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https://www.readbyqxmd.com/read/28821264/impact-of-early-initiation-versus-national-standard-of-care-of-antiretroviral-therapy-in-swaziland-s-public-sector-health-system-study-protocol-for-a-stepped-wedge-randomized-trial
#1
Fiona J Walsh, Till Bärnighausen, Wim Delva, Yvette Fleming, Gavin Khumalo, Charlotte L Lejeune, Sikhathele Mazibuko, Charmaine Khudzie Mlambo, Ria Reis, Donna Spiegelman, Mandisa Zwane, Velephi Okello
BACKGROUND: There is robust clinical evidence to support offering early access to antiretroviral treatment (ART) to all HIV-positive individuals, irrespective of disease stage, to both improve patient health outcomes and reduce HIV incidence. However, as the global treatment guidelines shift to meet this evidence, it is still largely unknown if early access to ART for all (also referred to as "treatment as prevention" or "universal test and treat") is a feasible intervention in the resource-limited countries where this approach could have the biggest impact on the course of the HIV epidemics...
August 18, 2017: Trials
https://www.readbyqxmd.com/read/28817643/peripheral-clinic-versus-centralized-laboratory-based-xpert-mtb-rif-performance-experience-gained-from-a-pragmatic-stepped-wedge-trial-in-botswana
#2
Tefera Agizew, Rosanna Boyd, Ndwapi Ndwapi, Andrew Auld, Joyce Basotli, Sambayawo Nyirenda, Zegabriel Tedla, Anikie Mathoma, Unami Mathebula, Chawangwa Lesedi, Sherri Pals, Anand Date, Heather Alexander, Thomas Kuebrich, Alyssa Finlay
BACKGROUND: In 2011, the Botswana National Tuberculosis Program adopted World Health Organization guidelines and introduced Xpert MTB/RIF (Xpert) assay to support intensified case finding among people living with HIV enrolling in care. An evaluation was designed to assess performance under operational conditions to inform the national Xpert scale-up. METHODS: Xpert was implemented from August 2012 through November 2014 with 13 GeneXpert instruments (GeneXpert) deployed in a phased approach over nine months: nine centralized laboratory and four point-of-care (POC) peripheral clinics...
2017: PloS One
https://www.readbyqxmd.com/read/28807020/feasibility-study-of-strengthening-the-public-private-partnership-for-tuberculosis-case-detection-in-bandung-city-indonesia
#3
Bony Wiem Lestari, Nita Arisanti, Adiatma Y M Siregar, Estro Dariatno Sihaloho, Gelar Budiman, Philip C Hill, Bachti Alisjahbana, Susan McAllister
OBJECTIVE: Private practitioner's (PPs) collaboration for detection, diagnosis and treatment of tuberculosis (TB) is recommended by the World Health Organization and encouraged by the Indonesian National TB control programme. TB case management by PPs, however, are mostly not in line with current guidelines. Therefore, we developed an intervention package for PPs comprising of TB training, implementation of a mobile phone application for notification of TB cases and a 6-month regular follow-up with PPs...
August 14, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28797860/palliative-care-for-tuberculosis
#4
Stephen R Connor
In 2014, 1.5 million people died of tuberculosis (TB) worldwide including 400,000 co-infected with HIV. TB remains a major cause of death and suffering globally, in spite of the fact that it is supposed to be a curable disease. Drug resistant forms of TB have developed as a result of poor treatment compliance including multi-drug and extreme drug resistant forms that take longer to treat and have higher likelihoods of treatment failure. In 2010, at the initiation of the TB community, a partnership was formed between the WHO Stop TB Program, the Worldwide Hospice Palliative Care Alliance, and the Open Society Foundation's International Palliative Care Initiative (OSF/IPCI) to explore how to improve the ability of TB professionals to deliver palliative care to their patients...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28776523/screening-of-health-care-workers-for-latent-tuberculosis-infection-in-a-tertiary-care-hospital
#5
Anand Bimari Janagond, Vithiya Ganesan, G S Vijay Kumar, Arunagiri Ramesh, Prem Anand, M Mariappan
BACKGROUND: Health-care workers (HCWs) are at increased risk of acquiring tuberculosis (TB) than the general population. While national-level data on the burden of TB in general population is available from reliable sources, nationally representative data on latent tuberculosis infection (LTBI) burden in HCWs in the high burden countries is lacking. METHODS: A prospective study was carried out to assess the risk of TB infection among HCWs who directly engage in medical duties...
July 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28764205/prevalence-and-patterns-of-multimorbidity-among-human-immunodeficiency-virus-positive-people-in-odisha-india-an-exploratory-study
#6
Sanghamitra Pati, Shreeporna Bhattacharya, Subhashisa Swain
INTRODUCTION: Improved and efficient Anti-Retroviral Therapy (ART) has turned HIV positive into a chronic disorder. The increase in life expectancy and quality of life comes with an increased risk of multimorbidity from the traditional risk factors. AIM: To explore the prevalence of multimorbidity among People Living with HIV (PLHIV). MATERIALS AND METHODS: An exploratory cross-sectional study was carried out in an ART center of Odisha, India, from November 2013 to December 2013...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761601/childhood-tuberculosis-management-and-treatment-outcomes-among-children-in-northwest-ethiopia-a-cross-sectional-study
#7
Zemene Tigabu Kebede, Belaynew Wasie Taye, Yohannes Hailu Matebe
INTRODUCTION: Childhood tuberculosis (TB) treatment is becoming a major challenge in the TB control efforts of the Ethiopian health system. This study assessed childhood tuberculosis management, and treatment outcomes among children who completed anti-TB treatment in Northwest Ethiopia. METHODS: A cross-sectional study was conducted among children who completed their anti-TB treatment in Gondar University Referral Hospital and 6 satellite health centers. Data from each child with tuberculosis were obtained from review of medical records...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28754530/tuberculosis-in-children-from-diagnosis-to-decision-to-treat
#8
S Ramos, R Gaio, F Ferreira, J Paulo Leal, S Martins, J Vasco Santos, I Carvalho, R Duarte
SETTING: Confirmation of tuberculosis (TB) in children is difficult, so clinicians use different procedures when deciding to treat. OBJECTIVE: Identify criteria to initiate and maintain TB treatment in children younger than 5 years-old, without diagnosis confirmation. DESIGN: A web-based survey was distributed by email to the corresponding authors of journal articles on childhood TB. The observations were clustered into disjoint groups, and analyzed by Ward's method...
July 25, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28747955/summary-of-the-chronic-obstructive-pulmonary-disease-clinical-practice-guideline-revised-in-2014-by-the-korean-academy-of-tuberculosis-and-respiratory-disease
#9
REVIEW
Hyoung Kyu Yoon, Yong-Bum Park, Chin Kook Rhee, Jin Hwa Lee, Yeon-Mok Oh
Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients both domestically and globally. The Korean clinical practice guideline for COPD was revised in 2014. It was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases, as well as participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. This revised guideline covers a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea...
July 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28729186/-tuberculosis-treatment-for-children-an-update
#10
María José Mellado Peña, Begoña Santiago García, Fernando Baquero-Artigao, David Moreno Pérez, Roi Piñeiro Pérez, Ana Méndez Echevarría, José Tomás Ramos Amador, David Gómez-Pastrana Durán, Antoni Noguera Julian
Tuberculosis (TB) is the most important infectious disease all over the world, with a high morbidity and mortality. Pediatric tuberculosis has been a neglected epidemic, due to the difficulties in assessing its global impact, reduced incidence and lower infectivity compared to adults. In 2015, the WHO reported 1 million cases of paediatric TB and 169,000 deaths. In Europe, the emergence of MDR TB is a major concern, representing 16% of the new diagnosis in Eastern Europe. In 2014, it was estimated that about 219,000 children were infected by MDR-TB-strains in Europe, and 2,120 developed the disease...
July 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28728346/suggestions-for-promoting-evidence-based-public-health-in-korea
#11
Jong-Myon Bae
The Public Health (EBPH) is defined as a decision-making in the domain of public health using current best evidences. Debates about the latent tuberculosis infection control program suggested by the Korea Centers for Disease Control and Prevention in 2017 bring the need for promoting EBPH. To do this, three strategies were suggested as following: drawing some necessary evidences by evaluating policy-evidence gaps, delivering good quality and relevant evidences timely by conducting systematic reviews and adapting public health guidelines, and making the value-driven decisions by training and educating public health policy makers...
July 19, 2017: Epidemiology and Health
https://www.readbyqxmd.com/read/28721972/ultrasound-imaging-features-of-isolated-pancreatic-tuberculosis
#12
Yi Dong, Christian Jürgensen, Rajesh Puri, Mirko D'Onofrio, Michael Hocke, Wen-Ping Wang, Nathan Atkinson, Malay Sharma, Christoph F Dietrich
BACKGROUND AND OBJECTIVES: Isolated pancreatic tuberculosis (PTB) is extremely rare worldwide. The purpose of this multicenter retrospective study is to analyze imaging features of histologically confirmed isolated PTB in order to determine the diagnostic features of the new methods contrast enhanced ultrasound (CEUS), ultrasound elastography and contrast enhanced endoscopic ultrasound (CE-EUS). PATIENTS AND METHODS: We report on a retrospective data collection of 12 cases of PTB confirmed by histology or cytology...
July 19, 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28721354/diagnostic-outcomes-after-chest-radiograph-interpretation-in-patients-with-suspected-tuberculosis-and-negative-sputum-smears-in-a-high-burden-human-immunodeficiency-virus-and-tuberculosis-setting
#13
Patrick G T Cudahy, Rodney Dawson, Brian W Allwood, Gary Maartens, Douglas Wilson
BACKGROUND: Evaluation of patients with suspected tuberculosis and negative sputum smears for acid-fast bacilli (AFB) is challenging, especially in high human immunodeficiency virus coinfection settings where sputum smears have lower sensitivity for detecting AFB. METHODS: We examined the utility of chest radiographs for detecting smear-negative pulmonary tuberculosis. Three hundred sixty sputum smear-negative patients who were referred from primary care clinics in the KwaZulu-Natal province of South Africa were evaluated...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28720136/bilateral-multiple-pulmonary-artery-aneurysms-associated-with-cavitary-pulmonary-tuberculosis-a-case-report
#14
Pedro Pallangyo, Frederick Lyimo, Smita Bhalia, Hilda Makungu, Bashir Nyangasa, Flora Lwakatare, Pal Suranyi, Mohamed Janabi
BACKGROUND: Pulmonary artery aneurysms constitute <1% of aneurysms occurring in the thoracic cavity. Congenital cardiac defects are responsible for the majority (>50%) of cases, however, pulmonary artery aneurysm is a rare sequelae of pulmonary tuberculosis reported in about 5% of patients with chronic cavitary tuberculosis on autopsy. The natural history of this potentially fatal condition remains poorly understood and guidelines for optimal management are controversial. CASE PRESENTATION: A 24-year-old man, a nursing student of African descent, was referred to us from an up-country regional hospital with a 4-week history of recurrent episodes of breathlessness, awareness of heartbeats and coughing blood 3 weeks after completing a 6-month course of anti-tuberculosis drugs...
July 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28717600/implementation-of-the-xpert-mtb-rif-assay-for-tuberculosis-in-mongolia-a-qualitative-exploration-of-barriers-and-enablers
#15
Nicole L Rendell, Solongo Bekhbat, Gantungalag Ganbaatar, Munkhjargal Dorjravdan, Madhukar Pai, Claudia C Dobler
OBJECTIVE: The aim of our study was to identify barriers and enablers to implementation of the Xpert MTB/RIF test within Mongolia's National Tuberculosis Program. METHODS: Twenty-foursemi-structured interviews were conducted between June and September 2015 with laboratory staff and tuberculosis physicians in Mongolia's capital Ulaanbaatar and regional towns where Xpert MTB/RIF testing had been implemented. Interviews were recorded, transcribed, translated and analysed thematically using NVIVO qualitative analysis software...
2017: PeerJ
https://www.readbyqxmd.com/read/28716677/incidence-of-active-tuberculosis-in-individuals-with-latent-tuberculosis-infection-in-rural-china-follow-up-results-of-a-population-based-multicentre-prospective-cohort-study
#16
Lei Gao, Xiangwei Li, Jianmin Liu, Xinhua Wang, Wei Lu, Liqiong Bai, Henan Xin, Haoran Zhang, Hengjing Li, Zongde Zhang, Yu Ma, Mufei Li, Boxuan Feng, Jiang Du, Hongtao Sui, Rong Zhao, Haoxiang Su, Shouguo Pan, Ling Guan, Fei Shen, Jian He, Shumin Yang, Hongyan Si, Xu Cheng, Zuhui Xu, Yunhong Tan, Tianzhu Chen, Weiguo Xu, Hong Peng, Zhijian Wang, Tao Zhu, Xiaoyou Chen, Xinhua Zhou, Xueling Guan, Qi Jin
BACKGROUND: The management of latent Mycobacterium tuberculosis infection is a new priority action for the WHO End Tuberculosis (TB) Strategy. However, national guidelines on latent tuberculosis infection testing and treatment have not yet been developed in China. Here, we present the results from the 2-year follow-up of a study that aimed to track the development of active disease in individuals with latent tuberculosis infection, identify priority populations for latent infection management, and explore the most suitable latent infection diagnostic approach...
July 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28705514/bacillus-calmette-gu%C3%A3-rin-bcg-vaccination-patterns-in-the-province-of-qu%C3%A3-bec-canada-1956-1974
#17
Marie-Claude Rousseau, Florence Conus, Khady Kâ, Mariam El-Zein, Marie-Élise Parent, Dick Menzies
BACKGROUND: In the province of Québec, Canada, the Bacillus Calmette-Guérin (BCG) vaccine was offered to newborns and school-age children from the 1950s to mid-1970s in an organized tuberculosis prevention program. OBJECTIVE: We aimed to describe the annual rates of skin test administration, proportion of skin tests that were positive, and rates of BCG vaccination from 1956 to 1974 according to age, sex, and administrative region. METHODS: For rates, numerators were extracted from the Québec BCG Vaccination Registry whereas population denominators were obtained from the Canadian Census and governmental publications...
July 10, 2017: Vaccine
https://www.readbyqxmd.com/read/28700283/update-on-immunological-test-quantiferon-tb-gold-contribution-in-the-management-of-tuberculosis-related-ocular-inflammation
#18
S Trad, B Bodaghi, D Saadoun
PURPOSE: To clarify interferon-gamma release assay (IGRA) contributions to intraocular tuberculosis management, according to related TB endemic prevalence. METHODS: Despite extensive investigations, including IGRA, the diagnosis of intraocular tuberculosis (TB) is still challenging and remains mostly presumptive. According to the literature, it appears that management of suspected ocular TB differs significantly based on whether patients are from areas of high TB prevalence or from non-TB-endemic countries...
July 12, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28697621/undiagnosed-tuberculosis-in-patients-with-hiv-infection-who-present-with-severe-anaemia-at-a-district-hospital
#19
Mbulelo Mntonintshi, Don O'Mahony, Sikhumbuzo Mabunda, Kakia A F Namugenyi
BACKGROUND: Tuberculosis (TB) is a major cause of severe anaemia in patients with human immunodeficiency virus (HIV) infection in South Africa. However, TB can be difficult to diagnose as it may be extra pulmonary and paucibacillary. AIM: The aim of this study was to investigate undiagnosed TB in patients with HIV infection and severe anaemia and to identify the optimal investigations for diagnosing TB. SETTING: Mthatha General Hospital, a district hospital...
June 30, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28690859/case-report-of-a-lupus-patient-with-a-severe-flare-and-miliary-tuberculosis-need-for-proper-guidelines-for-management
#20
Masooma Hashmat, Ramsa Suhail Rana, Tafazzul-E-Haque Mahmud, Aflak Rasheed, Ata Ur Rehman, Syed Ali Rukh Pirzada, Muhammad Ammad Asghar, Sadia Asif, Amjad Ali
Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently treated with high doses of corticosteroids and other immunosuppressive drugs. Thus patients with SLE are at increased risk for infections with several pathogens including Mycobacterium tuberculosis. There are no established guidelines available for treatment of tuberculosis in SLE patients with high disease activity due to lack of relevant studies and management based more on physician expertise. We report a case of a young SLE patient with high disease activity index (SLEDAI19) as evidenced by the presence of a vasculitic rash, non-healing ulcer on forearm and proteinuria of >1 g/d along with miliary tuberculosis...
July 2017: Oxford Medical Case Reports
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