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Biomedical subjects

J E Ollé-Goig

Publications and source records attributed to J E Ollé-Goig.

At least 19 recordsLinked to original sources
PubMed2005

Outcomes of individualised treatment for multidrug-resistant tuberculosis before DOTS-plus.

SETTING: A tuberculosis (TB) out-patient service in the city of Santa Cruz, Bolivia. OBJECTIVE: To evaluate the outcomes of patients with TB resistant to isoniazid and rifampicin (multidrug resistance [MDR]) treated in a resource-poor area before the introduction of the DOTS-Plus initiative. DESIGN: Retrospective cohort study of MDR-TB patients treated with individualised regimens between January 1983 and December 1993. RESULTS: Among 143 patients studied, 73 (51%) were males; the mean age was 33.9 years. Forty (28%) were new patients and 103 (72%) were previously treated patients. The treatment regimen had to be modified in 122 (85%) patients. A successful outcome was achieved in 41 (28%) patients; 68 (48%) defaulted, 18 (13%) died, and 14 (10%) were still under treatment in 1996. CONCLUSIONS: The treatment approach described had dismal results. The capacity for performing drug susceptibility testing and the availability of several second-line anti-tuberculosis drugs were not sufficient to achieve cure in more than one third of the patients treated. Other factors, such as a set of standard procedures, clear guidelines for the treatment and follow-up of patients and the administration of directly observed treatment, must be included in a programme for treating MDR-TB, to obtain better treatment results.

Adult↗
PubMed2002

Patients hospitalised in Bolivia with pulmonary tuberculosis: risk factors for dying.

SETTING: The adult tuberculosis ward of a public hospital in the city of Santa Cruz, Bolivia. OBJECTIVES: To identify risk factors for dying among adult patients hospitalised with pulmonary tuberculosis. DESIGN: Hospital-based cross-sectional study of patients admitted consecutively with pulmonary tuberculosis during the period November 1993-February 1996. RESULTS: A total of 466 patients were admitted to the study. There were 305 (65%) males, and the mean age was 33.1. Seventy-five patients (16%) died during hospitalisation. Multiple logistic regression analysis identified the following predicting variables for death: associated pathology (odds ratio [OR] 2.88; 95% confidence interval [CI] 1.48-5.36), female sex (OR 2.08; 95%CI 1.23-3.52), and number of lobes affected (OR 1.48; 95%CI 1.23-1.79). CONCLUSIONS: These three variables predicting death allow us to identify patients with a diagnosis of pulmonary tuberculosis who should have priority for receiving hospital care. In Bolivia, physicians faced with a shortage of hospital beds should determine the presence or absence of this group of variables when evaluating patients for possible admission.

Adolescent↗
PubMed2001

Treatment of tuberculosis in a rural area of Haiti: directly observed and non-observed regimens. The experience of H pital Albert Schweitzer.

SETTING: Artibonite Valley, a rural area in Haiti. OBJECTIVE: To evaluate a tuberculosis control program in rural Haiti and to compare two strategies for treatment implemented in two areas that were not chosen at random: treatment delivered at the patients' homes observed by former tuberculosis patients (DOT), and non observed treatment (non-DOT). DESIGN: Retrospective analysis of the clinical records of adult patients diagnosed with tuberculosis at H pital Albert Schweitzer in Deschapelles, Haiti, during 1994-1995. RESULTS: There were 143 patients in the non-DOT group and 138 patients in the DOT group. The results of treatment were significantly different: in the non-DOT group 29% defaulted, 12% died and 58% had a successful outcome; in the DOT group 7% defaulted (P < 0.01), 4% died (P = 0.01) and 87% had a successful outcome (P < 0.01). These differences are also significant when considering only human immunodeficiency virus (HIV) infected patients (defaulted P < 0.01; died P = 0.09; successful outcome P < 0.01). CONCLUSION: Delivering treatment in patients' homes with direct observation by former tuberculosis patients can achieve good results, even in an area of extreme poverty and high rates of HIV infection. In this population the number of patients who are able to complete their treatment without observed administration is far from optimal.

Adult↗
PubMed2000

Patients with tuberculosis in Bolivia: why do they die?

The objective of this research was to analyze why patients with tuberculosis (TB) die and to evaluate whether there are factors contributing to their fatal outcome that could be corrected. A cross-sectional observational study was conducted of the patients with active TB or its sequelae admitted to the TB ward of the main public hospital in the city of Santa Cruz, Bolivia, over a 29-month period, from October 1993 through February 1996. The available records of the patients who died during hospitalization were reviewed. Out of 597 patients, 94 of them (15.7%) died. We examined the records of 90 of these 94 patients. Their mean age was 35.1 years (standard deviation, 16.7 years), and 45 of the patients (50.0%) were male. On admission 42 of the 90 patients (46.7%) had never been treated for TB or had received anti-TB treatment for less than one month, 23 (25.6%) had returned after having abandoned their TB treatment, 8 (8.9%) had had an erroneous diagnosis, 6 (6.7%) had tuberculosis sequelae, 6 (6.7%) were undergoing tuberculosis treatment, and 5 (5.6%) were known to have multidrug-resistant TB. Of the 90 patients, 83 (92.2%) had pulmonary tuberculosis (median lobes affected, 4), 6 (6.7%) had pleural tuberculosis, and 12 (13.3%) had extrapulmonary tuberculosis (some patients had more than one form of TB). Patients died a median of 5.5 days after entering the TB ward. The causes of death were: hemoptysis, 6 patients (6.7%); other tuberculosis-related causes, 65 patients (72.2%); drug reactions, 6 patients (6.7%); nontuberculosis causes, 6 patients (6.7%); and undetermined causes, 7 patients (7.8%). Factors possibly contributing to death were late diagnosis (38.9%), errors in follow-up (14.4%), and errors in treatment (24.4%). In conclusion, most patients with active or inactive TB admitted to our ward died as a consequence of tuberculosis. There were several factors possibly contributing to their fatal outcome that could be corrected.

Adult↗
PubMed2000

DOTS in Haiti.

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Antitubercular Agents↗
PubMed1999

A survey of prescribing patterns for tuberculosis treatment amongst doctors in a Bolivian city.

SETTING: A sample survey of knowledge about prescribing tuberculosis treatment among private physicians in the city of Santa Cruz, Bolivia. OBJECTIVES: To study the anti-tuberculosis regimens prescribed by private physicians and to assess the number of tuberculosis patients treated by them. DESIGN: Questionnaire survey of a random sample of 401 private physicians in Santa Cruz. RESULTS: Of the 401 physicians, 165 (41%) could not be located or did not want to participate. Among the 236 completed questionnaires, 137 physicians (58%) stated that they did not see patients with tuberculosis, 16 (7%) referred them to other centres and 83 (35%) treated them in their practice. Among 80 prescribed regimens that could be evaluated there were 58 different regimens: 17 (21%) followed the National Tuberculosis Control Programme's standard regimen, but overall 35 regimens (60%) were incorrect-18 regimens (31%) were non-curative and 17 (29%) could not be recommended. Frequent errors were the prescription of medications not available in the market (7%) or not included in the national regimen (34%), the prescription of insufficient medications (9%), or of only one in the continuation phase (16%), or for too short (9%), or too long (12%) a period. Eighty physicians estimated that they attended in their practice an average total of 404 patients with tuberculosis per month. CONCLUSIONS: A significant number of physicians in private practice did not adhere to the standard norms for prescribing anti-tuberculosis treatment. This study also suggests that in the city of Santa Cruz, Bolivia, there is a not insignificant number of patients with tuberculosis treated outside the National Tuberculosis Control Programme.

Antitubercular Agents↗
PubMed1996

First case of Lagochilascaris minor infection in Bolivia.

Few cases of human infection with Lagochilascaris minor have been reported in the literature. They occurred in Central and South America and the Caribbean. We describe the first patient with this nematode infection in Bolivia.

Adolescent↗
PubMed1994

Tuberculosis.

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Developing Countries↗
PubMed1994

The impact of HIV infection in a rural hospital in Haiti.

To assess the impact of the human immunodeficiency virus type 1 (HIV) infection on the patients treated at the Medicine Department of the Hôpital Albert Schweitzer (HAS) in Haiti and the economic costs to this institution that their medical care caused, a group of HIV infected patients was followed and compared to a control group of non-infected patients. Infected patients had a significantly higher number of diagnoses suggestive of HIV infection and of sexually transmitted diseases (STDs) and also had a higher rate of mortality during the follow-up period. Infected patients attended the out-patient Medicine Clinic and were hospitalized more frequently than non-infected patients. The yearly cost of treating an HIV patient was estimated to be about US $860. We suggest that a wider use of HIV testing might be beneficial among patients such as ours for providing adequate care for them if the necessary resources are made available.

Adult↗