Factors of chemoresistant pulmonary tuberculosis progression in patients receiving palliative treatment

Authors

  • O. M. Raznatovska Zaporizhzhia State Medical University, Ukraine,
  • G. V. Khudiakov Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.3.130829

Keywords:

drug-resistant tuberculosis, palliative care, quality of life, tumor necrosis factor, body mass index

Abstract

Objective – to define factors of chemoresistant pulmonary tuberculosis (CRPTB) progression in patients receiving palliative treatment by means of their QL, TNF-α levels and body mass index complex assessment.

Materials and methods. 81 CRPTB patients were examined and divided into two groups: the main group consisted of 52 patients receiving palliative treatment and the control group consisted of 29 patients receiving antimycobacterial therapy by category 4 according to drug resistance. The MOS SF-36 questionnaire was used to evaluate the quality of life. Studies of serum TNF-α level were determined by enzyme-linked immunosorbent assay using immunoenzymometric reader Sirio S and a set “Bender MedSystems GmbH” (Austria), (pg/ml). Body mass index was calculated with the help of calculator New BMI (New Body Mass Index), (kg/m2). Results of this study were processed using the modern methods of analysis with the help of a personal computer and the statistical package of the licensed software program Statistica® for Windows 6.0 (StatSoft Inc., № AXXR712 D833214FAN5).

Results. CRPTB patients receiving palliative treatment have simultaneously a high activity of inflammatory specific process, predominant body mass deficit and low quality of life (both its physical and mental component). And along with this in patients receiving CRPTB treatment, activity of specific inflammatory process is 2.2 times lower, normal level of body weight predominate and quality of life is satisfactory (with satisfactory levels of both its components). Assessment of correlation relationships gave an opportunity to find out that in CRPTB patients, receiving palliative treatment, absence of the specific process antimycobacterial therapy leads to an increase in blood serum TNFα which in its turn promotes development of body mass deficit and as a consequence quality of life is decreased through decrease of all its components. In patients receiving etiotropic treatment activity of specific inflammatory process promotes decrease of body mass and quality of life but these changes are not so expressed as in case with patients receiving palliative treatment.

Conclusions. Factors of CRPTB progression in patients receiving palliative treatment include increase of TNFα level in the blood serum (≥180 pg/ml), deficit in body mass (≤18,1 kg/m2), decrease in quality of life index (≤50 relative units).

 

 

References

YeAPD. (2013). Prazka khartiia «Otrymannia paliatyvnoi dopomohy – pravo liudyny». [Prague Charter «Getting palliative care – a human right»]. Retrieved from: http://eapcspeaksrussian. eu.aspx. [in Ukrainian].

YeAPD. (2011). Bila knyha standartiv z paliatyvnoi dopomohy. Rekomendatsii Yevropeiskoi Asotsiatsii paliatyvnoi dopomohy [White Paper on standards and norms for hospice and palliative care in Europe. Recommendation of the European Association of Palliative Care]. Retrieved from: http://ligalife.com.ua/2011/paliativna/standart/ 4parent-kontekstta-metodologiya/. [in Ukrainian].

Internet-sajt MCYKZh. [Website MTSIKZH]. Retrieved from http://www.mcqlr.da.ru. [in Russian].

Velikaya, O. V., & Akulova, A. V. (2015). Ocenka kachestva zhizni zhenshchin, bol'nykh tuberkulezom legkikh, s ispol'zovaniyem ankety SF-36 [Evaluation of the quality of life of women, patients with pulmonary tuberculosis, using the SF-36 questionnaire]. Nauchnye vedomosti, 16(213), 110–115. [in Russian].

Aniskina, E. A., Makarova, I. I., Strakhov, K. A., & Al-Daud, S. D. (2012). Issledovaniye kachestva zhizni bol'nykh tuberkulezom legkikh [Study of quality of life of patients with pulmonary tuberculosis]. M'edicinskaya ekologiya, 4, 58–62. [in Russian].

Tsapenko, Y. P., Boiko, M. G., Kraevska, O. O., Alieva, N. M., & Krasnoshapka, Y. O. (2012). Porivnialna kharakterystyka yakosti zhyttia ta stanu zdorov’ia khvorykh infiltratyvnym tuberkulozom lehen v dynamitsi na riznykh etapakh medychnoi reabilitatsii [Comparative characteristics of life quality and health condition in patients with infiltrative tuberculosis of lungs in dynamics during different stages of medical rehabilitation]. Svit biolohii ta medytsyny, 3, 112–115. [in Ukrainian].

Ministry of Health of Ukraine (2014). Nakaz Ukrainy «Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy doroslym. Tuberkuloz» vid 31.12.14 roku №620 [Order of Ukraine «Unified clinical protocols of primary, secondary (specialized) and tertiary (highly specialized) medical care for adults. Tuberculosis» from December 31, 2014 №620]. [in Ukrainian].

WHO. (2015). Global Tuberculosis Report 2015. Retrieved from http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf.

Ware, J. E. (1992). The MOS 36-Item Short-Form Health Survey. Med. Care, 30, 473–483.

Santos, A. P. C., Lazzari, T. K., & Silva, D. R. (2017) .Health-Related Quality of Life, Depression and Anxiety in Hospitalized Patients with Tuberculosis. Tuberculosis and respiratory diseases, 80(1), 69–76. doi: 10.4046/trd.2017.80.1.69.

Sagwa, E. L., Ruswa, N., Mavhunga, F., Rennie, T., Leufkens, H. G. M., & Mantel-Tee,uwisse A. K. (Sagwa, E. L., Ruswa, N., Mavhunga, F., Rennie, T., Leufkens, H. G. M., & Mantel-Tee,uwisse A. K. ). Adverse events and patients’ perceived health-related quality of life at the end of multidrug-resistant tuberculosis treatment in Namibia. Patient preference and adherence, 10, 2369. doi: 10.2147/PPA.S116860.

Fan, H. M., Wang, Z., Feng, F. M., Zhang, K. L., Yuan, J. X., Sui, H. et al. (2010). Association of TNF-α-238G/A and 308 G/A Gene Polymorphisms with Pulmonary Tuberculosis among Patients with Coal Worker's Pneumoconiosis. Biomedical and Environmental Sciences, 23(2), 137–145. doi: 10.1016/S0895-3988(10)60043-8.

Moges, B., Amare, B., Asfaw, F., Tesfaye, W., Tiruneh, M., Belyhun, Yе., et al. (2012). Prevalence of smear positive pulmonary tuberculosis among prisoners in North Gondar Zone Prison, northwest Ethiopia. BMC infectious diseases, 12, 352. doi: 10.1186/1471-2334-12-352.

Downloads

How to Cite

1.
Raznatovska OM, Khudiakov GV. Factors of chemoresistant pulmonary tuberculosis progression in patients receiving palliative treatment. Zaporozhye medical journal [Internet]. 2018May30 [cited 2024Apr.24];(3). Available from: http://zmj.zsmu.edu.ua/article/view/130829

Issue

Section

Original research