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Peter MacPherson, Emily L Webb, David G Lalloo, Marriott Nliwasa, Hendramoorthy Maheswaran, Elizabeth Joekes, Dama Phiri, Bertie Squire, Madhukar Pai, Elizabeth L Corbett
Background: Adults seeking diagnosis and treatment for tuberculosis (TB) and HIV in low-resource settings face considerable barriers and have high pre-treatment mortality. Efforts to improve access to prompt TB treatment have been hampered by limitations in TB diagnostics, with considerable uncertainty about how available and new tests can best be implemented. Design and methods: The PROSPECT Study is an open, three-arm pragmatic randomised study that will investigate the effectiveness and cost-effectiveness of optimised HIV and TB diagnosis and linkage to care interventions in reducing time to TB diagnosis and prevalence of undiagnosed TB and HIV in primary care in Blantyre, Malawi...
2018: Wellcome Open Research
Christina Meiring, Paul D van Helden, Wynand J Goosen
Mycobacterium tuberculosis ( M. tb ) remains one of the most globally serious infectious agents for human morbidity and mortality, but with significant differences in prevalence across the globe. In many countries, the incidence is now low and declining, but control and eradication remain a distant view. Similarly, the prevalence of bovine TB caused by Mycobacterium bovis (M. bovis) , varies significantly across regions, although unlike for M. tuberculosis , data are sparse. The reduction in incidence and prevalence and control of both human and bovine TB is difficult and costly, yet some countries have managed to do this with some success...
2018: Frontiers in Veterinary Science
Patrizia Amelio, Damien Portevin, Jerry Hella, Klaus Reither, Lujeko Kamwela, Omar Lweno, Anneth Tumbo, Linda Geoffrey, Khalid Ohmiti, Song Ding, Giuseppe Pantaleo, Claudia Daubenberger, Matthieu Perreau
HIV infection is the major risk factor predisposing for Mycobacterium tuberculosis ( Mtb ) progression from latent tuberculosis infection (LTBI) to tuberculosis disease (TB). Since long-term treated aviremic HIV-infected individuals remained at higher risk of developing TB as compared to HIV-uninfected individuals, we hypothesized that progression from LTBI to pulmonary TB (PTB) might not only be due to CD4 T-cell depletion but also to Mtb -specific CD4 T-cell functional impairment. To test this hypothesis, Mtb -specific T-cell frequencies and cytokine profiles were investigated in untreated Tanzanian individuals suffering from LTBI (n=20) or PTB (n=67) and compared to those of untreated Mtb /HIV co-infected individuals suffering from LTBI (n=15) or PTB (n=10)...
December 12, 2018: Journal of Virology
Esther Karamagi, Simon Sensalire, Martin Muhire, Herbert Kisamba, John Byabagambi, Mirwais Rahimzai, Frank Mugabe, Upenytho George, Jacqueline Calnan, Dejene Seyoum, Estella Birabwa
BACKGROUND: Strategies to identify and treat undiagnosed prevalent cases that have not sought diagnostic services on their own, are necessary to treat TB in patients earlier and interrupt transmission. Late presentation for medical services of symptomatic patients require special efforts to detect early and notify TB in high risk populations. An intervention that combined quality improvement with facility-led active case finding (QI-ACF) was implemented in 10 districts of Northern Uganda with the highest TB burden to improve case notification among populations at highest risk of TB...
December 12, 2018: BMC Health Services Research
Bassirou Diarra, Mahamadou Kone, Antieme Combo Georges Togo, Yeya Dit Sadio Sarro, Aissata Boubakar Cisse, Amadou Somboro, Boureima Degoga, Mohamed Tolofoudie, Bourahima Kone, Moumine Sanogo, Bocar Baya, Ousmane Kodio, Mamoudou Maiga, Michael Belson, Susan Orsega, Meryam Krit, Sounkalo Dao, Ibrahim Izétiegouma Maiga, Robert L Murphy, Leen Rigouts, Seydou Doumbia, Souleymane Diallo, Bouke Catherine de Jong
OBJECTIVE: Ancestral M. tuberculosis complex lineages such as M. africanum are underrepresented among retreatment patients and those with drug resistance. To test the hypothesis that they respond faster to TB treatment, we determined the rate of smear conversion of new pulmonary tuberculosis patients in Bamako, Mali by the main MTBc lineages. METHODS: Between 2015 and 2017, we conducted a prospective cohort study of new smear positive pulmonary tuberculosis patients in Bamako...
2018: PloS One
Oluwatosin J Akinsola, Oyindamola B Yusuf, Olusoji Mayowa Ige, Patrick E Okonji
Background: Multi-drug resistant tuberculosis (MDR-TB) develops due to problems such as irregular drug supply, poor drug quality, inappropriate prescription, and poor adherence to treatment. These factors allow the development and subsequent transmission of resistant strains of the pathogen. However, due to the chronic nature of MDR-TB, cure models allow us to investigate the covariates that are associated with the long-term effects of time-to-sputum conversion among multi-drug resistant (MDR-TB) tuberculosis individuals...
2018: Frontiers in Public Health
Enzhuo Yang, Rui Yang, Ming Guo, Dan Huang, Wandang Wang, Zhuoran Zhang, Crystal Chen, Feifei Wang, Wenzhe Ho, Ling Shen, Heping Xiao, Zheng W Chen, Hongbo Shen
Tuberculosis (TB) has become the most deadly infectious diseases due to epidemics of HIV/AIDS and multidrug-resistant/extensively drug-resistant TB (MDR-/XDR-TB). Although person-to-person transmission contributes to MDR-TB, it remains unknown whether infection with MDR strains resembles infection with drug-sensitive (DS) TB strains, manipulating limited or broad immune responses. To address these questions, macaques were infected with MDR strain V791 and a drug-sensitive Erdman strain of TB. MDR bacilli burdens in the airway were significantly higher than those of the Erdman control after pulmonary exposure...
December 12, 2018: Emerging Microbes & Infections
Knut A Hestad, Jonathan Chinyama, Menon J Anitha, Mary S Ngoma, J Allen McCutchan, Donald R Franklin, Robert K Heaton
BACKGROUND: HIV infection may result in neurocognitive deficits, but the effects of pulmonary tuberculosis (TB+), a common comorbid condition in HIV infection, on cognition in HIV infections are unknown. Accordingly, we examined the effects of TB+, on neurocognitive functioning in HIV-infected (HIV+) Zambian adults. SETTING: All participants were drawn from HIV clinics in and around Lusaka, the capital of Zambia. METHODS: Participants were 275 HIV+, of whom 237 were HIV+ and TB-negative (HIV+/TB-), and 38 also had pulmonary TB+ (HIV+/TB+)...
January 1, 2019: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Myo Su Kyi, Prasit Palittapongarnpim, Angkana Chaiprasert, Pravech Ajawatanawong, H Ctor Guzmán GarcIa, Virasakdi Chongsuvivatwong
Background: Appearance of Mycobacterium tuberculosis (MTB) in the sputum of a tuberculosis (TB)/human immunodeficiency virus (HIV) co-infected patient under treatment may indicate either failure or new infection. This study aims to evaluate whether TB treatment failure among TB/HIV co-infected patients is a real failure. Methods: A prospective cohort study was conducted among 566 TB/HIV co-infected patients who started TB treatment in 12 townships in the upper Myanmar...
October 2018: International Journal of Mycobacteriology
Adeboye Azeez, James Ndege, Ruffin Mutambayi
Background: In Sub-Saharan Africa, HIV endemic has substantially contributed to the increasing tuberculosis (TB) incidence. The joint effect of the HIV and TB pestilences has confronted the feeble systems of healthcare in resource-limited countries. Methods: The aim of this study was to determine the pathological attributes, outcomes of TB treatment, and the contributing factors of unsuccessful results among TB/HIV patients. A retrospective cohort study of all confirmed adult TB/HIV coinfected hospitalized patients with drug-resistant TB reported for the treatment in two different hospitals from 2010 to 2016 in Eastern Cape, South Africa...
October 2018: International Journal of Mycobacteriology
Kim Elmore, Erin L P Bradley, Ashley C Lima, George M Khalil, Estella Obi-Tabot, Zanetta Gant, Hazel D Dean, Donna Hubbard McCree
BACKGROUND: HIV diagnoses among females in the United States declined 22% from 2010 to 2015, including a 27% decline in diagnoses among black females. Despite this progress, disparities persist. Black females accounted for 60% of new HIV diagnoses among females in 2015. Geographic disparities also exist. This article describes geographic differences in HIV diagnoses among black females in the United States, from 2010 to 2015. MATERIALS AND METHODS: We examined HIV surveillance data from 2010 to 2015 to determine in which geographic areas decreases or increases in HIV diagnoses occurred...
December 8, 2018: Journal of Women's Health
January Weiner, Jeroen Maertzdorf, Jayne S Sutherland, Fergal J Duffy, Ethan Thompson, Sara Suliman, Gayle McEwen, Bonnie Thiel, Shreemanta K Parida, Joanna Zyla, Willem A Hanekom, Robert P Mohney, W Henry Boom, Harriet Mayanja-Kizza, Rawleigh Howe, Hazel M Dockrell, Tom H M Ottenhoff, Thomas J Scriba, Daniel E Zak, Gerhard Walzl, Stefan H E Kaufmann
New biomarkers of tuberculosis (TB) risk and disease are critical for the urgently needed control of the ongoing TB pandemic. In a prospective multisite study across Subsaharan Africa, we analyzed metabolic profiles in serum and plasma from HIV-negative, TB-exposed individuals who either progressed to TB 3-24 months post-exposure (progressors) or remained healthy (controls). We generated a trans-African metabolic biosignature for TB, which identifies future progressors both on blinded test samples and in external data sets and shows a performance of 69% sensitivity at 75% specificity in samples within 5 months of diagnosis...
December 6, 2018: Nature Communications
O M Ige, Regina E Oladokun
BACKGROUND: Sputum conversion considered the most important interim indicator of the efficacy of anti-tuberculosis treatment was assessed at varying time points among the first cohort of multidrug resistant tuberculosis (MDR-TB) patients in a National TB Control Programme. METHODS: A retrospective study was conducted for the period between 2010 and 2013, at the premiere MDR-TB treatment center in Nigeria. Genexpert, culture and drug susceptibility tests were carried out...
October 2018: Indian Journal of Tuberculosis
V K Chadha, Bhoomika Bajaj Bhalla, Sowmya B Ramesh, J Gupta, N Nagendra, R Padmesh, J Ahmed, R K Srivastava, R K Jaiswal, P Praseeja
SETTING: Implementation study in private health facilities in an Indian metropolis. OBJECTIVES: Improve Tuberculosis (TB) care by private practitioners (PPs). METHODS: PPs from a defined city area were imparted short training in TB care and linkages made with public facilities; subsequent practices were recorded. RESULTS: Of 364 presumptive TB patient records, 70 (19.3%) did not conform to its definition. Of the conforming, 174 (59...
October 2018: Indian Journal of Tuberculosis
K S Sachdeva, R D Deshmukh, N S Seguy, S A Nair, B B Rewari, R Ramchandran, M Parmar, V Vohra, S Singh, M Ghedia, R Agarwal, A N Shah, D Balasubramanian, M Bamrotiya, R Sikhamani, R S Gupta, S D Khaparde
BACKGROUND: Tuberculosis (TB) is one of world's oldest infectious disease and ranks alongside HIV as leading infectious killer. Tuberculosis infection control especially in HIV and TB care facilities has warranted attention after the recent health care-associated outbreaks in South Africa. The aim of this study was to describe the tuberculosis infection control measures implemented by HIV and TB care facilities in five high HIV burden provinces in India. METHODS: Baseline assessment of 30 high burden Antiretroviral centers and TB facilities was conducted during Oct 2015-Dec 2015 by AIC trained staff using a structured format...
October 2018: Indian Journal of Tuberculosis
Vikash Paudel, Deepa Chudal, Dinesh Binod Pokhrel
Human Immunodeficiency Virus induced immune suppression leads the way for various infections with tuberculosis being the most common. Tuberculosis of the vulva is an extremely rare entity and is seen in only 1-2% of genital TB with increased risk in HIV co-infection. The co-infection places an immense burden on health care systems and poses particular diagnostic & therapeutic challenges with high mortality and morbidity. We present, here, a rare case of a 47 years postmenopausal female, who presented with itchy ulcerating lesions in the vulva with diagnostic dilemma turned to be vulval tuberculosis and during investigations, was found to be co-infected with HIV...
October 2018: Indian Journal of Tuberculosis
Alejandro Hernández-Solis, Maribel González-Villa, Ernesto Ramírez-González, Arturo Reding-Bernal, Tania Sánchez-Valadez, Rocío de la Torriente-Mata, Heleodora González-González, Raúl Cícero-Sabido
Background: Tuberculosis is a public health problem, extrapulmonary presentations have increased, it is difficult to diagnose because of the low bacillary load. Objective: To identify risk factors and to evaluate the efficiency of diagnostic methods in pleural, meningeal, peritoneal and pericardial tuberculosis. Methods: Prospective study of cases and controls. A multiple conditional logistic regression model was used to identify risk factors...
November 30, 2018: Revista Médica del Instituto Mexicano del Seguro Social
C K Indumathi, Aruna Sethuraman, Saurav Jain, Savita Krishnamurthy
OBJECTIVES: To compare the incidence of anti tuberculosis drug-induced hepatotoxicity (ATDH) with those on old vs. revised WHO doses in human immunodeficiency virus (HIV) negative children. The secondary objective was to determine the overall incidence of hepatitis in children on Anti tubercular treatment (ATT) and isoniazid prophylactic therapy (IPT). METHODS: Children attending pediatric outpatient / admitted in wards, on ATT/ IPT between January 2007 and December 2017 (11 y) were included...
December 4, 2018: Indian Journal of Pediatrics
Jiansong Tang, Yi Cai, Jianguo Liang, Zhiwu Tan, Xian Tang, Chi Zhang, Lin Cheng, Jingying Zhou, Haibo Wang, Wing-Cheong Yam, Xinchun Chen, Hui Wang, Zhiwei Chen
DNA vaccines have been extensively studied as preventative and therapeutic interventions for various infectious diseases such as tuberculosis, HIV/AIDS and influenza. Despite promising progresses made, improving the immunogenicity of DNA vaccine remains a technical challenge for clinical development. In this study, we investigated a tuberculosis DNA vaccine BERopt , which contained a codon-optimized fusion immunogen Ag85B-ESAT-6-Rv2660c for enhanced mammalian cell expression and immunogenicity. BERopt immunization through in vivo electroporation in BALB/c mice induced surprisingly high frequencies of Ag85B tetramer+ CD8+ T cells in peripheral blood and IFN-γ-secreting CD8+ T cells in splenocytes...
December 2018: Tuberculosis
Erik Tenland, Nitya Krishnan, Anna Rönnholm, Sadaf Kalsum, Manoj Puthia, Matthias Mörgelin, Mina Davoudi, Magdalena Otrocka, Nader Alaridah, Izabela Glegola-Madejska, Erik Sturegård, Artur Schmidtchen, Maria Lerm, Brian D Robertson, Gabriela Godaly
Tuberculosis has been reaffirmed as the infectious disease causing most deaths in the world. Co-infection with HIV and the increase in multi-drug resistant Mycobacterium tuberculosis strains complicate treatment and increases mortality rates, making the development of new drugs an urgent priority. In this study we have identified a promising candidate by screening antimicrobial peptides for their capacity to inhibit mycobacterial growth. This non-toxic peptide, NZX, is capable of inhibiting both clinical strains of M...
December 2018: Tuberculosis
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