Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study.
by G Reniers on 12 October, 2017 at 1:01
Women live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa-a high mortality population with a large sex disparity-is an exception, but the causes of death that contribute to this difference are not well understood. Using data from a demographic
Incidence of Tuberculosis amongst HIV positive individuals initiating antiretroviral treatment at higher CD4 counts in the HPTN 071 (PopART) trial in South Africa.
by P Bock on 12 October, 2017 at 1:01
Antiretroviral treatment (ART) guidelines recommend lifelong ART for all HIV positive individuals. This study evaluated TB incidence on ART in a cohort of HIV positive individuals starting ART regardless of CD4 count in a programmatic setting at three clinics included in the HPTN 071 (PopART) trial in South Africa. A retrospective cohort
What Have We Learnt about BCG Vaccination in the Last 20 Years?
by HM Dockrell on 3 October, 2017 at 1:01
: A number of new tuberculosis (TB) vaccines have been or are entering clinical trials, which include genetically modified mycobacteria, mycobacterial antigens delivered by viral vectors, or mycobacterial antigens in adjuvant. Some of these vaccines aim to replace the existing BCG vaccine but others will be given as a boosting vaccine following
Non-tuberculous Mycobacteria isolated from Pulmonary samples in sub-Saharan Africa - A Systematic Review and Meta Analyses.
by C Okoi on 26 September, 2017 at 1:01
Pulmonary non-tuberculous mycobacterial (NTM) disease epidemiology in sub-Saharan Africa is not as well described as for pulmonary tuberculosis. Earlier reviews of global NTM epidemiology only included subject-level data from one sub-Saharan Africa country. We systematically reviewed the literature and searched PubMed, Embase, Popline, OVID and
- The duration of protection of school-aged BCG vaccination in England: a population -based case–control study
Single nucleotide polymorphisms in efflux pumps genes in extensively drug resistant Mycobacterium tuberculosis isolates from Pakistan
by A Kanji on 17 September, 2017 at 7:07
It is challenging to understand mechanisms of drug resistance in Mycobacterium tuberculosis (MTB) due to the large variability in resistance associated genes. Efflux pump genes contribute to drug resistance and thus add to this complexity. Efflux pump gene protein superfamilies have been characterized by genome analysis of drug resistant strains
The seasonality of tuberculosis, sunlight, vitamin D, and household crowding.
by T Wingfield on 14 September, 2017 at 1:01
Unlike other respiratory infections, tuberculosis diagnoses increase in summer. We performed an ecological analysis of this paradoxical seasonality in a Peruvian shantytown over 4 years. Tuberculosis symptom-onset and diagnosis dates were recorded for 852 patients. Their tuberculosis-exposed cohabitants were tested for tuberculosis infection
Beyond pills and tests: addressing the social determinants of tuberculosis.
by T Wingfield on 14 September, 2017 at 1:01
Poverty drives tuberculosis (TB) rates but the approach to TB control has been disproportionately biomedical. In 2015, the World Health Organization's End TB Strategy explicitly identified the need to address the social determinants of TB through socio-economic interventions. However, evidence concerning poverty reduction and cost mitigation
Treatment outcomes of multidrug-resistant tuberculosis patients in Gauteng, South Africa.
by E Marais on 14 September, 2017 at 1:01
Multidrug-resistant tuberculosis (MDR-TB) is associated with lengthy treatment, expensive and potentially toxic regimens, and high rates of treatment failure and death. This study describes the outcomes of 351 MDR-TB patients who started treatment between 2004 and 2007 at the provincial MDR-TB referral hospital in Johannesburg, South Africa, and
Risk factors that may be driving the emergence of drug resistance in tuberculosis patients treated in Yangon, Myanmar.
by MS Khan on 12 September, 2017 at 1:01
The majority of new tuberculosis cases emerging every year occur in low and middle-income countries where public health systems are often characterised by weak infrastructure and inadequate resources. This study investigates healthcare seeking behaviour, knowledge and treatment of tuberculosis patients in Myanmar-which is facing an acute
Disseminated tuberculosis among hospitalised HIV patients in South Africa: a common condition that can be rapidly diagnosed using urine-based assays.
by AD Kerkhoff on 12 September, 2017 at 1:01
HIV-associated disseminated TB (tuberculosis) has been under-recognised and poorly characterised. Blood culture is the gold-standard diagnostic test, but is expensive, slow, and may under-diagnose TB dissemination. In a cohort of hospitalised HIV patients, we aimed to report the prevalence of TB-blood-culture positivity, performance of rapid
Scaling-up the Xpert MTB/RIF assay for the detection of tuberculosis and rifampicin resistance in India: An economic analysis.
by S Khaparde on 9 September, 2017 at 15:03
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. Using a decision analytical model, we compared four diagnostic strategies for TB patients: (i) sputum smear
- Pyrazinamide resistance-conferring mutations in pncA and the transmission of multidrug resistant TB in Georgia
- Screening for tuberculosis with Xpert MTB/RIF versus fluorescent microscopy among people newly diagnosed with HIV in rural Malawi: a cluster-randomized trial
Diagnostic accuracy of the Xpert(®) MTB/RIF cycle threshold level to predict smear positivity: a meta-analysis.
by B Lange on 27 August, 2017 at 0:12
Xpert® MTB/RIF is the most widely used molecular assay for rapid diagnosis of tuberculosis (TB). The number of polymerase chain reaction cycles after which detectable product is generated (cycle threshold value, CT) correlates with the bacillary burden.OBJECTIVE To investigate the association between Xpert CT values and smear status through a
- Language discordance between tuberculosis patients and healthcare providers challenging universal access.
Tuberculosis active case finding in Cambodia: a pragmatic, cost-effectiveness comparison of three implementation models.
by R James on 26 August, 2017 at 15:03
Globally, almost 40% of tuberculosis (TB) patients remain undiagnosed, and those that are diagnosed often experience prolonged delays before initiating correct treatment, leading to ongoing transmission. While there is a push for active case finding (ACF) to improve early detection and treatment of TB, there is extremely limited evidence about the
Modelling the social and structural determinants of tuberculosis: opportunities and challenges.
by D Pedrazzoli on 24 August, 2017 at 1:01
: Despite the close link between tuberculosis (TB) and poverty, most mathematical models of TB have not addressed underlying social and structural determinants.<br/> : To review studies employing mathematical modelling to evaluate the epidemiological impact of the structural determinants of TB.<br/> : We systematically searched PubMed
- Economic evaluation of TB screening programmes in migrants: need for a comprehensive framework.