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      Challenges on tuberculosis care in health care facilities during COVID-19 pandemic: Indonesian perspective

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          Abstract

          Indonesia is among the top three countries globally with the highest tuberculosis burden. During the past decades, Indonesian health authorities have struggled to improve tuberculosis care quality in health care facilities by optimizing the regulation and strengthening the private sector contributions. The coronavirus disease 2019 (COVID-19) pandemic has hardly affected the Indonesian health care system, including the National Tuberculosis Control Program. While the end of the COVID-19 pandemic in Indonesia is uncertain, the measure to control tuberculosis must not be weakened. Early identification and measurement of the problem size are essential to decide the most appropriate approach to maintain the sustainability of National Tuberculosis Control Program, particularly in health care facilities during the COVID-19 pandemic. This article points out the possible threats to the sustainability of TB care in Indonesia during the COVID-19 pandemic, including some approaches to overcome those problems.

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          Most cited references13

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          Coronavirus disease 2019 (COVID-19): A literature review

          In early December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan City, Hubei Province, China. On January 30, 2020 the World Health Organization declared the outbreak as a Public Health Emergency of International Concern. As of February 14, 2020, 49,053 laboratory-confirmed and 1,381 deaths have been reported globally. Perceived risk of acquiring disease has led many governments to institute a variety of control measures. We conducted a literature review of publicly available information to summarize knowledge about the pathogen and the current epidemic. In this literature review, the causative agent, pathogenesis and immune responses, epidemiology, diagnosis, treatment and management of the disease, control and preventions strategies are all reviewed.
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            Species distribution and susceptibility profile of Candida species in a Brazilian public tertiary hospital

            Background Species identification and antifungal susceptibility tests were carried out on 212 Candida isolates obtained from bloodstream infections, urinary tract infections and dialysis-associated peritonitis, from cases attended at a Brazilian public tertiary hospital from January 1998 to January 2005. Findings Candida albicans represented 33% of the isolates, Candida parapsilosis 31.1%, Candida tropicalis 17.9%,Candida glabrata 11.8%, and others species 6.2%. In blood culture, C. parapsilosis was the most frequently encountered species (48%). The resistance levels to the antifungal azoles were relatively low for the several species, except for C. tropicalis and C. glabrata. Amphotericin B resistance was observed in 1 isolate of C. parapsilosis. Conclusions The species distribution and antifungal susceptibility herein observed presented several epidemiological features common to other tertiary hospitals in Latin American countries. It also exhibited some peculiarity, such as a very high frequency of C. parapsilosis both in bloodstream infections and dialysis-associated peritonitis. C. albicans also occurred in an important number of case infections, in all evaluated clinical sources. C. glabrata presented a high proportion of resistant isolates. The data emphasize the necessity to carry out the correct species identification accompanied by the susceptibility tests in all tertiary hospitals.
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              New Coronavirus Variants are Creating More Challenges to Global Healthcare System: A Brief Report on the Current Knowledge

              The coronavirus is naturally mutating over time and producing new variants. Some of them are more contagious and destructive than previous strains. Also, some variants are capable of therapeutic escaping. Earlier SARS-CoV-2 variants proved that some are supercritical, and newly mutated strains are creating new challenges to the global healthcare systems. Here we aimed to evaluate different coronavirus variants and associated challenges for healthcare systems. We searched for information online and on the PubMed, Scopus, and Embase databases. We found the wild-type virus is more sensitive for neutralization and more controllable than newer variants. The Delta and Omicron variants are more highly transmissible than Alpha, Beta, and Gamma variants. Also, few strains are resistant to neutralization. Therefore, there is a chance of reinfection among the vaccinated population. The transmissibility and resistance of the recently identified Omicron variant is still unclear. The Delta variant is the most dangerous among all variants due to its high transmissibility, disease severity, and mortality rate. For poor and developing countries, oxygen supply, medication, vaccination, and device supply are challenging during epidemic waves. Slowing down the transmission, mass vaccination, vaccine redesign, re-compiling action plans, and following safety guidelines can be effective solutions to the new challenges.
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                Author and article information

                Journal
                Narra J
                Narra J
                NarraJ
                Narra J
                Narra Sains Indonesia
                2807-2618
                August 2022
                1 August 2022
                : 2
                : 2
                : e80
                Affiliations
                [1 ]Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
                [2 ]Faculty of Medicine, Universitas Malikussaleh, Lhokseumawe, Indonesia
                [3 ]Faculty of Medicine, Universitas Mataram, Indonesia
                [4 ]Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Indonesia, Jakarta, Indonesia
                [5 ]Genomic and Regenerative Medicine Center, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Japan
                [6 ]Kawakita General Hospital, Tokyo, Japan
                Author notes
                [* ]Corresponding author: wira.winardi@ 123456unsyiah.ac.id
                Article
                NarraJ-2-e80
                10.52225/narra.v2i2.80
                10914028
                38449701
                73585d27-8d99-4acf-97c3-eb4684204348
                © 2022 The Author(s).

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY NC 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited ( https://creativecommons.org/licenses/by-nc/4.0/).

                History
                : 20 April 2022
                : 31 July 2022
                Categories
                Review Article

                covid-19,tuberculosis,tuberculosis care,pandemic,health care disruption

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