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https://www.readbyqxmd.com/read/27932390/official-american-thoracic-society-infectious-diseases-society-of-america-centers-for-disease-control-and-prevention-clinical-practice-guidelines-diagnosis-of-tuberculosis-in-adults-and-children
#1
David M Lewinsohn, Michael K Leonard, Philip A LoBue, David L Cohn, Charles L Daley, Ed Desmond, Joseph Keane, Deborah A Lewinsohn, Ann M Loeffler, Gerald H Mazurek, Richard J O'Brien, Madhukar Pai, Luca Richeldi, Max Salfinger, Thomas M Shinnick, Timothy R Sterling, David M Warshauer, Gail L Woods
BACKGROUND: Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain. METHODS: A task force supported by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America searched, selected, and synthesized relevant evidence...
December 8, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27931330/policies-and-practices-on-the-programmatic-management-of-latent-tuberculous-infection-global-survey
#2
Y Hamada, A Sidibe, A Matteelli, A Dadu, M A Aziz, M Del Granado, N Nishikiori, K Floyd, H Getahun
SETTING: Global survey among low tuberculosis (TB) burden countries, which are primary target countries for the World Health Organization (WHO) guidelines on the programmatic management of latent tuberculous infection (LTBI). OBJECTIVE: To perform a baseline assessment of policies and practices for the programmatic management of LTBI. DESIGN: Online and paper-based pre-tested questionnaire filled out by national TB programme managers or their equivalents from 108 countries...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27906027/antiretroviral-treatment-regardless-of-cd4-count-the-universal-answer-to-a-contextual-question
#3
REVIEW
Serge P Eholié, Anani Badje, Gérard M Kouame, Jean-Baptiste N'takpe, Raoul Moh, Christine Danel, Xavier Anglaret
After a period where it was recommended to start antiretroviral therapy (ART) early, the CD4 threshold for treating asymptomatic adults dropped to 200/mm(3) at the beginning of the 2000s. This was mostly due to a great prudence with regards to drug toxicity. The ART-start CD4 threshold in most international guidelines was then raised to 350/mm(3) in 2006-2009 and to 500/mm(3) in 2009-2013. Between 2012 and 2015, international guidelines went the last step further and recommended treating all HIV-infected adults regardless of their CD4 count...
July 26, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27906009/current-trends-and-intricacies-in-the-management-of-hiv-associated-pulmonary-tuberculosis
#4
REVIEW
Narendran Gopalan, Padmapriyadarsini Chandrasekaran, Soumya Swaminathan, Srikanth Tripathy
Human immunodeficiency virus (HIV) epidemic has undoubtedly increased the incidence of tuberculosis (TB) globally, posing a formidable global health challenge affecting 1.2 million cases. Pulmonary TB assumes utmost significance in the programmatic perspective as it is readily transmissible as well as easily diagnosable. HIV complicates every aspect of pulmonary tuberculosis from diagnosis to treatment, demanding a different approach to effectively tackle both the diseases. In order to control these converging epidemics, it is important to diagnose early, initiate appropriate therapy for both infections, prevent transmission and administer preventive therapy...
September 26, 2016: AIDS Research and Therapy
https://www.readbyqxmd.com/read/27905897/cost-and-cost-effectiveness-of-tuberculosis-treatment-shortening-a-model-based-analysis
#5
G B Gomez, D W Dowdy, M L Bastos, A Zwerling, S Sweeney, N Foster, A Trajman, M A Islam, S Kapiga, E Sinanovic, G M Knight, R G White, W A Wells, F G Cobelens, A Vassall
BACKGROUND: Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. METHODS: We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27886429/assessing-health-care-quality-using-routine-data-evaluating-the-performance-of-the-national-tuberculosis-program-in-south-africa
#6
Zoë McLaren, Alana R Sharp, Jifang Zhou, Sean Wasserman, Ananta Nanoo
OBJECTIVE: To assess the performance of health care facilities by means of indicators based on guidelines for clinical care of TB, which is likely a good measure of overall facility quality. METHODS: We assessed quality of care in all public health facilities in South Africa using graphical, correlation and locally weighted kernel regression analysis of routine TB test data. RESULTS: Facility performance falls short of national standards of care...
November 25, 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27872018/preventive-therapy-for-latent-tuberculosis-infection-the-promise-and-the-challenges
#7
REVIEW
G J Fox, C C Dobler, B J Marais, J T Denholm
Around one third of the world's population may harbour latent tuberculosis infection (LTBI), an asymptomatic immunological state that confers a heightened risk of subsequently developing tuberculosis (TB). Effectively treating LTBI will be essential if the End TB Strategy is to be realized. This review evaluates the evidence in relation to the effectiveness of preventive antibiotic therapy to treat LTBI due to both drug-susceptible and drug-resistant bacteria. Current national and international preventive therapy guidelines are summarized, as well as ongoing randomized trials evaluating regimens to prevent drug-resistant TB...
November 18, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27867891/bangladesh-national-guidelines-on-the-management-of-tuberculosis-and-diabetes-mellitus-co-morbidity-summary
#8
REVIEW
Mohammad Delwar Hossain, Jamal Uddin Ahmed, Muhammad Abdur Rahim, A K M Musa, Zafar Ahmed Latif
Tuberculosis (TB) and diabetes mellitus (DM) have synergetic relationship. People with diabetes are 2-3 times at higher risk of getting active TB disease. On the other hand, TB or anti-TB treatment may cause glucose intolerance. The dual disease of DM and TB is more likely to be associated with atypical disease presentation, higher probability of treatment failure and complications. In most of the health-care delivery systems of the world, DM and TB are managed separately by two vertical health-care delivery programs in spite of clear interaction between the two diseases...
November 2016: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27828731/the-pharmacological-challenges-of-treating-tuberculosis-and-hiv-coinfections
#9
Eric F Egelund, Lori Dupree, Emily Huesgen, Charles A Peloquin
Tuberculosis (TB) is the most prevalent opportunistic infection among HIV patients, and the leading cause of death among HIV patients worldwide. Simultaneous treatment of both diseases is recommended by current guidelines, but can be challenging due to the potential for drug-drug interactions, overlapping toxicities, difficulty adhering to medications, and an increased risk for immune reconstitution inflammatory syndrome (IRIS). Clinical manifestations of TB can also vary between HIV-infected patients and uninfected patients, which can increase the risk for delayed diagnosis...
November 28, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27826815/is-there-a-role-for-opportunistic-infection-prophylaxis-in-pemphigus-an-expert-survey
#10
Yael A Leshem, Igor Snast, Rivka Friedland, Lihi Atzmony, Assi Levi, Emmilia Hodak, Daniel Mimouni
BACKGROUND: Opportunistic infections (OIs) are a dreaded adverse effect of immunosuppressive therapy, leading to the use of opportunistic infection prophylaxis (OIP) in many immunosuppressed conditions. However, guidelines for OIP in pemphigus are lacking. OBJECTIVE: Our objective was to evaluate the approach of leading pemphigus experts towards OIP. METHODS: We conducted an online survey of OIP trends. RESULTS: The survey was completed by 33 experts...
November 8, 2016: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/27818361/classifying-new-anti-tb-drugs-rationale-and-future-perspectives
#11
Simon Tiberi, Anna Scardigli, Rosella Centis, Lia D'Ambrosio, Marcela Muñoz-Torrico, Miguel Ángel Salazar-Lezama, Antonio Spanevello, Dina Visca, Alimuddin Zumla, Giovanni Battista Migliori, Jose A Caminero Luna
The classification of anti-tuberculosis (TB) drugs is important as it serves the clinician in building an appropriate anti-TB regimen for multidrug (MDR-) and extensively drug resistant (XDR-) TB cases which do not fulfil criteria for the shorter MDR-TB regimen. The World Health Organization (WHO) has recently approved a revision of the classification of new anti-TB drugs based on current evidence on each drug. In the previous WHO guidelines the drug choice was based on their efficacy and toxicity, in a step-down manner from Group 1, including first-line drugs and Group 2-5 including second- line drugs, to Group 5 including drugs with potentially limited efficacy or limited clinical evidence...
November 3, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27815270/controversies-in-ocular-tuberculosis
#12
REVIEW
Marcus Ang, Soon-Phaik Chee
Ocular tuberculosis still remains a presumptive, clinical diagnosis in the presence of supportive clinical signs and investigations, while in the absence of other possible causes of uveitis. The purpose of this review is to discuss three controversies of ocular tuberculosis today. First, it is unclear from many reports on how the diagnosis of ocular tuberculosis was defined, and if they included 'probable' or 'possible' diagnoses. Thus, there is a need to standardise the terminology used for ocular tuberculosis to allow for comparisons among studies...
November 4, 2016: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/27801499/six-month-therapy-for-abdominal-tuberculosis
#13
REVIEW
Sophie Jullien, Siddharth Jain, Hannah Ryan, Vineet Ahuja
BACKGROUND: Tuberculosis (TB) of the gastrointestinal tract and any other organ within the abdominal cavity is abdominal TB, and most guidelines recommend the same six-month regimen used for pulmonary TB for people with this diagnosis. However, some physicians are concerned whether a six-month treatment regimen is long enough to prevent relapse of the disease, particularly in people with gastrointestinal TB, which may sometimes cause antituberculous drugs to be poorly absorbed. On the other hand, longer regimens are associated with poor adherence, which could increase relapse, contribute to drug resistance developing, and increase costs to patients and health providers...
November 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27790274/tuberculosis-infection-control-in-health-care-facilities-environmental-control-and-personal-protection
#14
REVIEW
Ji Yeon Lee
Transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers in healthcare settings. The literature review suggests that implementation of combination control measures reduces the risk of TB transmission. Guidelines suggest a three-level hierarchy of controls including administrative, environmental, and respiratory protection. Among environmental controls, installation of ventilation systems is a priority because ventilation reduces the number of infectious particles in the air...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27790273/clinical-practice-guideline-of-acute-respiratory-distress-syndrome
#15
REVIEW
Young-Jae Cho, Jae Young Moon, Ein-Soon Shin, Je Hyeong Kim, Hoon Jung, So Young Park, Ho Cheol Kim, Yun Su Sim, Chin Kook Rhee, Jaemin Lim, Seok Jeong Lee, Won-Yeon Lee, Hyun Jeong Lee, Sang Hyun Kwak, Eun Kyeong Kang, Kyung Soo Chung, Won-Il Choi
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27769174/severe-adverse-events-during-second-line-tuberculosis-treatment-in-the-context-of-high-hiv-co-infection-in-south-africa-a-retrospective-cohort-study
#16
Kathryn Schnippel, Rebecca H Berhanu, Andrew Black, Cynthia Firnhaber, Norah Maitisa, Denise Evans, Edina Sinanovic
BACKGROUND: According to the World Health Organization, South Africa ranks as one of the highest burden of TB, TB/HIV co-infection, and drug-resistant TB (DR-TB) countries. DR-TB treatment is complicated to administer and relies on the use of multiple toxic drugs, with potential for severe adverse drug reactions. We report the occurrence of adverse events (AEs) during a standardised DR-TB treatment regimen at two outpatient, decentralized, public-sector sites in Johannesburg, South Africa...
October 21, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27756438/does-health-related-quality-of-life-among-adults-with-pulmonary-tuberculosis-improve-across-the-treatment-period-a-hospital-based-cross-sectional-study-in-mbale-region-eastern-uganda
#17
Stevens M B Kisaka, Elizeus Rutebemberwa, Simon Kasasa, Francis Ocen, Joan Nankya-Mutyoba
BACKGROUND: Most tuberculosis (TB) case management guidelines emphasize microbiological cure as treatment goal without highlighting quality of life outcomes. This study assessed health-related quality of life (HRQoL) and related factors in the pre-treatment, intensive and continuation phases of anti-TB therapy among sputum smear positive pulmonary TB patients in Mbale region, Eastern Uganda. METHODS: In this cross-sectional study, questionnaires and 36-Item Short-Form Health Survey Version 2...
October 18, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/27755106/tuberculosis-and-hiv-coinfection-in-europe-looking-at-one-reality-from-two-angles
#18
Marieke J van der Werf, Csaba Ködmön, Phillip Zucs, Vahur Hollo, Andrew J Amato-Gauci, Anastasia Pharris
OBJECTIVE: To better understand the epidemiology of tuberculosis (TB)/HIV coinfection in the European Union (EU) and European Economic Area (EEA) for planning of prevention and control measures. DESIGN: Analysis of surveillance data. METHODS: We performed an analysis of the 2014 TB and AIDS data to assess the burden of TB/HIV coinfection and we applied multivariable logistic regression to evaluate predictors for coinfection. RESULTS: Twenty-one of 31 EU/EEA countries reported HIV testing results for 64...
November 28, 2016: AIDS
https://www.readbyqxmd.com/read/27754536/implementation-of-the-national-tuberculosis-guidelines-on-culture-and-drug-sensitivity-testing-in-guatemala-2013
#19
Maritza Samayoa-Peláez, Nancy Ayala, Zaida E Yadon, Einar Heldal
Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notification rates by department (geographic area), disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates...
January 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/27742642/partnerships-to-design-novel-regimens-to-treat-childhood-tuberculosis-sui-generis-the-road-ahead
#20
Tawanda Gumbo, Mamodikoe K Makhene, James A Seddon
There has been a recent expansion of preclinical models to predict the efficacy of regimens to treat adults with tuberculosis. Despite increasing global interest in childhood tuberculosis, these same tools have not been employed to develop pediatric regimens. Children differ from adults in bacillary burden, spectrum of disease, the metabolism and distribution of antituberculosis drugs, and the toxicity experienced. The studies documented in this series describe a proof-of-concept approach to pediatric regimen development...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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