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Oberleitner LM, Lucia VC, Navin MC, Ozdych M, M. Afonso N, Kennedy RH, Keil H, Wu L, Mathew TA. COVID-19 Vaccination Concerns and Reasons for Acceptance Among US Health Care Personnel. Public Health Rep 2022; 137:1227-1234. [PMID: 36073241 PMCID: PMC9459372 DOI: 10.1177/00333549221120590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Because health care personnel (HCP) are potentially at increased risk of contracting COVID-19, high vaccination rates in this population are essential. The objective of this study was to assess vaccination status, barriers to vaccination, reasons for vaccine acceptance, and concerns about COVID-19 vaccination among HCP. METHODS We conducted an anonymous online survey at a large US health care system from April 9 through May 4, 2021, to assess COVID-19 vaccination status and endorsement of reasons for acceptance and concerns related to vaccination (based on selections from a provided list). RESULTS A total of 4603 HCP (12.2% response rate) completed the survey, 3947 (85.7%) had received at least 1 dose of a COVID-19 vaccine at the time of the survey, and 550 (11.9%) reported no plans to receive the vaccine. Unvaccinated HCP were 30 times more likely than vaccinated HCP to endorse religious or personal beliefs as a vaccine concern (odds ratio = 30.95; 95% CI, 21.06-45.48) and 15 times more likely to believe that personal vaccination is not needed if enough others are vaccinated (odds ratio = 14.99; 95% CI, 10.84-20.72). The more reasons endorsed for vaccination (ß = 0.60; P < .001), the higher the likelihood of having received the vaccine. However, the number of concerns about COVID-19 vaccine was not related to vaccination status (ß = 1.01; P = .64). CONCLUSIONS Our findings suggest that reasons for vaccination acceptance and concerns about vaccination need to be considered to better understand behavioral choices related to COVID-19 vaccination among HCP, because these beliefs may affect vaccination advocacy, responses to vaccine mandates, and promotion of COVID-19 vaccine boosters.
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Affiliation(s)
| | - Victoria C. Lucia
- William Beaumont School of Medicine, Oakland University, Rochester, MI, USA
| | - Mark C. Navin
- William Beaumont School of Medicine, Oakland University, Rochester, MI, USA
- Department of Philosophy, Oakland University, Rochester, MI, USA
- Beaumont Health, Royal Oak, MI, USA
| | | | - Nelia M. Afonso
- William Beaumont School of Medicine, Oakland University, Rochester, MI, USA
| | - Richard H. Kennedy
- William Beaumont School of Medicine, Oakland University, Rochester, MI, USA
- Beaumont Health, Royal Oak, MI, USA
| | | | | | - Trini A. Mathew
- William Beaumont School of Medicine, Oakland University, Rochester, MI, USA
- Beaumont Health, Royal Oak, MI, USA
- HealthTAMCycle3 PLLC, Troy, MI, USA
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Navin MC, Oberleitner LMS, Lucia VC, Ozdych M, Afonso N, Kennedy RH, Keil H, Wu L, Mathew TA. COVID-19 Vaccine Hesitancy Among Healthcare Personnel Who Generally Accept Vaccines. J Community Health 2022; 47:519-529. [PMID: 35277813 PMCID: PMC8916908 DOI: 10.1007/s10900-022-01080-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 12/16/2022]
Abstract
To identify psychological antecedents of COVID-19 vaccine hesitancy among healthcare personnel (HCP). We surveyed 4603 HCP to assess psychological antecedents of their vaccination decisions (the ‘5 Cs’) for vaccines in general and for COVID-19 vaccines. Most HCP accept vaccines, but many expressed hesitancy about COVID-19 vaccines for the psychological antecedents of vaccination: confidence (vaccines are effective), complacency (vaccines are unnecessary), constraints (difficult to access), calculation (risks/benefits), collective responsibility (need for vaccination when others vaccinate). HCP who were hesitant only about COVID-19 vaccines differed from HCP who were consistently hesitant: those with lower confidence were more likely to be younger and women, higher constraints were more likely to have clinical positions, higher complacency were more likely to have recently cared for COVID-19 patients, and lesser collective responsibility were more likely to be non-white. These results can inform interventions to encourage uptake of COVID-19 vaccines in HCP.
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Mathew TA, Hopkins J, Kamerer D, Ali SN, Ortiz D, Johnson P, Chittick P, Carpenter CF. 458. Molecular SARS-CoV-2 Testing During the COVID-19 Outbreak: Experiences of a Hospital in Southeast Michigan, USA. Open Forum Infect Dis 2020. [PMCID: PMC7777634 DOI: 10.1093/ofid/ofaa439.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARS-CoV-2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the positivity rate reached 68% by the end of March (Figure 1). Many state and hospital initiatives were implemented during the outbreak, including social distancing and screening of asymptomatic patients to increase case-finding and prevent transmission. We also adopted a process for clinical review of symptomatic patients who initially tested negative for SARS-CoV-2 by a group of infectious disease physicians (Figure 2). This process was expanded to include other trained clinicians who were redeployed from other departments in the hospital. Repeat testing was performed to allow consideration of discontinuation of isolation precautions. During the surge of community cases from March 16 to April 30, 2020, we identified patients with negative PCR tests who subsequently had repeat testing based on clinical evaluation, with 7.1% (39/551) returning positive for SARS- CoV2. Of the patients who expired due to COVID-19 during this period, 4.3% (9/206) initially tested negative before ultimately testing positive. Figure 1 BH RO testing Epicurve ![]()
Figure 2: Screening tool for repeat COVID19 testing and precautions ![]()
Conclusion Many state and hospital initiatives helped us flatten the curve for COVID-19. Our hospital testing experience indicate that repeat testing may be warranted for those patients with clinical features suggestive of COVID-19. We will further analyze these cases and clinical features that prompted repeat testing. Disclosures All Authors: No reported disclosures
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Tan TQ, Kullar R, Swartz TH, Mathew TA, Piggott DA, Berthaud V. Location Matters: Geographic Disparities and Impact of Coronavirus Disease 2019. J Infect Dis 2020; 222:1951-1954. [PMID: 32942299 PMCID: PMC7543383 DOI: 10.1093/infdis/jiaa583] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/11/2020] [Indexed: 11/12/2022] Open
Abstract
The COVID-19 pandemic in the United States has revealed major disparities in the access to testing and messaging about the pandemic based on the geographic location of individuals, particularly in communities of color, rural areas, and areas of low income. This geographic disparity, in addition to deeply rooted structural inequities, have posed additional challenges to adequately diagnose and provide care for individuals of all ages living in these settings. We describe the impact that COVID-19 has had on geographic disparate populations in the United States and share our recommendations to what might be done to ameliorate the current situation.
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Affiliation(s)
- Tina Q Tan
- Feinberg School of Medicine, Northwestern University, Department of Pediatrics, Division of Infectious Diseases, Chicago, Illinois, USA
| | | | - Talia H Swartz
- Icahn School of Medicine at Mount Sinai, Department of Medicine, Division of Infectious Diseases, New York, New York, USA
| | - Trini A Mathew
- Division of Infectious Diseases and International Medicine, Beaumont Hospital, Royal Oak, Michigan, USA
| | - Damani A Piggott
- Johns Hopkins University School of Medicine, Department of Medicine, Division of Infectious Diseases, Baltimore, Maryland, USA
| | - Vladimir Berthaud
- Meharry Medical College, Department of Medicine, Division of Infectious Diseases, Nashville, Tennessee, USA
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Kullar R, Marcelin JR, Swartz TH, Piggott DA, Macias Gil R, Mathew TA, Tan T. Racial Disparity of Coronavirus Disease 2019 in African American Communities. J Infect Dis 2020; 222:890-893. [PMID: 32599614 PMCID: PMC7337812 DOI: 10.1093/infdis/jiaa372] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/23/2020] [Indexed: 12/27/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has unveiled unsettling disparities in the outcome of the disease among African Americans. These disparities are not new but are rooted in structural inequities that must be addressed to adequately care for communities of color. We describe the historical context of these structural inequities, their impact on the progression of COVID-19 in the African American (black) community, and suggest a multifaceted approach to addressing these healthcare disparities. (Of note, terminology from survey data cited for this article varied from blacks, African Americans, or both; for consistency, we use African Americans throughout.)
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Affiliation(s)
| | - Jasmine R Marcelin
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Talia H Swartz
- Icahn School of Medicine at Mount Sinai, Department of Medicine, Division of Infectious Diseases, New York, New York, USA
| | - Damani A Piggott
- Johns Hopkins University School of Medicine, Department of Medicine, Division of Infectious Diseases, Baltimore, Maryland, USA
| | - Raul Macias Gil
- Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, Rhode Island, USA
| | - Trini A Mathew
- Division of Infectious Diseases and International Medicine, Beaumont Hospital, Royal Oak, Michigan, USA
| | - Tina Tan
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Sosa LE, Njie GJ, Lobato MN, Morris SB, Buchta W, Casey ML, Goswami ND, Gruden M, Hurst BJ, Khan AR, Kuhar DT, Lewinsohn DM, Mathew TA, Mazurek GH, Reves R, Paulos L, Thanassi W, Will L, Belknap R. Tuberculosis screening, testing, and treatment of U.S. health care personnel: Recommendations from the National Tuberculosis Controllers Association and
CDC
, 2019. Am J Transplant 2019. [DOI: 10.1111/ajt.15512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Lynn E. Sosa
- Connecticut Department of Public Health Hartford Connecticut
- National Tuberculosis Controllers Association Smyrna Georgia
| | - Gibril J. Njie
- Division of Tuberculosis Elimination National Center for HIV/AIDS Viral Hepatitis, STD, and TB Prevention CDC Atlanta Georgia
| | - Mark N. Lobato
- National Tuberculosis Controllers Association Smyrna Georgia
| | - Sapna Bamrah Morris
- Division of Tuberculosis Elimination National Center for HIV/AIDS Viral Hepatitis, STD, and TB Prevention CDC Atlanta Georgia
| | - William Buchta
- Logistics Health Incorporated La Crosse Wisconsin
- American College of Occupational and Environmental Medicine Elk Grove Village Illinois
| | - Megan L. Casey
- Respiratory Health Division National Institute for Occupational Safety and Health CDC Atlanta Georgia
| | - Neela D. Goswami
- Division of Tuberculosis Elimination National Center for HIV/AIDS Viral Hepatitis, STD, and TB Prevention CDC Atlanta Georgia
| | - MaryAnn Gruden
- Association of Occupational Health Professionals in Healthcare Warrendale Pennsylvania
| | - Bobbi Jo Hurst
- Association of Occupational Health Professionals in Healthcare Warrendale Pennsylvania
| | - Amera R. Khan
- Division of Tuberculosis Elimination National Center for HIV/AIDS Viral Hepatitis, STD, and TB Prevention CDC Atlanta Georgia
| | - David T. Kuhar
- Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic Infectious Diseases CDC Atlanta Georgia
| | | | | | - Gerald H. Mazurek
- Division of Tuberculosis Elimination National Center for HIV/AIDS Viral Hepatitis, STD, and TB Prevention CDC Atlanta Georgia
| | - Randall Reves
- National Tuberculosis Controllers Association Smyrna Georgia
- Denver Health and Hospital Authority Denver Public Health Denver Colorado
| | - Lisa Paulos
- National Tuberculosis Controllers Association Smyrna Georgia
- Maryland Department of Health Baltimore Maryland
| | - Wendy Thanassi
- National Tuberculosis Controllers Association Smyrna Georgia
- Veterans Administration Palo Alto Healthcare System Palo Alto California
| | - Lorna Will
- National Tuberculosis Controllers Association Smyrna Georgia
| | - Robert Belknap
- National Tuberculosis Controllers Association Smyrna Georgia
- Denver Health and Hospital Authority Denver Public Health Denver Colorado
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Sosa LE, Njie GJ, Lobato MN, Bamrah Morris S, Buchta W, Casey ML, Goswami ND, Gruden M, Hurst BJ, Khan AR, Kuhar DT, Lewinsohn DM, Mathew TA, Mazurek GH, Reves R, Paulos L, Thanassi W, Will L, Belknap R. Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. MMWR Morb Mortal Wkly Rep 2019; 68:439-443. [PMID: 31099768 PMCID: PMC6522077 DOI: 10.15585/mmwr.mm6819a3] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Crook PR, Swink CD, Freedman K, Koval L, Vivian K, Mason LC, Hoegg L, Rearick JA, Mathew TA. Lessons from the Field: Challenges and Solutions to Active Surveillance Culturing of Duodenoscopes in Endoscopic Retrograde Cholangiopancreatography (ERCP). Am J Infect Control 2016. [DOI: 10.1016/j.ajic.2016.04.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mason LC, Petrovich H, Hoegg L, Dodson T, Rearick JA, Mathew TA, Vivian K, Crook PR. Lessons from the Field: Surveillance Cultures of Heater Cooler Units Used in Cardiothoracic Surgery. Am J Infect Control 2016. [DOI: 10.1016/j.ajic.2016.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Suhadev M, Thomas BE, Raja Sakthivel M, Murugesan P, Chandrasekaran V, Charles N, Durga R, Auxilia M, Mathew TA, Wares F. Alcohol use disorders (AUD) among tuberculosis patients: a study from Chennai, South India. PLoS One 2011; 6:e19485. [PMID: 21611189 PMCID: PMC3096635 DOI: 10.1371/journal.pone.0019485] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 04/08/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Alcohol Use Disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. Studies from Tuberculosis Research Centre (TRC), Chennai have reported that alcoholism has been one of the major reasons for default and mortality in under the DOTS programme in South India. Hence, it is planned to conduct a study to estimate prevalence of alcohol use and AUDs among TB patients attending the corporation health centres in Chennai, India. METHODOLOGY This is a cross-sectional cohort study covering 10 corporation zones at Chennai and it included situational assessment followed by screening of TB patients by a WHO developed Alcohol Use Disorders Identification Test AUDIT scale. Four zones were randomly selected and all TB patients treated during July to September 2009 were screened with AUDIT scale for alcohol consumption. RESULTS Out of 490 patients, 66% were males, 66% were 35 years and above, 57% were married, 58% were from the low monthly income group of 8. Age (>35 years), education (less educated), income (CONCLUSIONS AUD among TB patients needs to be addressed urgently and the findings suggest the importance of integrating alcohol treatment into TB care.
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Shin SS, Mathew TA, Yanova GV, Fitzmaurice GM, Livchits V, Yanov SA, Strelis AK, Mishustin SP, Bokhan NA, Lastimoso CS, Connery HS, Hart JE, Greenfield SF. Alcohol consumption among men and women with tuberculosis in Tomsk, Russia. Cent Eur J Public Health 2010; 18:132-8. [PMID: 21033607 DOI: 10.21101/cejph.a3590] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Drinking behavior among Russian women remains poorly described. We analyzed gender differences in alcohol use among 374 tuberculosis patients in Tomsk, Siberia. Twenty-six (28.3%) women had lifetime alcohol abuse or dependence, compared with 70.6% of men. Women with alcohol use disorders drank 12.7 +/- 14.0 standard drinks per day and > or = 34.6% drank 2 three days per week. Among individuals with a lifetime alcohol use disorder, age of onset and typical consumption did not differ significantly by gender. We conclude that Russian women with alcohol use disorders consume almost as much alcohol as men and may be at greater risk for negative social and medical consequences.
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Affiliation(s)
- Sonya S Shin
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA 02115, USA.
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12
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Greenfield SF, Shields A, Connery HS, Livchits V, Yanov SA, Lastimoso CS, Strelis AK, Mishustin SP, Fitzmaurice G, Mathew TA, Shin S. Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients: Design and Implementation. Alcohol Clin Exp Res 2010; 34:317-30. [PMID: 19930235 PMCID: PMC2898509 DOI: 10.1111/j.1530-0277.2009.01094.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND While the integration of alcohol screening, treatment, and referral in primary care and other medical settings in the U.S. and worldwide has been recognized as a key health care priority, it is not routinely done. In spite of the high co-occurrence and excess mortality associated with alcohol use disorders (AUDs) among individuals with tuberculosis (TB), there are no studies evaluating effectiveness of integrating alcohol care into routine treatment for this disorder. METHODS We designed and implemented a randomized controlled trial (RCT) to determine the effectiveness of integrating pharmacotherapy and behavioral treatments for AUDs into routine medical care for TB in the Tomsk Oblast Tuberculosis Service (TOTBS) in Tomsk, Russia. Eligible patients are diagnosed with alcohol abuse or dependence, are newly diagnosed with TB, and initiating treatment in the TOTBS with Directly Observed Therapy-Short Course (DOTS) for TB. Utilizing a factorial design, the Integrated Management of Physician-delivered Alcohol Care for Tuberculosis Patients (IMPACT) study randomizes eligible patients who sign informed consent into 1 of 4 study arms: (1) Oral Naltrexone + Brief Behavioral Compliance Enhancement Therapy (BBCET) + treatment as usual (TAU), (2) Brief Counseling Intervention (BCI) + TAU, (3) Naltrexone + BBCET + BCI + TAU, or (4) TAU alone. RESULTS Utilizing an iterative, collaborative approach, a multi-disciplinary U.S. and Russian team has implemented a model of alcohol management that is culturally appropriate to the patient and TB physician community in Russia. Implementation to date has achieved the integration of routine alcohol screening into TB care in Tomsk; an ethnographic assessment of knowledge, attitudes, and practices of AUD management among TB physicians in Tomsk; translation and cultural adaptation of the BCI to Russia and the TB setting; and training and certification of TB physicians to deliver oral naltrexone and brief counseling interventions for alcohol abuse and dependence as part of routine TB care. The study is successfully enrolling eligible subjects in the RCT to evaluate the relationship of integrating effective pharmacotherapy and brief behavioral intervention on TB and alcohol outcomes, as well as reduction in HIV risk behaviors. CONCLUSIONS The IMPACT study utilizes an innovative approach to adapt 2 effective therapies for treatment of alcohol use disorders to the TB clinical services setting in the Tomsk Oblast, Siberia, Russia, and to train TB physicians to deliver state of the art alcohol pharmacotherapy and behavioral treatments as an integrated part of routine TB care. The proposed treatment strategy could be applied elsewhere in Russia and in other settings where TB control is jeopardized by AUDs. If demonstrated to be effective, this model of integrating alcohol interventions into routine TB care has the potential for expanded applicability to other chronic co-occurring infectious and other medical conditions seen in medical care settings.
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Affiliation(s)
- Shelly F Greenfield
- Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, MA 02478, USA.
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Mathew TA, Shields AL, Imasheva A, Shin SS, Furin JJ, Mishustin SP, Peremitin GG, Strelis AK, Yanova GV, Greenfield SF. Knowledge, attitudes, and practices of physicians in Tomsk Oblast tuberculosis services regarding alcohol use among tuberculosis patients in Tomsk, Russia. Cult Med Psychiatry 2009; 33:523-37. [PMID: 19768525 PMCID: PMC3042364 DOI: 10.1007/s11013-009-9148-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In recent years, the Russian Federation has seen a dramatic rise in morbidity and mortality from tuberculosis (TB), attributed in part to an increase in alcohol use disorders (AUDs), which are associated with worse TB treatment outcomes. This study describes the knowledge, attitudes and practices of physicians who treat TB patients in Tomsk, Russia. We conducted semistructured interviews with 16 TB physicians and 1 addiction specialist. Interviews were audiorecorded, transcribed, translated and systematically analyzed. We identified four key domains: definitions of alcohol use and abuse and physicians' knowledge, attitudes and practices regarding these problems. Physicians described patients as largely precontemplative and reluctant to seek treatment. Physicians recognized their limited knowledge in diagnosing and treating AUDs but expressed interest in acquiring these skills. Few options are currently available for treatment of AUDs in TB patients in Tomsk. These findings suggest that Tomsk physicians are aware of the need to engage AUDs in TB patients but identify a knowledge gap that restricts their ability to do so. Training TB physicians to use simple screening instruments and deliver evidence-based alcohol interventions improves TB outcomes among patients with co-occurring AUDs.
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Affiliation(s)
- Trini A. Mathew
- Division of Infectious Diseases, University of Mississippi Medical Center, 2500 North State Street, Jackson, Mississippi 39216, United States of America
| | - Alan L. Shields
- Department of Psychology, East Tennessee State University, Box 70649, Johnson City, Tennessee 37614, United States of America
| | - Aizhan Imasheva
- 1230 13th Street, Apt 918, NW, Washington, District of Columbia 20005, United States of America
| | - Sonya S. Shin
- Division of Social Medicine and Health Inequalities, Brigham and Women's Hospital, 651 Huntington Avenue, Boston, Massachusetts 02115, United States of America
| | - Jennifer J. Furin
- Division of Social Medicine and Health Inequalities, Brigham and Women's Hospital, 651 Huntington Avenue, Boston, Massachusetts 02115, United States of America
| | - Sergey P. Mishustin
- Tomsk Oblast Tuberculosis Services, R. Luxembourg 17, Tomsk, Tomsk Oblast, 634009, Russian Federation
| | - Gennady G. Peremitin
- Tomsk Oblast Tuberculosis Services, R. Luxembourg 17, Tomsk, Tomsk Oblast, 634009, Russian Federation
| | - Aivar K. Strelis
- Tuberculosis and Pulmonology Department, Siberian State Medical University, Moskovky trakt 2, Tomsk, Tomsk Oblast, 634050, Russian Federation
| | - Galina V. Yanova
- Tomsk Oblast Clinical Tuberculosis Hospital, Ul. Novaya 1, Timiryazevo, Tomsk, Tomsk Oblast, 634510, Russian Federation
| | - Shelly F. Greenfield
- Harvard Medical School, Alcohol and Drug Abuse Treatment Program, McLean Hospital, 115 Mill Street, Belmont, Massachusetts 02478, United States of America
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Mathew TA, Yanov SA, Mazitov R, Mishustin SP, Strelis AK, Yanova GV, Golubchikova VT, Taran DV, Golubkov A, Shields AL, Greenfield SF, Shin SS. Integration of alcohol use disorders identification and management in the tuberculosis programme in Tomsk Oblast, Russia. Eur J Public Health 2008; 19:16-8. [PMID: 19112073 DOI: 10.1093/eurpub/ckn093] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Alcohol use disorders (AUDs) among tuberculosis (TB) patients are associated with nonadherence and poor treatment outcomes. We developed a multidisciplinary model to manage AUDs among TB patients in Tomsk, Russia. First, we assessed current standards of care through stakeholder meetings and ethnographic work. The Alcohol Use Disorders Identification Test (AUDIT) was incorporated into routine assessment of all patients starting TB treatment. We established treatment algorithms based on AUDIT scores. We then hired specialists and addressed licensing requirements to provide on-site addictions care. Our experience offers a successful model in the management of co-occurring AUDs among patients with chronic medical problems.
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Affiliation(s)
- Trini A Mathew
- Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Mathew TA, Ovsyanikova TN, Shin SS, Gelmanova I, Balbuena DA, Atwood S, Peremitin GG, Strelis AK, Murray MB. Causes of death during tuberculosis treatment in Tomsk Oblast, Russia. Int J Tuberc Lung Dis 2006; 10:857-63. [PMID: 16898369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
SETTING Tuberculosis (TB) incidence and mortality in Russia have risen dramatically over the past 15 years. OBJECTIVE To identify risk factors and causes of death among TB patients in Russia. DESIGN A retrospective study conducted to determine the risk factors and causes of death in patients receiving TB therapy in Tomsk, Siberia. RESULTS Of 1916 patients who initiated treatment between 1 January 2002 and 31 December 2003, 183 (9.6%) died during treatment, 38 (21%) in the first week of therapy. Twenty-five per cent of deaths were not directly attributable to TB. Risk factors for death included older age, previous treatment for TB, multidrug resistance and alcoholism. CONCLUSIONS The high death rate during TB treatment observed in this cohort likely reflects an increased risk of dying not only from TB, but also from comorbid conditions, such as alcoholism and cardiovascular disease. Overall, alcoholism and late presentation both contributed substantially to the mortality in this cohort.
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Affiliation(s)
- T A Mathew
- Brigham and Women's Hospital, Boston, Massachusetts, USA.
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Tandon S, Mathew TA. Effect of acid-etching on fluoride-treated caries-like lesions of enamel: a SEM study. ASDC J Dent Child 1997; 64:344-8. [PMID: 9391712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Etching patterns by 20 percent phosphoric acid on caries-like lesions of enamel (white spot) untreated and treated with 0.4 APF were studied at 30, 60, 120 seconds of etch-times using the Scanning Electron Microscope (SEM). The surface topography of acid-etched teeth varied according to the etch time. Acid etching of caries-like lesions treated with fluoride showed etching patterns similar to sound enamel. Based on Silverstone's classification, thirty seconds etch-time produced type III pattern of surface morphology, while type I and type II were observed with 60 and 120 seconds of etch time. Fluoride treated lesions showed increased porosity and in addition to a surface coating of numerous small globules of calcium fluoride. Low level of topical fluoride before sealant application should be beneficial, since this allows a more rapid rate and increased degree of remineralization and possible arrest in the progress of caries lesions.
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Affiliation(s)
- S Tandon
- Department of Pedodontics and Preventive Dentistry, College of Dental Surgery, Kasturba Medical College, Manipal, India
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Samraj T, Mathew TA, Nair S. Ameloblastoma arising from a dental cyst. J Indian Dent Assoc 1985; 57:213-6. [PMID: 3865965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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