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https://www.readbyqxmd.com/read/28431845/infection-prevention-and-control-and-the-refugee-population-experiences-from-the-university-of-louisville-global-health-center
#1
Ruth M Carrico, Linda Goss, Timothy L Wiemken, Rahel S Bosson, Paula Peyrani, William A Mattingly, Allison Pauly, Rebecca A Ford, Stanley Kotey, Julio A Ramirez
BACKGROUND: During 2016, approximately 140,000 individuals entered the United States as part of the federal government refugee resettlement program and established themselves in communities in virtually every state. No national database regarding refugee health currently exists; therefore, little is known about existing infectious diseases, conditions, and cultural practices that impact successful acculturation. The objective of this report is to identify what is currently known about refugees and circumstances important to infection prevention and control with respect to their roles as new community members, employees, and consumers of health care...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28426273/preclinical-development-of-bcg-hiva-2auxo-int-harboring-an-integrative-expression-vector-for-a-hiv-tb-pediatric-vaccine-enhancement-of-stability-and-specific-hiv-1-t-cell-immunity
#2
Aakash Mahant, Narcís Saubi, Yoshiki Eto, Núria Guitart, Josep M ª Gatell, Tomáš Hanke, Joan Joseph
One of the critical issues that should be addressed in the development of a BCG-based HIV vaccine is genetic plasmid stability. Therefore, to address this issue we have considered using integrative vectors and the auxotrophic mutant of BCG complemented with a plasmid carrying a wild-type complementing gene. In this study, we have constructed an integrative E. coli-mycobacterial shuttle plasmid, p2auxo.HIVA(int), expressing the HIV-1 clade A immunogen HIVA. This shuttle vector employs an antibiotic resistance-free mechanism for plasmid selection and maintenance...
April 20, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28420356/an-assessment-of-the-hiv-tb-knowledge-and-skills-of-home-based-carers-working-in-the-north-west-province-in-south-africa-a-cross-sectional-study
#3
Justin G Engelbrecht, Mabjala R Letsoalo, Admire C Chirowodza
BACKGROUND: Home-based carers (HBCs) play a critical role in ensuring the success of the primary health care re-engineering strategy in South Africa. Their role includes ensuring improved access to and delivery of primary health care at the household level, and better co-ordination and improved linkages between community and health facilities for HIV/TB services. The objective of this study was to assess the knowledge, skills, challenges and training needs of HBCs involved in HIV/TB care in one sub-district in the North-West province of South Africa...
April 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28419368/leukotriene-a4-hydrolase-genotype-and-hiv-infection-influence-intracerebral-inflammation-and-survival-from-tuberculous-meningitis
#4
Nguyen T T Thuong, Dorothee Heemskerk, Trinh T B Tram, Le T P Thao, Lalita Ramakrishnan, Vu T N Ha, Nguyen D Bang, Tran T H Chau, Nguyen H Lan, Maxine Caws, Sarah J Dunstan, Nguyen V V Chau, Marcel Wolbers, Nguyen T H Mai, Guy E Thwaites
Background.: Tuberculous meningitis (TBM) is the most devastating form of tuberculosis, yet very little is known about the pathophysiology. We hypothesized that the genotype of leukotriene A4 hydrolase (encoded by LTA4H), which determines inflammatory eicosanoid expression, influences intracerebral inflammation, and predicts survival from TBM. Methods.: We characterized the pretreatment clinical and intracerebral inflammatory phenotype and 9-month survival of 764 adults with TBM...
April 17, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28419314/adverse-drug-reactions-during-drug-resistant-tb-treatment-in-high-hiv-prevalence-settings-a-systematic-review-and-meta-analysis
#5
Kathryn Schnippel, Cynthia Firnhaber, Rebecca Berhanu, Liesl Page-Shipp, Edina Sinanovic
Objectives: To estimate the prevalence of adverse drug reactions or events (ADR) during drug-resistant TB (DR-TB) treatment in the context of settings with high HIV prevalence (at least 20% of patients). Methods: We conducted a systematic review and meta-analysis of articles in PubMed and Scopus. Pooled proportions of patients experiencing adverse events and relative risk with 95% CI were calculated. Results: The search yielded 24 studies, all observational cohorts...
April 16, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28419277/prevention-of-tb-using-rifampicin-plus-isoniazid-reduces-nevirapine-concentrations-in-hiv-exposed-infants
#6
Helen McIlleron, Paolo Denti, Silvia Cohn, Fildah Mashabela, Jennifer D Hoffmann, Saba Shembe, Regina Msandiwa, Lubbe Wiesner, Sithembiso Velaphi, Sanjay G Lala, Richard E Chaisson, Neil Martinson, Kelly E Dooley
Background: Newborns of HIV-infected mothers are given daily doses of nevirapine to prevent HIV-1 acquisition. Infants born to mothers with TB should also receive TB preventive therapy. TB preventive regimens include isoniazid for 6 months or rifampicin plus isoniazid for 3 months (RH preventive therapy). The effect of concomitant RH preventive therapy on nevirapine concentrations in infants is unknown. Patients and methods: Tshepiso was a prospective case-control cohort study of pregnant HIV-infected women with and without TB whose newborn infants received standard doses of nevirapine for HIV prophylaxis...
April 16, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28419200/switching-to-efavirenz-versus-remaining-on-ritonavir-boosted-lopinavir-in-hiv-infected-children-exposed-to-nevirapine-long-term-outcomes-of-a-randomized-trial
#7
Pamela M Murnane, Renate Strehlau, Stephanie Shiau, Faeezah Patel, Ndileke Mbete, Gillian Hunt, Elaine J Abrams, Ashraf Coovadia, Louise Kuhn
Background: We previously demonstrated the non-inferiority of switching to efavirenz (EFV) versus remaining on ritonavir-boosted lopinavir (LPV/r) for virologic control in HIV-infected children exposed to nevirapine (NVP) for prevention of mother-to-child transmission. Here we assess outcomes up to four years post-randomization. Methods: From 2010-2013, 298 NVP-exposed HIV-infected children ≥3 years of age were randomized to switch to EFV or remain on LPV/r in Johannesburg, South Africa (Clinicaltrials...
April 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28419149/mobile-health-treatment-support-intervention-for-hiv-and-tuberculosis-in-mozambique-perspectives-of-patients-and-healthcare-workers
#8
José António Nhavoto, Åke Grönlund, Gunnar O Klein
BACKGROUND: Studies have been conducted in developing countries using SMS to communicate with patients to reduce the number of missed appointments and improve retention in treatment, however; very few have been scaled up. One possible reason for this could be that patients or staff are dissatisfied with the method in some way. This paper reports a study of patients' and healthcare workers' (HCW) views on an mHealth intervention aiming to support retention in antiretroviral therapy (ART) and tuberculosis (TB) treatment in Mozambique...
2017: PloS One
https://www.readbyqxmd.com/read/28414762/transcriptional-networks-are-associated-with-resistance-to-mycobacterium-tuberculosis-infection
#9
Chetan Seshadri, Nafiseh Sedaghat, Monica Campo, Glenna Peterson, Richard D Wells, Gregory S Olson, David R Sherman, Catherine M Stein, Harriet Mayanja-Kizza, Ali Shojaie, W Henry Boom, Thomas R Hawn
RATIONALE: Understanding mechanisms of resistance to M. tuberculosis (M.tb) infection in humans could identify novel therapeutic strategies as it has for other infectious diseases, such as HIV. OBJECTIVES: To compare the early transcriptional response of M.tb-infected monocytes between Ugandan household contacts of tuberculosis patients who demonstrate clinical resistance to M.tb infection (cases) and matched controls with latent tuberculosis infection. METHODS: Cases (n = 10) and controls (n = 18) were selected from a long-term household contact study in which cases did not convert their tuberculin skin test (TST) or develop tuberculosis over two years of follow up...
2017: PloS One
https://www.readbyqxmd.com/read/28410693/clinical-and-radiological-spectrum-of-intracranial-tuberculosis-a-hospital-based-study-in-northeast-india
#10
Baiakmenlang Synmon, Marami Das, Ashok K Kayal, Munindra Goswami, Jogesh Sarma, Lakshya Basumatary, Suvorit Bhowmick
Central nervous system tuberculosis (TB) is the most severe extra pulmonary TB having a high mortality and morbidity. OBJECTIVE: To study the various clinical, biochemical, and radiological spectrum of intracranial TB. MATERIALS AND METHOD: Ninety-three patients were enrolled in this prospective study after ethical clearance and consent from August 2013 to May 2015. The entire clinical course with complications and predictors of mortality were assessed. RESULTS: 36 females (38...
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28410692/treatment-outcome-of-extrapulmonary-tuberculosis-under-revised-national-tuberculosis-control-programme
#11
J J Cherian, I Lobo, A Sukhlecha, U Chawan, N A Kshirsagar, B L Nair, L Sawardekar
BACKGROUND: Extrapulmonary tuberculosis (EPTB) constitutes 15-20% of tuberculosis cases in India. Earlier studies have evaluated treatment outcomes of EPTB with little information on outcomes of individual site of EPTB. AIMS: The objective was to study the outcome of Directly Observed Treatment Short course (DOTS) treatment of EPTB in different organ systems under Revised National Tuberculosis Control Programme. METHODS: Multi-centric retrospectives record review was carried out in three states in India...
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28407810/does-task-shifting-yield-cost-savings-and-improve-efficiency-for-health-systems-a-systematic-review-of-evidence-from-low-income-and-middle-income-countries
#12
Gabriel Seidman, Rifat Atun
BACKGROUND: Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. METHODS: Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016...
April 13, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28406806/improved-hiv-and-tb-knowledge-and-competence-among-mid-level-providers-in-a-cluster-randomized-trial-of-one-on-one-mentorship-for-task-shifting
#13
Sarah Naikoba, Kaggwa Dan Senjovu, Pallen Mugabe, Carey McCarthy, Patricia L Riley, Damazo Trevor Kadengye, Shona Dalal
INTRODUCTION: Health worker shortages pose a challenge to the scale-up of HIV care and treatment in Uganda. Training mid-level providers (MLP) in the provision of HIV and TB treatment can expand existing health workforce capacity and access to HIV services. METHODS: We conducted a cluster-randomized trial of, on-site clinical mentorship for HIV and TB care at 10 health facilities in rural Uganda. Twenty MLP and were randomly assigned to an intervention of eight hours a week of one on one mentorship, every six weeks over a nine month period; and another twenty to the control of no clinical mentorship...
April 12, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28406247/hba1c-level-cannot-predict-the-treatment-outcome-of-smear-positive-non-multi-drug-resistant-hiv-negative-pulmonary-tuberculosis-inpatients
#14
Ken Tashiro, Nobuyuki Horita, Kenjiro Nagai, Misako Ikeda, Masaharu Shinkai, Masaki Yamamoto, Takashi Sato, Yu Hara, Hideyuki Nagakura, Yuji Shibata, Hiroki Watanabe, Kentaro Nakashima, Ryota Ushio, Akimichi Nagashima, Atsuya Narita, Nobuaki Kobayashi, Makoto Kudo, Takeshi Kaneko
We conducted a single-center retrospective cohort study to evaluate whether the HbA1c level on admission could predict the in-hospital treatment outcome of smear-positive non-multi-drug-resistant HIV-negative culture-proven pulmonary tuberculosis inpatients. Our standard regimens under the direct observation were HRZE or HRE for the first two months followed by combination therapy with isoniazid and rifampicin. Our cohort consisted of consecutive 239 patients consisted of 147 men and 92 women with a median age of 73 years...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28405623/bcg-vaccination-induces-hiv-target-cell-activation-in-hiv-exposed-infants-in-a-randomized-trial
#15
Melanie A Gasper, Anneke C Hesseling, Isaac Mohar, Landon Myer, Tali Azenkot, Jo-Ann S Passmore, Willem Hanekom, Mark F Cotton, I Nicholas Crispe, Donald L Sodora, Heather B Jaspan
BACKGROUND. Bacillus Calmette-Guérin (BCG) vaccine is administered at birth to protect infants against tuberculosis throughout Africa, where most perinatal HIV-1 transmission occurs. We examined whether BCG vaccination alters the levels of activated HIV target T cells in HIV-exposed South African infants. METHODS. HIV-exposed infants were randomized to receive routine (at birth) or delayed (at 8 weeks) BCG vaccination. Activated and CCR5-expressing peripheral blood CD4(+) T cell, monocyte, and NK cell frequencies were evaluated by flow cytometry and immune gene expression via PCR using Biomark (Fluidigm)...
April 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28404672/increased-tuberculosis-patient-mortality-associated-with-mycobacterium-tuberculosis-mutations-conferring-resistance-to-second-line-antituberculous-drugs
#16
Sophia B Georghiou, Marva Seifert, Donald G Catanzaro, Richard S Garfein, Timothy C Rodwell
Rapid molecular diagnostics have great potential to limit the spread of multi- and extensively drug-resistant tuberculosis (M/XDR-TB). These technologies detect mutations in the Mycobacterium tuberculosis (Mtb) genome that confer phenotypic drug resistance. However, there is little data published regarding the relationships between the detected Mtb resistance mutations and M/XDR-TB treatment outcomes, limiting our current ability to exploit the full potential of molecular diagnostics. We analyzed clinical, microbiological and sequencing data for 451 patients and their clinical isolates collected in a multinational, observational cohort study to determine if there was an association between Mtb resistance mutations and patient mortality...
April 12, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28403028/compatibility-of-next-generation-first-line-antiretrovirals-with-rifampicin-based-antituberculosis-therapy-in-resource-limited-settings
#17
Gary Maartens, Marta Boffito, Charles Flexner
PURPOSE OF REVIEW: Reduced dose efavirenz, dolutegravir, and/or tenofovir alafenamide (TAF) are likely to be used in the next generation of first-line antiretroviral therapy in resource limited settings, where HIV-associated tuberculosis is common. Rifampicin, which is a key component of first-line antituberculosis therapy, is a potent inducer of many drug transporters and metabolising enzymes. We reviewed the literature for potential or actual drug--drug interactions between these antiretrovirals and rifampicin...
April 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28403027/candidates-for-inclusion-in-a-universal-antiretroviral-regimen-tenofovir-alafenamide
#18
Dzintars Gotham, Andrew Hill, Anton L Pozniak
PURPOSE OF REVIEW: Tenofovir disoproxil fumarate (TDF) is a standard first-line therapy for HIV. Recently, tenofovir alafenamide (TAF), a different prodrug for the same active moiety, has been approved. In this review, we have conducted a meta-analysis comparing efficacy and safety data for TDF and TAF, to inform a discussion of which drug would be best for a proposed 'universal antiretroviral (ARV) regimen'. RECENT FINDINGS: We identified 10 randomized controlled trials comparing TDF with TAF (6969 patients, 8043 patient-years of follow-up)...
April 11, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28399972/economic-support-intervention-improves-tuberculosis-treatment-outcomes-in-rural-nigeria
#19
K N Ukwaja, I Alobu, M Gidado, O Onazi, D C Oshi
SETTING: A secondary care hospital in rural Nigeria. OBJECTIVE: To investigate the feasibility of providing financial incentives to tuberculosis (TB) patients under routine conditions, and to determine their impact on TB treatment outcomes in a low-resource setting. DESIGN: A prospective, non-randomised intervention study. RESULTS: A total of 294 TB patients (respectively 173 and 121 in the control and intervention periods of 3 months' duration each) were registered in the study...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28399969/implementing-isoniazid-preventive-therapy-in-a-tuberculosis-treatment-experienced-cohort-on-art
#20
B Maharaj, T N Gengiah, N Yende-Zuma, S Gengiah, A Naidoo, K Naidoo
SETTING: Urban clinical research site in Durban, South Africa. OBJECTIVE: To describe outcomes associated with the implementation of isoniazid preventive therapy (IPT) in a cohort of tuberculosis (TB) treatment-experienced human immunodeficiency virus (HIV) infected patients on antiretroviral therapy (ART). DESIGN: We conducted a secondary analysis of data collected between October 2009 and October 2013 from patients enrolled in a prospective cohort study conducted in Durban, South Africa...
May 1, 2017: International Journal of Tuberculosis and Lung Disease
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