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https://www.readbyqxmd.com/read/29145924/pharmacokinetic-interaction-between-bedaquiline-and-clofazimine-in-patients-with-drug-resistant-tuberculosis
#1
G Maartens, M J E Brill, M Pandie, E M Svensson
<h2>BACKGROUND:</h2>Bedaquiline (BDQ) and clofazimine (CFZ) are both recommended for treating drug-resistant tuberculosis (DR-TB). As CFZ is an inhibitor of the cytochrome P450 isoenzyme 3A4 (CYP3A4) in vitro, and BDQ a substrate of CYP3A4, there is a potential for pharmacokinetic (PK) drug-drug interaction that may result in increased BDQ exposure when co-administered with CFZ, which could increase the toxicity of BDQ.<h2>METHODS:</h2>We assessed the effect of co-administered CFZ on BDQ bioavailability, or on clearance of BDQ and its N-monodesmethyl metabolite (M2), in patients with DR-TB using a population PK model developed from data of patients with DR-TB...
November 16, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29142889/rapid-detection-of-streptomycin-resistant-mycobacterium-tuberculosis-by-rpsl-restriction-fragment-length-polymorphism
#2
Sediqe Karimi, Hossein Mirhendi, Fatemh Riyahi Zaniani, Soroor Erfani Manesh, Mahshd Salehi, Bahram Nasr Esfahani
Background: Molecular methods for the detection of drug-resistant tuberculosis (DR-TB) are potentially more rapid than conventional culture-based drug susceptibility testing, facilitating the commencement of appropriate treatment for patients with DR-TB. The aim of this study was to evaluate and develop polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays for the detection of mutations within rpsL, and for the determination of streptomycin (STR) resistance in Mycobacterium tuberculosis...
2017: Advanced Biomedical Research
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
#3
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/29137626/treatment-outcomes-of-mdr-tuberculosis-patients-in-brazil-a-retrospective-cohort-analysis
#4
Mayara Lisboa Bastos, Lorrayne Beliqui Cosme, Geisa Fregona, Thiago Nascimento do Prado, Adelmo Inácio Bertolde, Eliana Zandonade, Mauro N Sanchez, Margareth Pretti Dalcolmo, Afrânio Kritski, Anete Trajman, Ethel Leonor Noia Maciel
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a threat for the global TB epidemic control. Despite existing evidence that individualized treatment of MDR-TB is superior to standardized regimens, the latter are recommended in Brazil, mainly because drug-susceptibility tests (DST) are often restricted to first-line drugs in public laboratories. We compared treatment outcomes of MDR-TB patients using standardized versus individualized regimens in Brazil, a high TB-burden, low resistance setting...
November 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29112693/comparison-of-two-cash-transfer-strategies-to-prevent-catastrophic-costs-for-poor-tuberculosis-affected-households-in-low-and-middle-income-countries-an-economic-modelling-study
#5
COMPARATIVE STUDY
William E Rudgard, Carlton A Evans, Sedona Sweeney, Tom Wingfield, Knut Lönnroth, Draurio Barreira, Delia Boccia
BACKGROUND: Illness-related costs for patients with tuberculosis (TB) ≥20% of pre-illness annual household income predict adverse treatment outcomes and have been termed "catastrophic." Social protection initiatives, including cash transfers, are endorsed to help prevent catastrophic costs. With this aim, cash transfers may either be provided to defray TB-related costs of households with a confirmed TB diagnosis (termed a "TB-specific" approach); or to increase income of households with high TB risk to strengthen their economic resilience (termed a "TB-sensitive" approach)...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29110862/low-pre-diagnosis-attrition-but-high-pre-treatment-attrition-among-patients-with-mdr-tb-an-operational-research-from-chennai-india
#6
Hemant Deepak Shewade, Dina Nair, Joel S Klinton, Malik Parmar, J Lavanya, Lakshmi Murali, Vivek Gupta, Jaya Prasad Tripathy, Soumya Swaminathan, Ajay M V Kumar
BACKGROUND: Worldwide, there's concern over high pre-diagnosis and pre-treatment attritions or delays in Multidrug resistant tuberculosis (MDR-TB) diagnosis and treatment pathway (DTP). We conducted this operational research among patients with presumptive MDR-TB in north and central Chennai, India to determine attrition and turnaround times (TAT) at various steps of DTP and factors associated with attrition. METHODS: Study was conducted in Revised National Tuberculosis Control Programme setting...
December 2017: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/29047424/drug-resistant-tuberculosis-among-children-china-2006-2015
#7
Ning-Ning Tao, Xiao-Chun He, Xian-Xin Zhang, Yao Liu, Chun-Bao Yu, Huai-Chen Li
Microbial drug resistance has become a major public health concern worldwide. To acquire epidemiologic data on drug-resistant tuberculosis (DR TB) among children, a major cause of illness and death for this population, we conducted a retrospective study of 2006-2015 data from 36 TB prevention and control institutions in Shandong Province, China. A total of 14,223 new TB cases, among which children (<18 years of age) accounted for only 5.5%, were caused by culture-confirmed Mycobacterium tuberculosis. Among children with TB, 18...
November 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29042338/drug-resistant-mycobacterium-tuberculosis-epidemiology-and-role-of-morphological-alterations
#8
REVIEW
Ali Akbar Velayati, Parissa Farnia, Sven Hoffner
In this brief review, various forms of drug resistant tuberculosis (DR-TB) are discussed. The focus of the study is to highlight morphological alterations of DR-TB bacilli at cellular level.
October 14, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29041901/prevalence-of-drug-resistant-pulmonary-tuberculosis-in-india-systematic-review-and-meta-analysis
#9
Vishal Goyal, Vijay Kadam, Prashant Narang, Vikram Singh
BACKGROUND: Drug-resistant pulmonary tuberculosis (DR-TB) is a significant public health issue that considerably deters the ongoing TB control efforts in India. The purpose of this review was to investigate the prevalence of DR-TB and understand the regional variation in resistance pattern across India from 1995 to 2015, based on a large body of published epidemiological studies. METHODS: A systematic review of published studies reporting prevalence of DR-TB from biomedical databases (PubMed and IndMed) was conducted...
October 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29038231/evaluation-of-clinical-drug-interaction-potential-of-clofazimine-using-static-and-dynamic-modeling-approaches
#10
Ramachandra Sangana, Helen Gu, Dung Yu Chun, Heidi J Einolf
The 2016 World Health Organization treatment recommendations for drug-resistant tuberculosis (DR-TB) positioned clofazimine as a core second-line drug. Being identified as a cytochrome P450 (CYP) inhibitor in vitro, a CYP-mediated drug interaction may be likely when clofazimine is co-administered with substrates of these enzymes. The CYP-mediated drug interaction potential of clofazimine was evaluated using both static (estimation of "R1" and area under the plasma concentration-time curve ratio [AUCR] values) and dynamic (physiologically based pharmacokinetic [PBPK]) modeling approaches...
October 16, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/29037297/innovative-approach-to-the-design-and-evaluation-of-treatment-adherence-interventions-for-drug-resistant-tb
#11
K Alegria-Flores, B J Weiner, C A Wiesen, K L H Lich, A Van Rie, J E Paul, M A Tovar
BACKGROUND: Drug-resistant tuberculosis (DR-TB) treatment is expensive, lengthy, and can cause severe side effects. Patients face socio-economic, psychosocial, and systemic barriers to adherence; poor adherence results in poor treatment outcomes. OBJECTIVE: To estimate the effects of the components of the information-motivation-behavioral skills model on DR-TB treatment adherence. DESIGN: We recruited 326 adults receiving DR-TB treatment and 86 of their health care service providers from 40 health centers in Lima, Peru...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28992819/tb-pcr-and-drug-resistance-pattern-in-balf-in-smear-negative-active-pulmonary-tb
#12
K Chavalertsakul, V Boonsarngsuk, S Saengsri, P Santanirand
<h2>SETTING:</h2>A tertiary referral hospital in Bangkok, Thailand.<h2>OBJECTIVES:</h2>To evaluate the efficacy of a bronchoalveolar lavage fluid (BALF) tuberculosis (TB) polymerase chain reaction (PCR) assay for the diagnosis of sputum smear-negative pulmonary TB (PTB) and the usefulness of a drug-resistant (DR) TB-PCR assay compared with standard drug susceptibility testing (DST).<h2>DESIGN:</h2>BALF samples from 918 patients with acid-fast bacilli (AFB) negative sputum smears who underwent bronchoscopy for diagnostic evaluations of pulmonary diseases were prospectively determined for specific genetic elements of TB using the Anyplex(TM) MTB/NTM Real-Time Detection kit...
October 9, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28962599/predictors-of-unsuccessful-interim-treatment-outcomes-of-multidrug-resistant-tuberculosis-patients
#13
Muhammad Atif, Arslan Bashir, Nafees Ahmad, Razia Kaneez Fatima, Sehar Saba, Shane Scahill
BACKGROUND: Interim treatment outcomes at 6-months for multidrug-resistant tuberculosis (MDR-TB) treatment are among the most basic performance monitoring and key evaluation indicators in the Stop and End TB strategy of the World Health Organization (WHO). Therefore, this study was conducted to evaluate the interim treatment outcomes of MDR-TB patients in Pakistan. METHODS: This study was conducted at the Programmatic Management Unit for Drug-resistance TB (PMDT) site of the National Tuberculosis Program (NTP), Pakistan...
September 29, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28958922/trends-and-characteristics-of-drug-resistant-tuberculosis-in-rural-shandong-china
#14
Ning-Ning Tao, Xiao-Chun He, Xian-Xin Zhang, Yao Liu, Chun-Bao Yu, Huai-Chen Li
OBJECTIVES: The aim of this study was to describe the secular trends in drug-resistant tuberculosis (DR-TB) and to identify unique characteristics of multidrug-resistant tuberculosis (MDR-TB) in rural China. METHODS: A retrospective study was conducted using TB data collected from 36 TB prevention and control institutions serving rural populations in Shandong Province, China, for the period 2006-2015. RESULTS: Approximately 8.3% of patients suffered from MDR-TB, among whom 70% were newly treated patients; this rate increased by 1...
September 25, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28899805/performance-of-genotype-%C3%A2-mtbdrplus-assay-in-the-diagnosis-of-drug-resistant-tuberculosis-in-tangier-morocco
#15
Hind Karimi, Latifa En-Nanai, Amal Oudghiri, Imane Chaoui, Amin Laglaoui, Jamal Eddine Bourkadi, Mohammed El Mzibri, Mohammed Abid
OBJECTIVES: In Morocco, tuberculosis (TB) is a major public health problem with high morbidity and mortality. The main problem faced by the National TB program is the high rate of drug resistant (DR), particularly multi-drug resistant (MDR) strains. Diagnosis of DR-TB is mainly performed by conventional techniques which are time consuming with limited efficacy. In 2014, GenoType(®) MTBDRplus assay was introduced in Morocco for drug resistance testing. In this regard, the present study was planned to assess the diagnostic accuracy of GenoType(®) MTBDRplus assay...
September 9, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28889065/profiling-dendritic-cell-subsets-in-the-patients-with-active-pulmonary-tuberculosis
#16
Yuan-Bin Lu, De-Qian Xiao, Kui-Di Liang, Jun-Ai Zhang, Wan-Dang Wang, Shi-Yan Yu, Bi-Ying Zheng, Yu-Chi Gao, You-Chao Dai, Yan Jia, Chen Chen, Ze-Gang Zhuang, Xin Wang, Xiao-Xia Fu, Yong Zhou, Jixin Zhong, Zheng W Chen, Jun-Fa Xu
Dendritic cell (DC) plays an important role in the immune response against pulmonary tuberculosis. However, the phenotypic profile of DC subsets in peripheral blood in individuals with active pulmonary tuberculosis (APT) is still inconclusive. Here, we demonstrated that the absolute numbers of total DC (tDC), myeloid DC (mDC) and plasmacytoid DC (pDC) in individuals with APT were decreased compared to healthy controls (HCs). The decreased number of DCs, especially of pDC, seems to be a useful diagnostic marker of APT...
November 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28880875/scaling-up-the-xpert-mtb-rif-assay-for-the-detection-of-tuberculosis-and-rifampicin-resistance-in-india-an-economic-analysis
#17
Sunil Khaparde, Neeraj Raizada, Sreenivas Achuthan Nair, Claudia Denkinger, Kuldeep Singh Sachdeva, Chinnambedu Nainarappan Paramasivan, Virender Singh Salhotra, Anna Vassall, Anja Van't Hoog
BACKGROUND: India is considering the scale-up of the Xpert MTB/RIF assay for detection of tuberculosis (TB) and rifampicin resistance. We conducted an economic analysis to estimate the costs of different strategies of Xpert implementation in India. METHODS: Using a decision analytical model, we compared four diagnostic strategies for TB patients: (i) sputum smear microscopy (SSM) only; (ii) Xpert as a replacement for the rapid diagnostic test currently used for SSM-positive patients at risk of drug resistance (i...
2017: PloS One
https://www.readbyqxmd.com/read/28869693/diabetes-prevalence-and-its-impact-on-health-related-quality-of-life-in-tuberculosis-patients
#18
Ali Nasir Siddiqui, Khalid Umer Khayyam, Nahida Siddiqui, Rohit Sarin, Manju Sharma
OBJECTIVE: To determine the prevalence of diabetes mellitus (DM), assess its influence on health-related quality of life (HRQoL) among patients with TB. METHODS: In this prospective study, eligible patients at three primary healthcare centres in urban slum region of south Delhi, India, underwent blood glucose screening at treatment initiation. HRQoL scores were determined by conducting face-to-face interviews using Dhingra and Rajpal (DR-12) scale at pre-treatment, end of intensive phase and end of the treatment...
November 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28861650/optimal-timing-of-drug-sensitivity-testing-for-patients-on-first-line-tuberculosis-treatment
#19
Sze-Chuan Suen, Margaret L Brandeau, Jeremy D Goldhaber-Fiebert
Effective treatment for tuberculosis (TB) patients on first-line treatment involves triaging those with drug-resistant (DR) TB to appropriate treatment alternatives. Patients likely to have DR TB are identified using results from repeated inexpensive sputum-smear (SS) tests and expensive but definitive drug sensitivity tests (DST). Early DST may lead to high costs and unnecessary testing; late DST may lead to poor health outcomes and disease transmission. We use a partially observable Markov decision process (POMDP) framework to determine optimal DST timing...
August 31, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28810911/outcomes-from-patients-with-presumed-drug-resistant-tuberculosis-in-five-reference-centers-in-brazil
#20
MULTICENTER STUDY
D M P Ramalho, P F C Miranda, M K Andrade, T Brígido, M P Dalcolmo, E Mesquita, C F Dias, A N Gambirasio, J Ueleres Braga, A Detjen, P P J Phillips, I Langley, P I Fujiwara, S B Squire, M M Oliveira, A L Kritski
BACKGROUND: The implementation of rapid drug susceptibility testing (DST) is a current global priority for TB control. However, data are scarce on patient-relevant outcomes for presumptive diagnosis of drug-resistant tuberculosis (pDR-TB) evaluated under field conditions in high burden countries. METHODS: Observational study of pDR-TB patients referred by primary and secondary health units. TB reference centers addressing DR-TB in five cities in Brazil. Patients age 18 years and older were eligible if pDR-TB, culture positive results for Mycobacterium tuberculosis and, if no prior DST results from another laboratory were used by a physician to start anti-TB treatment...
August 15, 2017: BMC Infectious Diseases
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