Browsing by Author "Ramjee, A."

Now showing 1 - 2 of 2

Case series of the long-term psychosocial impact of drug-resistant tuberculosis in HIV-negative medical doctors.
(International Union against Tuberculosis and Lung Disease., 2010) Padayatchi, Nesri.; Daftary, Amrita.; Moodley, T.; Madansein, Rajhmun.; Ramjee, A.
BACKGROUND: Health care workers (HCWs) are at greater risk for tuberculosis (TB), including multidrug-resistant TB (MDR-TB), compared to the general population. The psychosocial impact of nosocomial TB on HCWs has received little attention in the literature. METHODS: A retrospective medical record review from 1999 to 2003 found 15 HCWs who were treated for drug-resistant TB at a specialist hospital in South Africa. Five human immunodeficiency virus (HIV) negative doctors with no predisposing factors for drug resistance are included in this case series. We collectively present their clinical case histories based on medical records from 2000 to 2005, and explore the long-term psychosocial impact of TB from interviews conducted in 2009. RESULTS: Four doctors had primary MDR-TB and one had primary resistance to multiple first-line drugs. Time from symptom onset to commencement of effective treatment ranged from 8 to 39 weeks. Time for bacteriological confirmation of drug-resistant TB ranged from 6 to 24 weeks. All were cured within 3 years of initial presentation. Content analysis of follow-up interviews revealed five main themes: 1) prolonged morbidity, 2) psychological impact, 3) poor infection control, 4) weak support structures and 5) attrition from the field. CONCLUSION: Themes emergent from this case series encourage prioritisation of TB infection control education and practice to minimise HCW morbidity and prevent HCW attrition from high-burden resource-constrained settings.
Pregnancies complicated by multidrug-resistant tuberculosis and HIV co-infection in Durban, South Africa.
(International Union against Tuberculosis and Lung Disease., 2006) Khan, Munira.; Moodley, Jagidesa.; Pillay, T.; Ramjee, A.; Padayatchi, Nesri.
SETTING: Tertiary hospitals in KwaZulu Natal, South Africa. OBJECTIVE: To study the impact of multidrug-resistant tuberculosis (MDR-TB) and human immunodeficiency virus-1 (HIV-1) co-infection during pregnancy on maternal and perinatal outcome. DESIGN: Prospective study performed between 1996 and 2001. Symptomatic pregnant women were investigated for TB. Those with confirmed MDR-TB were reported on. RESULTS: Three of five pregnant women with MDR-TB were HIV-1 co-infected. One woman decided to terminate the pregnancy and one experienced pre-term labour. Two neonates had features of growth restriction. CONCLUSION: Management of pregnant women with MDR-TB in an HIV-endemic area is possible in developing countries.