METHODS: This is a retrospective cohort study among TB with Comorbidities cases in Negeri Sembilan using multiple secondary surveillance databases: National Tuberculosis Registry (NTBR), National Aids Registry (NAR) and National Diabetic Registry (NDR). The data review was from April 2024 until June 2024. All registered TB cases with comorbidities in Negeri Sembilan from the year 2018 to 2023 were analysed to determine the determinants of successful TB treatment among TB with comorbidities patients.
RESULTS: Out of 712 TB cases with comorbidities, 541 (76.0%) achieved a successful TB treatment outcome, and 171 (24.0%) did not. The successful TB treatment among TB with comorbidities showed predominantly among male (72.5%), Malay ethnicity (65.4%), secondary education level (60.3%), and unemployed working status (70.1%). Diabetes mellitus (DM) was the most common comorbidity (70.4%), followed by hypertension (44.8%), dyslipidaemia (36.0%), HIV (19.5%), and viral hepatitis (18.1%). Factors significantly associated with successful TB treatment were those who had a secondary education level (AOR: 2.222; 95% CI: 1.129, 4.374) and a tertiary education level (AOR: 4.474; 95% CI: 1.428- 14.01), were diagnosed with TB in the government hospital (AOR: 0.053; 95% CI: 0.008-0.376), and were not done Acid- Fast Bacillus sputum in the intensive phase of treatment (AOR: 0.191; 95% CI: 0.046, 0.785), cases followed the Directly Observed Therapy at the intensive phase (AOR: 9.045; 95% CI: 4.604, 17.770), and the treatment duration was more than 6 months (AOR: 6.511; 95% CI: 3.383, 12.532).
CONCLUSION: The successful treatment outcome for TB with comorbidities still falls short of the target and, if not treated well, could potentially lead to prolonged disease transmission, higher mortality rates, and increased healthcare costs. Identifying the proportion of successful treatment rates and their determinants provides insight into the disease burden and helps the public health sector and medical professionals assess and take appropriate action to improve local integration and collaborative service approaches for TB patients with concurrent comorbidities.
METHODS: This was a retrospective analysis of long COVID data collected by the Port Dickson District Health Office between 1 September 2021 to 31 October 2021. Monitoring long COVID symptoms was our quality improvement initiative to safeguard residents' health in the district. The study population was patients previously diagnosed with COVID-19 who resided in Port Dickson. The inclusion criteria were adults aged 18 years and above and were in the fifth week (day 29 to 35) post-COVID-19 diagnosis during the data collection period. We called all consecutive eligible patients to inquire regarding long COVID symptoms. Long COVID was defined as new or ongoing symptoms lasting more than 28 days from the date of positive SARS-CoV-2 by polymerase chain reaction test. Binary multivariate logistic regression was conducted to determine factors associated with long COVID.
RESULTS: Among 452 patients, they were predominantly male (54.2%), Malays (68.8%) and aged 18-29 years (58.6%). A total of 27.4% (95% CI [23.4-31.8]) of patients experienced long COVID symptoms and were referred to government clinics. The most frequent long COVID symptoms experienced were fatigue (54.0%), cough (20.2%), muscle pain (18.5%), headache (17.7%) and sleep disturbance (16.1%). Females, patients with underlying cardiovascular disease, asthma and chronic obstructive airway disease, those who received symptomatic care, and patients with myalgia and headaches at COVID-19 diagnosis were more likely to have long COVID. Three patients with suspected severe mental health problems were referred to the district psychologist, and ten patients with no/incomplete vaccination were referred for vaccination.
CONCLUSION: Long COVID is highly prevalent among COVID-19 patients in Port Dickson, Malaysia. Long-term surveillance and management of long COVID, especially among the high-risk groups, are needed as we transition to living with COVID-19.