The use of information and communication technology in continuing education in tuberculosis

Introduction: The use of information and communication technologies (ICT) tools has been impacting health care. Distance learning has been used for the continuing improvement of healthcare workers (HCWs). In this systematic review, we evaluated the use of ICT in tuberculosis (TB) continuing education. Methods: We searched Medline and Embase for cross-sectional studies that included HCWs or students, and that reported participants’ learning level. Results: Four studies proved eligible. Three used online educational tools, and another one used CDroms and live video conferencing. All studies evaluated participants’ learning level through online pre- and post-tests. The quality of the studies was high. Conclusions: There is a paucity of studies evaluating distance learning in TB training. Continuing education of students and HCWs is essential for TB control. Accomplishing this is critical in increasing the skills and the numbers of qualified HCWs capable of meeting the health care needs of the population

Boletín oficial de la provincia de Santander: Año XXXVII Número 123 - 1973 Octubre 12

Introdução: A formação contínua de profissionais da saúde (PS) é uma estratégia essencial para o controle da transmissão da tuberculose (TB), capacitando os PS para a detecção precoce e o tratamento adequado dos casos de TB. Métodos: Desenvolvemos um curso de educação a distância (EAD) sobre TB para enfermeiros. Realizou-se um estudo quasi-experimental antes e depois para avaliar a comunidade de EAD no nível de aprendizagem do participante. Além disso, para avaliar a comunidade de EAD no nível de satisfação dos participantes, foi realizado um estudo transversal após o curso. Foram recrutados enfermeiros envolvidos em atendimento a pacientes internados ou ambulatoriais. Resultados: Sessenta e seis participantes iniciaram e completaram o curso e então foram incluídos na análise. Os escores médios do pré-teste e pós-teste foram 10,3 ± 2,2 e 11,4 ± 2,7, respectivamente. O teste de Wilcoxon mostrou que os alunos aumentaram seu conhecimento, e isso foi estatisticamente significativo (p <0,0001). Na avaliação basal, a frequência de respostas corretas foi muito baixa em algumas questões: número de pessoas infectadas pelo Mycobacterium tuberculosis no mundo (10,6%); número de casos de TB no Brasil (36,4%); contagiosidade da infecção latente por TB (ILTB) (28,8%) e definição de busca ativa de casos (45,5%). O feedback do curso foi em geral positivo, com a maioria dos usuários dizendo que estavam satisfeitos ou totalmente satisfeitos. Conclusões: Um breve curso de EAD sobre TB foi associado a uma melhora geral do conhecimento entre enfermeiros. O conhecimento basal era baixo em relação aos dados epidemiológicos da TB e conceitos sobre ILTB e busca ativa de casos. Esta constatação enfatiza a necessidade de melhorar ainda mais as competências e o conhecimento dos enfermeiros.Introduction: Continuing education of healthcare workers (HCW) is an essential strategy for the control of tuberculosis (TB) transmission, enabling HCW to early detection and appropriate treatment of TB cases. Methods: We develop a distance learning (DL) course on TB for nurses. We conducted a quasi-experimental before-andafter study to evaluate the DL community at the participant's learning level. Also, to evaluate the DL community at the level of participant satisfaction, a cross-sectional study was carried out after the course. Nurses involved in active inpatient or outpatient care of patients were recruited to participate in the study. Results: Sixty-six participants started and completed the course and those were included in the analysis. The overall mean pre-test and post-test scores were 10.3 ± 2.2 and 11.4 ± 2.7, respectively. Wilcoxon’s test showed that learners increased their knowledge to a statistically significant degree (p < 0.0001). At baseline, the frequency of correct answers was very low in some questions: number of people infected by Mycobacterium tuberculosis in the world (10.6%); number of TB cases in Brazil (36.4%); contagiousness of latent TB infection (LTBI) (28.8%), and definition of active case finding (45.5%). Course feedback was mostly positive, with the majority of users saying they were satisfied or totally satisfied. Conclusions: A brief DL course on TB was associated with an overall improvement in knowledge among nurses. The baseline knowledge was low regarding TB epidemiologic data, and concepts on LTBI and active case finding. This finding emphasizes the need to further improve the competencies and knowledge of nurses

Predictors of in-hospital mortality among patients with pulmonary tuberculosis : a protocol of systematic review and meta-analysis of observational studies

Introduction: Tuberculosis (TB) continues to be a major public health issue worldwide, with 1.4 million deaths occurring annually. There is uncertainty regarding which factors are associated with in-hospital mortality among patients with pulmonary TB. This knowledge gap complicates efforts to identify and improve the management of those individuals with TB at greatest risk of death. The aim of this systematic review and meta-analysis is to establish predictors of in-hospital mortality among patients with pulmonary TB to enhance the evidence base for public policy. Methods and analysis: Studies will be identified by a MEDLINE, EMBASE and Global Health search. Eligible studies will be cohort and case–control studies that report predictors or risk factors for in-hospital mortality among patients with pulmonary TB and an adjusted analysis to explore factors associated with inhospital mortality. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to summarise the findings of some reported predictors. Teams of 2 reviewers will screen the titles and abstracts of all citations identified in our search, independently and in duplicate, extract data, and assess scientific quality using standardised forms quality assessment and tools tailored. We will pool all factors that were assessed for an association with mortality that were reported by >1 study, and presented the OR and the associated 95% CI. When studies provided the measure of association as a relative risk (RR), we will convert the RR to OR using the formula provided by Wang. For binary data, we will calculate a pooled OR, with an associated 95% CI. Ethics and dissemination: This study is based on published data, and therefore ethical approval is not a requirement. Findings will be disseminated through publication in peer-reviewed journals and conference presentations at relevant conferences

Geospatial intelligence and health analitycs : its application and utility in a city with high tuberculosis incidence in Brazil

Background: Geospatial Intelligence and Health Analysis have been used to identify tuberculosis (TB) hotspots and to better understand their relationship to social and economic factors. The purpose of this study was to use geospatial intelligence to assess the distribution of TB and its correlations with Human Development Index (HDI) in a city with high TB incidence in Brazil. Methods: We conducted an ecological study, using National System of Information on Noticeable Disease (SINAN) to identify TB cases. Geocoding was performed using QGIS 2.0 software and Google Maps API 3.0. We applied geospatial intelligence to detect where in the city clustering of TB cases occurred, and assessed the association of an area’s HDI (each one of the components — longevity, education, and income) with TB spatial distribution. Results: During the study period (2011–2013), there were 737 TB cases. TB cases showed heterogeneity across the 29 neighborhoods. The neighborhoods with HDI-income lower than the mean had higher TB incidence (p = 0.036). Conclusions: We found several hotspots of TB across the 29 neighborhoods, and an inverse association between HDI-income and TB incidence. These findings provide useful information and may help to guide TB control programs