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The problem of Tuberculosis in Zambia
LUBASI, Sundano Kutoma
Tuberculosis is one of the worlds? deadliest infectious diseases, and is one of the major causes of morbidity and mortality especially in poor countries. In Zambia, Tuberculosis remains a major health problem and is among the top ten causes of morbidity and mortality. Tuberculosis notifications have increased 5- fold in the last 20 years, mainly due to HIV/AIDS, it is estimated that approximately 70 % of all detected tuberculosis cases are also co-infected with HIV. The interaction of tuberculosis with the human immunodeficiency virus (HIV) infection has complicated and made difficult the Tuberculosis control program. Tuberculosis has become the leading cause of death among people living with HIV/AIDS. The management of tuberculosis in Zambia is faced with many challenges, such as lack of compliance to treatment by patients, poverty as well as lack of adequate finance for diagnosis, treatment and follow-up care. The main aim of my thesis was monitoring the problem of tuberculosis in Zambia, other accompanying aims were to find out how well informed the Zambian population is, about tuberculosis, monitor the diagnostic procedure for tuberculosis, analyse the tuberculosis treatment regime and lastly to analyse the preventive measures that have been implemented and how effective they have been. In this thesis, both qualitative and quantitative types of research were used. With the qualitative research, secondary analysis of data was used. Data from different sources of information like books, publications and research findings of various surveys and researches that were done not only by the Zambian Ministry of Health but also by other organizations was used. With the quantitative research, a questionnaire was formulated whose main aim was to find out about how well informed the Zambian people are about tuberculosis. This was done only in the capital city of Zambia which is Lusaka, and the number of respondents was 100. From the results obtained, the tuberculosis burden in Zambia still remains high and tuberculosis continues to be a serious public health problem. The implementation of the various preventive measures, though still facing difficulties, has however yielded positive results. There have been improvements in the treatment success rates from 77 % in the year 2000 to the current 86 %, the incidence rate per 100 000 population has also reduced from 504 in the year 2000 to the current 365 per 100 000 population. This reduction in incidence rates can be attributed to the preventive measures like the expansion of directly observed therapy treatment ? shortcourse (DOTS)strategy to all the districts in the country, the strengthening of the National Tuberculosis Control program and many others. This work can be used as a source of reference for future research in relation to the topic of tuberculosis in Zambia.
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Analysis of the parents to approach the issue of vaccination of children in the Czech Republic, on the example of vaccination against tuberculosis
Kremličková, Jitka ; Střítecký, Rudolf (advisor) ; Lešetický, Ondřej (referee)
Dissertation is about the problems with vaccination of children, whose part is also the inoculation against tuberculosis. The objective is the analysis of opinions and approaches of parents toward the problems with vaccination of children in Czech Republic and to discover the level of their knowledge about tuberculosis disease and about vaccination against it. To get the information needed, the anonymous questionary has been used. In the first part we will familiarize ourselves with the main terms from the area of vaccination and also about tuberculosis's basic data. The second part includes presentation of data collected, which are sorted into the bars and graphs. It includes also the calculation of coefficient of benefit for area vaccination against tuberculosis. In the conclusion of work is the summary of collected data and their rating
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Population health by regions in Czech Republic
Zemanová, Ivana ; Durdisová, Jaroslava (advisor) ; Mertl, Jan (referee)
This bachelor thesis deals with population health. Population health is important discipline bordering with medicine, statistics and public sector economics. It is monitoring method of collection medical information in Czech Republic. It interprets selected indicator and compares them between regions of Czech Republic. It finds probable causes of differences. They we can divide into socioeconomic factors and differences caused by the system of medical statistic evidence. The thesis evaluates and generalizes factors, which influent population health.
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Meeting the needs of foreign in-patient at the isolation unit of tuberculosis treatment according to the principles of the holism.
STRNKOVÁ, Romana
Abstract:Even today tuberculosis is a major health problem all round the world. The Czech Republic belongs among countries with low incidence of tuberculosis these days. In recent years the representation of foreigners in the total number of patients suffering from tuberculosis in our country has been increasing due to migration. In practice this results in the increase of number of foreigners hospitalized at isolation wards ? units for treating tuberculosis. Due to differences concerning culture, language, eating habits, customs, rituals and traditions, the stay at the isolation ward is for those patients traumatic experience for those patients. Hence, the thesis deals with the issue of meeting the needs of patients ? foreigners hospitalized at isolation ward for treating tuberculosis according to holistic principles. Two objectives were set at the very beginning. The first objective was to find out whether the needs of patients- foreigners hospitalized at isolation wards are met according to holistic principles. The other objective was to find out whether there are differences in the patients´- foreigners´ perception of the hospital environment. The theoretical part deals with holistic approach in patients care, present multicultural nursing, communication in providing nursing care, specificities of nursing at isolation ward and cultural specificities of hospitalized patients. The research part is based on qualitative data collection. An interview, observation and content data analysis were the methods applied in the research. The research set consisted of 5 patients-foreigners, who were hospitalized at isolation wards for treating tuberculosis in Hospital of České Budějovice, plc. and in the Lung Hospital in Humpolec. On the basis of information collected from patients during interviews, case histories were completed and these histories say that during hospitalization patient?s ? foreigner?s needs are met according to holistic principles. However, meeting the needs is to some extend influenced by the necessity to follow hygienic - epidemiological standards, relating to specificities of the ward operation. The environment of the isolation ward is perceived by the patients ? foreigners, due to the cultural and language differences, very intensively. Hospitalization, where these people are in a foreign country isolated from their relatives and friends, influences their behaviour, perception and reactions in a negative way. Language barrier makes the problem even worse. We are able to provide multicultural friendly care respecting opinions, traditions, habits and cultural specificities of an individual and non- traumatic adaptation to new environment in hospital.
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problem of tuberculosis in Afghanistan
BAKHSHI, Mirwais
This thesis is focused on problem of tuberculosis in Afghanistan, which takes thousands of lives every year and constitute one of the major and the most serious public health issues. The thesis introductory part informs us about condition of health system in Afghanistan, status of tuberculosis in Afghanistan, history of TB in Afghanistan, facts about tuberculosis in Afghanistan, knowledge of the people about TBC in Afghanistan last but not the least, Prevention and treatment of tuberculosis. Using a qualitative research I interviewed a medical specialist. In quantitative research I used questioners containing 20 questions to inquire of 120 men and women living in the rural areas north of Kábul (60 persons) and in the capital of Kábul urban (60 persons) in order to be able to objectively assess the knowledge of Afghanistan people these areas.
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Tuberculosis as a nursing problem
KUBEKOVÁ, Martina
Tuberculosis (TBC) is an infectious disease affecting mostly the respiration system. According to the World Health Organization (WHO), every year approximately eight million new cases of tuberculosis are reported and around two million people die of this disease. The Czech Republic ranks among the countries with the lowest annual incidence of tuberculosis. Patients suffering from tuberculosis are hospitalized in tuberculosis and respiration diseases (TRN) wards where they have to follow a certain medical regimen. They are hospitalized in isolated rooms, have to observe increased hand hygiene, use disposable tissues for coughing, spit the sputum into sputum containers, cover their month while coughing and use their own eating utensils and drinking glasses. In terms of comprehensive nursing care of tuberculosis patients, the problematic issue is observance of the barrier nursing care. While providing nursing care to a tuberculosis patient it is important that the nurse uses disposable protective aids and observes hand hygiene and disinfection principles. For these reasons the theoretical part includes the barrier nursing care, hygienic-epidemiologic techniques and principles of the medical regimen of tuberculosis patients. The research was qualitative and used interviews and monitoring. The research set were the patients and nurses in the TRN ward in Nemocnice Jihlava a.s. The objective of the thesis was to ascertain whether the TBC patients observe the medical regimen and whether the nurses observe the principles of the barrier nursing care of TBC patients. Two research issues were set in respect of the objectives. 1. Do the tuberculosis patients observe the medical regimen? 2. Do the nurses observe the principles of the barrier nursing care of tuberculosis patients? The research revealed that the monitored patients observed the medical regimen. The monitored nurses observed the barrier nursing care and hygienic-epidemiologic measures. Based on these results it can be stated that the nurses have both theoretical and practical knowledge in the area of the barrier nursing care and use the knowledge while providing nursing care to tuberculosis patients. Three hypotheses followed from the research. H1: The patients in the TRN ward observe the medical regimen. H2: The nurses know the principles of the barrier nursing technique. H3: The nurses observe the principles of the barrier nursing care. The results of the research will be provided to the nurse manager of the hospital of Jihlava and to the head nurse of the tuberculosis and respiration diseases ward of Nemocnice Jihlava a.s. as a source of information for continuous improvement of quality of the nursing care of tuberculosis patients in the tuberculosis and respiration diseases ward.
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Influence of Unemployment on Tuberculosis Distribution in the Czech Republic in 2000-2007
SOPROVÁ, Martina
This degree work dealt with the relation between the occurrence of TBC and the unemployment rate in the Czech Republic between 2000-2007. The work researched whether an increase or decrease in the unemployment rate in the Czech Republic influenced changes in the occurrence of TBC. The work was based on an analysis of data from the Authority of Medical Informatics and Statistics regarding the occurrence of TBC and analysis of the number of unemployed people as stated by the Czech Statistics Bureau. The hypothesis {--} with an increasing number of unemployed people the number of people suffering from TBC is increasing in the Czech Republic {--} was confirmed. Results of the research showed that it is necessary to deal with this issue regularly and intensely and that none of us may remain indifferent towards unemployed people (regardless of the fact whether they suffer from TBC or not) because each of use can suddenly become unemployed. Work has ranked among natural human activities for about ten thousand years. It is the most reliable and longest social support in people{\crq}s lives and its loss usually results in a serious disruption of mental and physical health.
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Algorithm of imaging methods in suspicion on pulmonary tuberculosis
MIKULÁŠOVÁ, Jana
Tuberculosis is an infectious disease which more than 8 million people are taken ill with throughout the world every year. During the last decade more than 30 million people succumbed to it. The Czech Republic succeeds in decreasing the number of TB cases, despite of it the physicians warn how dangerous is still this infectious disease. Basic diagnostic examination in pulmonary TB is an X-ray examination. Radiophotography, so called {\clqq}štítovka`` enacted remarkable part in combating TB. This apparatus was used in past for collective X-ray examination. The disadvantage of this technique is substantionally higher radiation load. In my work I dealt mostly with contemporary possibilities of radiodiagnostics in pulmonary TB examination (with regard to radiophotography). I carried out measurement of entering surface kerma with the help of water phantom in different work places, with different types of machines. In my thesis I compared examination techniques, both from the point of diagnostic yield , and from the point of patients´ radiation load. X-ray diagnostics participates in big rate in medical irradiation, which is the most important part in human irradiation from artificial radiation sources. Implementation of new diagnostic methods (especially computer tomography) resulted in important expansion of diagnostic possibilities . On the other hand, historical equipment still functions, e.g. cabin machines for imaging from the photographic plate. The most important factors affecting radiation load of patients is modern machine equipment, regular running of tests of long-term stableness and working steadiness , as well as protective aids use. In every work place with sources of ionizing radiation a permanent supervision on respecting of radiation protection rules must be ensured.
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Epidemiology of tuberculosis - reaction on vaccine BCG
FOŠUM, Pavel
Epidemiology of tuberculosis-reaction to BCG vaccine World Health Organization records nine million people worldwide who fall ill with tuberculosis and more than three million who die of this disease a year. Tuberculosis has been known for a long time and despite the discovery of Mycobacterium tuberculosis etiological role by Robert Koch, the invention of RTG diagnostics by Roentgen and effective treatment using antibiotics by Waksman as the first, this disease still represents a considerable risk for society. Prevention using BCG vaccine has positive as well as negative aspects. This thesis is focused on describing newborn vaccination coverage, occurrence and duration of side and adverse effects after the application of BCG vaccine during the first days of life and on the influence on the following compulsory vaccination. We used the method of quantitative research in the form of epidemiology descriptive study using the technique of individual data collection and analysis. As a research area the group of children born in 2004, 2005, and 2006 was used. The group of 804 children (410 boys and 393 girls) was selected by the technique of random cluster sampling. We found out that out of 804 respondents 98.6 % were vaccinated with BCG vaccine. The group of 11 children was not vaccinated due to: HBsAg positivity of mother, low birth weight or health problems. Reaction after BCG vaccination was not healed until the next planed shot in 307 children (38.1 %). There were 4 people with no reaction at all to BCG (0.8%). The most frequent side (adverse) reaction after vaccination was scar unhealed at the time of next planed vaccination in 274 cases, (34.1%). Monoreactions accounted for more than a half of recorded reactions. Reaction time period was in the range from 11 to 300 days. Median of reaction time period was 30 days. We did not find any serious adverse reaction. Our research demonstrated, that frequency of side and adverse reactions after BCG vaccination is high (38.1 %). These are mainly benign side effects. We found that these reactions lead to postponing of the subsequent vaccination of the compulsory vaccination scheme in all who reacted to BCG vaccination. The occurrence of side reactions after BCG vaccine raises the question of appropriateness to carry out the BCG vaccination in first days of life. The results of this thesis can be used as a pilot study for the whole country study of mapping side and adverse reactions and further consideration of compulsory vaccination scheme.
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Medical care and diseases in the developing countries
KRČMÁRIKOVÁ, Lucie
This diploma thesis focuses on HIV/AIDS problematics in Africa. Africa is a continent most affected by the HIV/AIDS epidemic. Two thirds of all HIV positive individuals (25,8 milion)live in sub-Saharan Africa. Among others, spreading the HIV virus is also the result of some traditions and social and cultural custome. The extent of the HIV/AIDS epidemic in Africa is also connected with the deterioration in the epidemiologic situation of other serious infections, tuberculosis and malaria in particular. Uganda is country that has manager to stop the HIV/AIDS epidemic. The WHO{\crq}s estimations show that 10-12% of HIV positive individuals live in Uganda. Another problem faced by Uganda is a high perinatal and maternal death rate, whose decrease is one of the Uganda goverment{\crq}s priorities.
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