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https://www.readbyqxmd.com/read/29232366/estimating-the-impact-of-antiretroviral-treatment-on-adult-mortality-trends-in-south-africa-a-mathematical-modelling-study
#1
Leigh F Johnson, Margaret T May, Rob E Dorrington, Morna Cornell, Andrew Boulle, Matthias Egger, Mary-Ann Davies
BACKGROUND: Substantial reductions in adult mortality have been observed in South Africa since the mid-2000s, but there has been no formal evaluation of how much of this decline is attributable to the scale-up of antiretroviral treatment (ART), as previous models have not been calibrated to vital registration data. We developed a deterministic mathematical model to simulate the mortality trends that would have been expected in the absence of ART, and with earlier introduction of ART. METHODS AND FINDINGS: Model estimates of mortality rates in ART patients were obtained from the International Epidemiology Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaboration...
December 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29228918/nevirapine-versus-efavirenz-based-antiretroviral-therapy-regimens-in-antiretroviral-naive-patients-with-hiv-and-tuberculosis-infections-in-india-a-multi-centre-study
#2
Sanjeev Sinha, Kartik Gupta, Srikanth Tripathy, Sahajal Dhooria, Sanjay Ranjan, R M Pandey
BACKGROUND: According to World Health Organization (WHO) guidelines, which have also been adopted by the National AIDS Control Organization (NACO), India, Efavirenz-based Anti-Retroviral Therapy (ART) is better in Human-Immunodeficiency-Virus (HIV)-infected patients who are also being treated with Rifampicin-based Anti-Tuberculous Therapy (ATT). However, Efavirenz is much more expensive. We hypothesize that Nevirapine is a cheaper alternative that possesses equal efficacy as Efavirenz in HIV-Tuberculosis (TB) co-infected patients...
December 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29226191/time-to-drug-resistant-tuberculosis-treatment-in-a-prospective-south-african-cohort
#3
Brittney J van de Water, Janet Prvu Bettger, Susan Silva, Janice Humphreys, Coleen K Cunningham, Jason E Farley
This study examined time to treatment initiation by age among a prospective cohort with drug-resistant tuberculosis (DR-TB). Participants aged 13 years or older nested within a cluster-randomized trial in 2 South African provinces were evaluated. Outcomes were treatment initiation within 5 days of DR-TB diagnosis (National Tuberculosis Program guidelines) and days from diagnosis to treatment. A total of 521 participants met inclusion criteria. Eighty-two patients (16%) met national guidelines; median time to treatment was 11 days (range = 0-180)...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29225937/use-of-standardised-patients-to-assess-quality-of-healthcare-in-nairobi-kenya-a-pilot-cross-sectional-study-with-international-comparisons
#4
Benjamin Daniels, Amy Dolinger, Guadalupe Bedoya, Khama Rogo, Ana Goicoechea, Jorge Coarasa, Francis Wafula, Njeri Mwaura, Redemptar Kimeu, Jishnu Das
Introduction: The quality of clinical care can be reliably measured in multiple settings using standardised patients (SPs), but this methodology has not been extensively used in Sub-Saharan Africa. This study validates the use of SPs for a variety of tracer conditions in Nairobi, Kenya, and provides new results on the quality of care in sampled primary care clinics. Methods: We deployed 14 SPs in private and public clinics presenting either asthma, child diarrhoea, tuberculosis or unstable angina...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29211793/assessing-infection-control-practices-to-protect-health-care-workers-and-patients-in-malawi-from-nosocomial-transmission-of-mycobacterium-tuberculosis
#5
Robert J Flick, Adamson Munthali, Katherine Simon, Mina Hosseinipour, Maria H Kim, Lameck Mlauzi, Peter N Kazembe, Saeed Ahmed
Transmission of Mycobacterium tuberculosis (TB) in health settings threatens health care workers and people living with HIV in sub-Saharan Africa. Nosocomial transmission is reduced with implementation of infection control (IC) guidelines. The objective of this study is to describe implementation of TB IC measures in Malawi. We conducted a cross-sectional study utilizing anonymous health worker questionnaires, semi-structured interviews with facility managers, and direct observations at 17 facilities in central Malawi...
2017: PloS One
https://www.readbyqxmd.com/read/29196066/cough-due-to-tuberculosis-and-other-chronic-infections-chest-guideline-and-expert-panel-report
#6
Stephen K Field, Patricio Escalante, Dina A Fisher, Belinda Ireland, Richard S Irwin
BACKGROUND: Cough is common in pulmonary tuberculosis (TB) and other chronic respiratory infections. Identifying features that predict whether pulmonary TB is the cause would help target appropriate individuals for rapid and cost-effective screening, potentially limiting disease progression, and preventing transmission to others. METHODS: A systematic literature search for individual studies to answer 8 Key questions (KQ) was conducted according to established Chest Organization methods using the following databases: MEDLINE via PubMed, EMBASE, Scopus and the Cochrane Database of Systematic Reviews from 1/1/1984 to April 2014...
November 28, 2017: Chest
https://www.readbyqxmd.com/read/29193951/-disseminated-tuberculosis-in-a-patient-with-overlap-syndrome-challenges-in-preventing
#7
Sergio García-Méndez, Lamberto Miguel Caballero-Zavala, Imelda García-Olivera, Fortunato Vásquez-Manuel, Gerardo Pérez-Bustamante, Fabián Tafoya-Ramírez
Patients with autoimmune rheumatic diseases are at increased risk for developing infections and these are associated with increased morbidity and mortality from these diseases, especially in patients with systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and autoimmune inflammatory myopathies. The objective of this paper is to address the challenges in detecting latent tuberculosis in immunosuppressed patients and the initiation of prophylactic treatment because currently there are no well-defined guidelines indicating what action to take for detection and treatment; so far the available scientific evidence is scarce and some methodological shortcomings...
September 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29190430/evaluating-uk-national-guidance-for-screening-of-children-for-tb-a-prospective-multi-centre-study
#8
Beate Kampmann, James A Seddon, James Paton, Zohreh Nademi, Denis Keane, Bhanu Williams, Amanda Williams, Sue Liebeschutz, Anna Riddell, Jolanta Bernatoniene, Sanjay Patel, Nuria Martinez, Paddy McMaster, Robindra Basu-Roy, Steven B Welch
Rationale and Objective In order to identify infected contacts of tuberculosis (TB) cases, the UK National Institute for Health and Care Excellence (NICE) recommended the addition of interferon-gamma release assays (IGRA) to the tuberculin skin test (TST) in its 2006 TB guidelines. Treatment for TB infection was no longer recommended for children screened TST-positive but IGRA-negative. We carried out a cohort study to evaluate the risk of TB disease in this group. Methods Children exposed to an infectious case of TB in their household were recruited from 11 paediatric TB clinics...
November 30, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29183354/motives-for-change-of-first-line-antiretroviral-therapy-regimens-in-an-unselected-cohort-of-hiv-aids-patients-at-a-major-referral-centre-in-south-west-cameroon
#9
Christian Akem Dimala, Ndemazie Nkafu Bechem, Desmond Aroke, Benjamin Momo Kadia
OBJECTIVE: The rapid scale-up of antiretroviral therapy (ART) coverage in sub-Saharan Africa has encountered the challenge of maintaining international clinical standards of ART utilization and change of ART regimens. In Cameroon, scarce reports have documented the motives for change of ART. This study had as objective to investigate the reasons for switch in ART through a secondary analysis and descriptive synthesis of data from a cross-sectional study at the Limbe Regional Hospital...
November 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29179699/gastrointestinal-tuberculosis-following-renal-transplantation-accompanied-with-septic-shock-and-acute-respiratory-distress-syndrome-a-survival-case-presentation
#10
Andrea Cikova, Diana Vavrincova-Yaghi, Peter Vavrinec, Anna Dobisova, Andrea Gebhardtova, Zora Flassikova, Mark A Seelen, Robert H Henning, Aktham Yaghi
BACKGROUND: Post-transplant tuberculosis (PTTB) is a serious opportunistic infection in renal graft recipients with a 30-70 fold higher incidence compared to the general population. PTTB occurs most frequently within the first years after transplantation, manifesting as pulmonary or disseminated TB. Gastrointestinal TB (GITB) is a rare and potentially lethal manifestation of PTTB and may show delayed onset in renal transplant recipients due to the use of lower doses of immunosuppressants...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29178937/an-optimized-background-regimen-design-to-evaluate-the-contribution-of-levofloxacin-to-multidrug-resistant-tuberculosis-treatment-regimens-study-protocol-for-a-randomized-controlled-trial
#11
Tara C Bouton, Patrick P J Phillips, Carole D Mitnick, Charles A Peloquin, Kathleen Eisenach, Ramonde F Patientia, Leonid Lecca, Eduardo Gotuzzo, Neel R Gandhi, Donna Butler, Andreas H Diacon, Bruno Martel, Juan Santillan, Kathleen Robergeau Hunt, Dante Vargas, Florian von Groote-Bidlingmaier, Carlos Seas, Nancy Dianis, Antonio Moreno-Martinez, C Robert Horsburgh
BACKGROUND: Current guidelines for treatment of multidrug-resistant tuberculosis (MDR-TB) are largely based on expert opinion and observational data. Fluoroquinolones remain an essential part of MDR-TB treatment, but the optimal dose of fluoroquinolones as part of the regimen has not been defined. METHODS/DESIGN: We designed a randomized, blinded, phase II trial in MDR-TB patients comparing across levofloxacin doses of 11, 14, 17 and 20 mg/kg/day, all within an optimized background regimen...
November 25, 2017: Trials
https://www.readbyqxmd.com/read/29176633/epidemiology-and-predictors-of-ntm-pulmonary-infection-in-taiwan-a-retrospective-five-year-multicenter-study
#12
Hung-Ling Huang, Meng-Hsuan Cheng, Po-Liang Lu, Chin-Chung Shu, Jann-Yuan Wang, Jann-Tay Wang, Inn-Wen Chong, Li-Na Lee
Multicenter, longitudinal studies on nontuberculous mycobacteria (NTM) pulmonary infection (PI) are lacking. This study provides a 5-year epidemiological overview of NTM-PI in Taiwan and investigated its predictors. The clinical relevance of each respiratory NTM isolate in six hospitals between 2008 and 2014 was determined according to current guidelines. Recurrent episodes were judged by serial bacteriological results. New episodes of NTM-PI and pulmonary colonization (PC) occurring since 2010 were analyzed...
November 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29165621/treatment-of-tuberculosis-in-complex-emergencies-in-developing-countries-a-scoping-review
#13
Geraldine Munn-Mace, Divya Parmar
Almost 172 million people live in complex emergencies globally resulting from political and/or economic instability. The provision and continuity of health care in complex emergencies remain a significant challenge. Health agencies are often hesitant to implement tuberculosis programmes in particular because its treatment requires a longer commitment than most acute diseases. However, not treating tuberculosis promptly increases mortality and untreated tuberculosis further increases the incidence of tuberculosis...
November 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29157275/the-prevent-study-to-evaluate-the-effectiveness-and-acceptability-of-a-community-based-intervention-to-prevent-childhood-tuberculosis-in-lesotho-study-protocol-for-a-cluster-randomized-controlled-trial
#14
Yael Hirsch-Moverman, Andrea A Howard, Koen Frederix, Limakatso Lebelo, Anneke Hesseling, Sharon Nachman, Joanne E Mantell, Tsepang Lekhela, Llang Bridget Maama, Wafaa M El-Sadr
BACKGROUND: Effective, evidence-based interventions to prevent childhood tuberculosis (TB) in high TB/HIV-burden, resource-limited settings are urgently needed. There is limited implementation of evidence-based contact management strategies, including isoniazid preventive therapy (IPT), for child contacts of TB cases in Lesotho. METHODS/DESIGN: This mixed-methods implementation science study utilizes a two-arm cluster-randomized trial design with randomization at the health facility level...
November 21, 2017: Trials
https://www.readbyqxmd.com/read/29143466/tuberculosis-serosurveillance-and-management-practices-of-captive-african-elephants-loxodonta-africana-in-the-kavango-zambezi-transfrontier-conservation-area
#15
L E Rosen, T G Hanyire, J Dawson, C M Foggin, A L Michel, K P Huyvaert, M A Miller, F J Olea-Popelka
Transfrontier conservation areas represent an international effort to encourage conservation and sustainable development. Their success faces a number of challenges, including disease management in wildlife, livestock and humans. Tuberculosis (TB) affects humans and a multitude of non-human animal species and is of particular concern in sub-Saharan Africa. The Kavango-Zambezi Transfrontier Conservation Area encompasses five countries, including Zimbabwe, and is home to the largest contiguous population of free-ranging elephants in Africa...
November 16, 2017: Transboundary and Emerging Diseases
https://www.readbyqxmd.com/read/29142744/-who-has-to-do-it-at-the-end-of-the-day-programme-officials-or-hospital-authorities-airborne-infection-control-at-drug-resistant-tuberculosis-dr-tb-centres-of-karnataka-india-a-mixed-methods-study
#16
Kibballi Madhukeshwar Akshaya, Hemant Deepak Shewade, Ottapura Prabhakaran Aslesh, Sharath Burugina Nagaraja, Abhay Subashrao Nirgude, Anil Singarajipura, Anil G Jacob
Background: Drug resistant tuberculosis (DR-TB) centers admit patients with DR-TB for initiation of treatment and thereby concentrate the patients under one setting. It becomes imperative to assess the compliance of DR-TB centres to national airborne infection control (AIC) guidelines and explore the provider perspectives into reasons for unsatisfactory compliance. Methods: This mixed methods study (triangulation design) was carried out across all the six DR-TB centers of Karnataka state, India, between November 2016 and April 2017...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29140933/t-spot-tb%C3%A2-performance-in-routine-pediatric-practice-in-a-low-tb-burden-setting
#17
Anna M Mandalakas, Heather Y Highsmith, Nadine M Harris, Anna Pawlicka, H Lester Kirchner
BACKGROUND: The T-SPOT.TB, an interferon-γ release assay (IGRA), is an indirect test of Mycobacterium tuberculosis infection. Due to sparse and conflicting evidence, IGRA use is limited in young and HIV-infected children. We determined the prevalence of invalid, borderline, positive, and negative results and associations with key demographic variables during routine pediatric use in a TB low-burden setting. METHODS: For pediatric samples received at Oxford Diagnostic Laboratories from 2010-2015, the associations between initial test outcome and demographics were estimated by bivariate analysis and logistic regression...
November 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29136014/treatment-guidelines-and-early-loss-from-care-for-people-living-with-hiv-in-cape-town-south-africa-a-retrospective-cohort-study
#18
Ingrid T Katz, Richard Kaplan, Garrett Fitzmaurice, Dominick Leone, David R Bangsberg, Linda-Gail Bekker, Catherine Orrell
BACKGROUND: South Africa has undergone multiple expansions in antiretroviral therapy (ART) eligibility from an initial CD4+ threshold of ≤200 cells/μl to providing ART for all people living with HIV (PLWH) as of September 2016. We evaluated the association of programmatic changes in ART eligibility with loss from care, both prior to ART initiation and within the first 16 weeks of starting treatment, during a period of programmatic expansion to ART treatment at CD4+ ≤ 350 cells/μl...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29132380/addressing-challenges-in-scaling-up-tb-and-hiv-treatment-integration-in-rural-primary-healthcare-clinics-in-south-africa-suthi-a-cluster-randomized-controlled-trial-protocol
#19
Kogieleum Naidoo, Santhanalakshmi Gengiah, Nonhlanhla Yende-Zuma, Nesri Padayatchi, Pierre Barker, Andrew Nunn, Priashni Subrayen, Salim S Abdool Karim
BACKGROUND: A large and compelling clinical evidence base has shown that integrated TB and HIV services leads to reduction in human immunodeficiency virus (HIV)- and tuberculosis (TB)-associated mortality and morbidity. Despite official policies and guidelines recommending TB and HIV care integration, its poor implementation has resulted in TB and HIV remaining the commonest causes of death in several countries in sub-Saharan Africa, including South Africa. This study aims to reduce mortality due to TB-HIV co-infection through a quality improvement strategy for scaling up of TB and HIV treatment integration in rural primary healthcare clinics in South Africa...
November 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29108007/drop-out-from-the-tuberculosis-contact-investigation-cascade-in-a-routine-public-health-setting-in-urban-uganda-a-prospective-multi-center-study
#20
Mari Armstrong-Hough, Patricia Turimumahoro, Amanda J Meyer, Emmanuel Ochom, Diana Babirye, Irene Ayakaka, David Mark, Joseph Ggita, Adithya Cattamanchi, David Dowdy, Frank Mugabe, Elizabeth Fair, Jessica E Haberer, Achilles Katamba, J Lucian Davis
SETTING: Seven public tuberculosis (TB) units in Kampala, Uganda, where Uganda's national TB program recently introduced household contact investigation, as recommended by 2012 guidelines from WHO. OBJECTIVE: To apply a cascade analysis to implementation of household contact investigation in a programmatic setting. DESIGN: Prospective, multi-center observational study. METHODS: We constructed a cascade for household contact investigation to describe the proportions of: 1) index patient households recruited; 2) index patient households visited; 3) contacts screened for TB; and 4) contacts completing evaluation for, and diagnosed with, active TB...
2017: PloS One
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