervention of the issues that caused the life threatening disease. In the modern era, there are several modernised and innovative tenement processes for TB that reduce the chances of people get infected by TB across the world. Tuberculosis is a preventable as well as a curable disease. However, in the 21st century, there are many under-developed nations in which people are still affected by TB at a faster rate than becomes a matter of great concern. In Lunda-Angola, there are ever-increasing numbers of TB cases that highlighted the importance of implementing effective healthcare policies and innovative care plan for people affected by this infectious disease to improve their health and wellbeing. As per the outcome of the study, the majority of 22 files were reported that the appropriate education and training to patients could support the patients in managing the appropriate treatment of the Tuberculosis. In addition to that, the evaluation of 7 files has determined that patients wanted a significant improvement in the attitude of medical practitioners that could be emerged the key approach to improve the treatment quality in the context of Tuberculosis. In this context, the selection of this topic is highly justified as it will present a clear concept on the risk factors of TB, its cause, epidemiology, pathophysiology and severity of its occurrence in Angola as compared to the severity of TB infection.

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References

Alghamdi, W.A., Antwi, S., Enimil, A., Yang, H., Dompreh, A., Wiesner, L., Langaee, T., Peloquin, C.A. and Kwara, A., 2019. Population pharmacokinetics of efavirenz in HIV and TB/HIV coinfected children: the significance of genotype-guided dosing. Journal of Antimicrobial Chemotherapy, 74(9), pp.2698-2706.

Anastasopoulou, A., Ziogas, D.C., Samarkos, M., Kirkwood, J.M. and Gogas, H., 2019. Reactivation of tuberculosis in cancer patients following administration of immune checkpoint inhibitors: current evidence and clinical practice recommendations. Journal for immunotherapy of cancer, 7(1), pp.1-13.

Conradie, F., Diacon, A.H., Ngubane, N., Howell, P., Everitt, D., Crook, A.M., Mendel, C.M., Egizi, E., Moreira, J., Timm, J. and McHugh, T.D., 2020. Treatment of highly drug-resistant pulmonary tuberculosis. New England Journal of Medicine, 382(10), pp.893-902.

Khan, H., Gómez‐Aguilar, J.F., Alkhazzan, A. and Khan, A., 2020. A fractional order HIV‐TB coinfection model with nonsingular Mittag‐Leffler Law. Mathematical Methods in the Applied Sciences, 43(6), pp.3786-3806.

Lange, C., Aarnoutse, R.E., Alffenaar, J.W.C., Bothamley, G., Brinkmann, F., Costa, J., Chesov, D., Van Crevel, R., Dedicoat, M., Dominguez, J. and Duarte, R., 2019. Management of patients with multidrug-resistant tuberculosis. The international journal of tuberculosis and lung disease, 23(6), pp.645-662.

Mirzayev, F., Viney, K., Linh, N.N., Gonzalez-Angulo, L., Gegia, M., Jaramillo, E., Zignol, M. and Kasaeva, T., 2021. World Health Organization recommendations on the treatment of drug-resistant tuberculosis, 2020 update. European Respiratory Journal, 57(6).

Romanowski, K., Baumann, B., Basham, C.A., Khan, F.A., Fox, G.J. and Johnston, J.C., 2019. Long-term all-cause mortality in people treated for tuberculosis: a systematic review and meta-analysis. The Lancet Infectious Diseases, 19(10), pp.1129-1137.

Romanowski, K., Baumann, B., Basham, C.A., Khan, F.A., Fox, G.J. and Johnston, J.C., 2019. Long-term all-cause mortality in people treated for tuberculosis: a systematic review and meta-analysis. The Lancet Infectious Diseases, 19(10), pp.1129-1137.

van Kampen, S.C., Wanner, A., Edwards, M., Harries, A.D., Kirenga, B.J., Chakaya, J. and Jones, R., 2018. International research and guidelines on post-tuberculosis chronic lung disorders: a systematic scoping review. BMJ global health, 3(4), p.e000745.

Villa, S., Ferrarese, M., Sotgiu, G., Castellotti, P.F., Saderi, L., Grecchi, C., Saporiti, M., Raviglione, M. and Codecasa, L.R., 2019. Latent tuberculosis infection treatment completion while shifting prescription from isoniazid-only to rifampicin-containing regimens: a two-decade experience in Milan, Italy. Journal of clinical medicine, 9(1), p.101.

World Health Organization, 2018. A patient-centred approach to TB care (No. WHO/CDS/TB/2018.13). World Health Organization.

World Health Organization, 2019. Lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis of active tuberculosis in people living with HIV: policy update (2019): evidence to decision tables (No. WHO/CDS/TB/2019.21). World Health Organization.


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