Treatment delay among tuberculosis patients in Tanzania: Data from the FIDELIS Initiative

<p>Abstract</p> <p>Background</p> <p>Several FIDELIS projects (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) in Tanzania were conducted by the National Tuberculosis and Leprosy Programme (NTLP) during the years 2004-2008 to strengthen diagnostic and treatment services. These projects collected information on <it>treatment delay </it>and some of it was available for research purposes. With this database our objective was to assess the duration and determinants of treatment delay among new smear positive pulmonary tuberculosis (TB) patients in FIDELIS projects, and to compare delay according to provider visited prior to diagnosis.</p> <p>Methods</p> <p>Treatment delay among new smear positive TB patients was recorded for each patient at treatment initiation and this information was available and fairly complete in 6 out of 57 districts with FIDELIS projects enrolling patients between 2004 and 2007; other districts had discarded their forms at the time of analysis. It was analysed as a cross sectional study.</p> <p>Results</p> <p>We included 1161 cases, 10% of all patients recruited in the FIDELIS projects in Tanzania. Median delay was 12 weeks. The median duration of cough, weight loss and haemoptysis was 12, 8 and 3 weeks, respectively. Compared to Hai district Handeni had patients with longer delays and Mbozi had patients with shorter delays. Urban and rural patients reported similar delays. Patients aged 15-24 years and patients of 65 years or older had longer delays. Patients reporting contact with traditional healers before diagnosis had a median delay of 15 weeks compared to 12 weeks among those who did not. Patients with dyspnoea and with diarrhoea had longer delays.</p> <p>Conclusion</p> <p>In this patient sample in Tanzania half of the new smear positive pulmonary tuberculosis patients had a treatment delay longer than 12 weeks. Delay was similar in men and women and among urban and rural patients, but longer in the young and older age groups. Patients using traditional healers had a 25% longer median delay.</p

Medically Biodegradable Hydrogenated Amorphous Silicon Microspheres

[EN] Hydrogenated amorphous silicon colloids of low surface area (<5 m(2)/g) are shown to exhibit complete in-vitro biodegradation into orthosilicic acid within 10-15 days at 37 degrees C. When converted into polycrystalline silicon colloids, by high temperature annealing in an inert atmosphere, microparticle solubility is dramatically reduced. The data suggests that amorphous silicon does not require nanoscale porosification for full in-vivo biodegradability. This has significant implications for using a-Si:H coatings for medical implants in general, and orthopedic implants in particular. The high sphericity and biodegradability of submicron particles may also confer advantages with regards to contrast agents for medical imaging.This work has been partially supported by the Spanish CICyT projects, FIS2009-07812, Consolider CSD2007-046, MAT2009-010350 and PROMETEO/2010/043.Shabir, Q.; Pokale, A.; Loni, A.; Johnson, DR.; Canham, L.; Fenollosa Esteve, R.; Tymczenko, MK.... (2011). Medically Biodegradable Hydrogenated Amorphous Silicon Microspheres. Silicon. 3(4):173-176. https://doi.org/10.1007/s12633-011-9097-4S17317634Salonen J, Kaukonen AM, Hirvonen J, Lehto VP (2008) J Pharmaceutics 97:632–53Anglin EJ, Cheng L, Freeman WR, Sailor MJ (2008) Adv Drug Deliv Rev 60:1266–77O’Farrell N, Houlton A, Horrocks BR (2006) Int J Nanomedicine 1:451–72Canham LT (1995) Adv Mater 7:1037, PCT patent WO 97/06101,1999Park JH, Gui L, Malzahn G, Ruoslahti E, Bhatia SN, Sailor MJ (2009) Nature Mater 8:331–6Cullis AG, Canham LT, Calcott PDJ (1997) J Appl Phys 82:909–66Canham LT, Reeves CR (1996) Mat Res Soc Symp 414:189–90Edell DJ, Toi VV, McNeil VM, Clark LD (1992) IEEE Trans Biomed Eng 39:635–43Fenollosa R, Meseguer F, Tymczenko M (2008) Adv Mater 20:95Fenollosa R, Meseguer F, Tymczenko M, Spanish Patent P200701681, 2007Pell LE, Schricker AD, Mikulec FV, Korgel BA (2004) Langmuir 20:6546Xifré-Perez E, Fenollosa R, Meseguer F (2011) Opt Express 19:3455–63Fenollosa R, Ramiro-Manzano F, Tymczenko M, Meseguer F (2010) J Mater Chem 20:5210Xifré-Pérez E, Domenech JD, Fenollosa R, Muñoz P, Capmany J, Meseguer F (2011) Opt Express 19–4:3185–92Rodriguez I, Fenollosa R, Meseguer F, Cosmetics & Toiletries 2010;42–49Ramiro-Manzano F, Fenollosa R, Xifré-Pérez E, Garín M, Meseguer F (2011) Adv Mater 23:3022–3025. doi: 10.1002/adma.201100986Iler RK (1979) Chemistry of silica: solubility, polymerization, colloid & surface properties & biochemistry. Wiley, New YorkTanaka K, Maruyama E, Shimado T, Okamoto H (1999) Amorphous silicon. Wiley, New York, NYPatterson AL (1939) Phys Rev 56:978–82Canham LT, Reeves CL, King DO, Branfield PJ, Gabb JG, Ward MC (1996) Adv Mater 8:850–2Iler RK In: Chemistry of silica: solubility, polymerization, colloid & surface properties &Biochemistry. Wiley, New York, NYFinnie KS, Waller DJ, Perret FL, Krause-Heuer AM, Lin HQ, Hanna JV, Barbe CJ (2009) J Sol-Gel Technol 49:12–8Zhao D, Huo Q, Feng J, Chmelka BF, Stucky GD (1998) J Am Chem Soc 120:6024–36Fan D, Akkaraju GR, Couch EF, Canham LT, Coffer JL (2010) Nanoscale 1:354–61Tasciotti E, Godin B, Martinez JO, Chiappini C, Bhavane R, Liu X, Ferrari M (2011) Mol Imaging 10:56–