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Risk factors for high death and loss-to-follow-up rates among patients with multidrug-resistant tuberculosis at a programmatic management unit

Javaid A, Shaheen Z, Shafqat M, Khan AH, Ahmad N

Am J Infect Control, 2017 Feb 01;45(2):190-193.
PMID: 27769706 DOI: 10.1016/j.ajic.2016.07.026

Among 186 retrospectively evaluated patients with multidrug-resistant tuberculosis, 33.9% were cured, 6.6% completed treatment, 25% died, 18.3% were lost to follow-up, 2.2% failed treatment, and 13.8% were still undergoing treatment by the end of the study period. Rural residence was a risk factor for loss to follow-up (odds ratio [OR], 3.315; P = .016), whereas baseline body weight <40 kg (OR, 2.175; P = .042) and resistance to ofloxacin (OR, 2.889; P = .025) were risk factors for death. Despite programmatic management, treatment outcomes of the current cohort were distressing.
Fulltext How self leadership enhances normative commitment and work performance by engaging people at work?

Inam A, Ho JA, Sheikh AA, Shafqat M, Najam U

Curr Psychol, 2023;42(5):3596-3609.
PMID: 33867780 DOI: 10.1007/s12144-021-01697-5

Leadership and its connection with social sustainability are frequently prescribed for effective management. Integrating self-leadership among the employees is an emerging area to focus on empowering an organization. The principal objective of this study was to empirically investigate the impact of self-leadership on normative commitment and work performance through the mediating role of work engagement. This phenomenon of self-leadership was explained by using the theoretical lens of the social cognitive theory and intrinsic motivation theory. Data was collected from 318 employees who worked in the telecom sector in Pakistan and analyzed using Structural Equation Modeling (SEM) AMOS. The findings revealed that in the presence of self-leadership, employee's work engagement, commitment to the organization, and overall work performance elevated significantly. Furthermore, the results also illustrated the occurrence of two significant mediating paths. First, the mediating role of work engagement in the relationship between self-leadership and normative commitment, and second, the mediation of work engagement in the relationship between self-leadership and work performance. The findings of the study significantly contribute practically, and theoretically to the existing literature.
Fulltext Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan

Massud A, Khan AH, Syed Sulaiman SA, Ahmad N, Shafqat M, Ming LC

PLoS One, 2023;18(8):e0287966.
PMID: 37561810 DOI: 10.1371/journal.pone.0287966

INTRODUCTION: Tuberculosis (TB), a curable and preventable infectious disease, becomes difficult to treat if resistance against most effective and tolerable first line anti-TB drugs is developed. The objective of the present study was to evaluate the treatment outcomes and predictors of poor outcomes among drug-resistant tuberculosis (DR-TB) patients treated at a programmatic management unit of drug resistant tuberculosis (PMDT) unit, Punjab, Pakistan.
METHODS: This prospective observational study was conducted at a a PMDT unit in Multan, Punjab, Pakistan. A total of 271 eligible culture positive DR-TB patients enrolled for treatment at the study site between January 2016 and May 2017 were followed till their treatment outcomes were recorded. World Health Organization's (WHO) defined criteria was used for categorizing treatment outcomes. The outcomes of cured and treatment completed were collectively placed as successful outcomes, while death, lost to follow-up (LTFU) and treatment failure were grouped as unsuccessful outcomes. Multivariable binary logistic regression analysis was employed for getting predictors of unsuccessful treatment outcomes. A p-value <0.05 was considered statistically significant.
RESULTS: Of the 271 DR-TB patients analysed, nearly half (51.3%) were males. The patient's (Mean ± SD) age was 36.75 ± 15.69 years. A total of 69% patients achieved successful outcomes with 185 (68.2%) patients being cured and 2 (0.7%) completed therapy. Of the remaining 84 patients with unsuccessful outcomes, 48 (17.7%) died, 2 (0.7%) were declared treatment failure, 34 (12.5%) were loss to follow up. After adjusting for confounders, patients' age > 50 years (OR 2.149 (1.005-4.592) with p-value 0.048 and baseline lung cavitation (OR 7.798 (3.82-15.919) with p-value <0.001 were significantly associated with unsuccessful treatment outcomes.
CONCLUSIONS: The treatment success rate (69%) in the current study participants was below the target set by WHO (>75%). Paying special attention and timely intervention in patients with high risk of unsuccessful treatment outcomes may help in improving treatment outcomes at the study site.

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