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Priska Bwana, Joshua Ageng'o, Matilu Mwau
BACKGROUND: In Kenya, access to early infant diagnosis and viral load monitoring services for HIV patients on ART is significantly hampered by sample transportation challenges and long turnaround times. Near patient care testing technologies have the potential to obviate such constraints. The Cepheid GeneXpert was launched in 2010 as a TB assay and in 2014 as a potential point of care HIV viral load assay. Whereas it is widely is used for TB in Kenya, its utility for HIV testing has not been evaluated...
2019: PloS One
Adam MacNeil, Philippe Glaziou, Charalambos Sismanidis, Susan Maloney, Katherine Floyd
Worldwide, tuberculosis (TB) is the leading cause of death from a single infectious disease agent (1) and the leading cause of death among persons living with human immunodeficiency virus (HIV) infection, accounting for approximately 40% of deaths in this population (2). The United Nations' (UN) Sustainable Development Goals (3) and the World Health Organization's (WHO's) End TB Strategy (4) have defined ambitious targets for 2020-2035, including a 35% reduction in the absolute number of TB deaths and a 20% reduction in TB incidence by 2020, compared with 2015 (4)...
March 22, 2019: MMWR. Morbidity and Mortality Weekly Report
Susan L Ford, Yu Lou, Nicole Lewis, Kostapanos Michalis, Ronald D'Amico, William Spreen, Parul Patel
BACKGROUND: Cabotegravir (CAB) is an integrase strand transfer inhibitor in development as a long-acting injectable formulation, with an oral formulation used during a safety lead-in period. Tuberculosis (TB)/HIV co-infection is common, often requiring simultaneous treatment. Rifabutin (RBT) is an alternative antimycobacterial agent for TB and a moderate inducer of cytochrome P450 and UDP-glucuronosyltransferase isoenzymes. This study evaluated the impact of RBT on the pharmacokinetics (PK) of oral CAB...
March 21, 2019: Antiviral Therapy
M Tetart, A Meybeck, A Assaf, M Valette, P Choisy, N Blondiaux, E Senneville
OBJECTIVE: The proportion of successfully treated tuberculosis (TB) patients remains below the WHO target in France, because of a high proportion of loss to follow-up. We aimed to identify factors associated with loss to follow-up in northern France, a low-incidence area. METHODS: Between 1997 and 2017, all consecutive patients diagnosed with TB at the Tourcoing Hospital, except those infected with multidrug-resistant or extensively drug-resistant strains, were included in a retrospective cohort study...
March 16, 2019: Médecine et Maladies Infectieuses
Priya B Shete, Katherine Farr, Luke Strnad, Christen M Gray, Adithya Cattamanchi
BACKGROUND: The need for a rapid, molecular test to diagnose tuberculosis (TB) has prompted exploration of TB-LAMP (Eiken; Tokyo, Japan) for use in resource-limited settings. We conducted a systematic review to assess the accuracy of TB-LAMP as a diagnostic test for pulmonary TB. METHODS: We analyzed individual-level data for eligible patients from all studies of TB-LAMP conducted between Jan 2012 and October 2015 to compare the diagnostic accuracy of TB-LAMP with that of smear microscopy and Xpert MTB/RIF® using 3 reference standards of varying stringency...
March 19, 2019: BMC Infectious Diseases
Ursula K Rohlwink, Naomi F Walker, Alvaro A Ordonez, Yifan J Li, Elizabeth W Tucker, Paul T Elkington, Robert J Wilkinson, Katalin A Wilkinson
Tuberculosis (TB) remains the single biggest infectious cause of death globally, claiming almost two million lives and causing disease in over 10 million individuals annually. Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes with various physiological roles implicated as key factors contributing to the spread of TB. They are involved in the breakdown of lung extracellular matrix and the consequent release of Mycobacterium tuberculosis bacilli into the airways. Evidence demonstrates that MMPs also play a role in central nervous system (CNS) tuberculosis, as they contribute to the breakdown of the blood brain barrier and are associated with poor outcome in adults with tuberculous meningitis (TBM)...
March 18, 2019: International Journal of Molecular Sciences
Muhammad Tahir Khan, Aman Chandra Kaushik, Linxiang Ji, Shaukat Iqbal Malik, Sajid Ali, Dong-Qing Wei
Background: The global burden of tuberculosis (TB) and antibiotic resistance is attracting the attention of researchers to develop some novel and rapid diagnostic tools. Although, the conventional methods like culture are considered as the gold standard, they are time consuming in diagnostic procedure, during which there are more chances in the transmission of disease. Further, the Xpert MTB/RIF assay offers a fast diagnostic facility within 2 h, but due to low sensitivity in some sample types may lead to more serious state of the disease...
2019: Frontiers in Microbiology
Ville Holmberg, Hanna Soini, Pia Kivelä, Jukka Ollgren, Matti Ristola
BACKGROUND: Tuberculosis (TB) is a major cause of death in HIV patients worldwide. Here we describe the epidemiology and outcome of HIV-TB co-infections in a high-income country with low TB incidence and integrated HIV and TB therapy according to European guidelines. METHODS: This study was based on the HIV cohort of the Helsinki University Hospital which includes all HIV patients in the Helsinki region with a population of 1.5 million. Totally, 1939 HIV-positives who have been under follow-up between 1998 and 2015 were included...
March 18, 2019: BMC Infectious Diseases
Thomas J Bollyky, Tara Templin, Matthew Cohen, Diana Schoder, Joseph L Dieleman, Simon Wigley
BACKGROUND: Previous analyses of democracy and population health have focused on broad measures, such as life expectancy at birth and child and infant mortality, and have shown some contradictory results. We used a panel of data spanning 170 countries to assess the association between democracy and cause-specific mortality and explore the pathways connecting democratic rule to health gains. METHODS: We extracted cause-specific mortality and HIV-free life expectancy estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 and information on regime type from the Varieties of Democracy project...
March 13, 2019: Lancet
Noelle A Benzekri, Jacques F Sambou, Sanou Ndong, Ibrahima Tito Tamba, Dominique Faye, Mouhamadou Baïla Diallo, Jean Phillippe Diatta, Khadim Faye, Ibrahima Sall, Fatima Sall, Noël Magloire Manga, Jean Jacques Malomar, Cheikh T Ndour, Stephen E Hawes, Moussa Seydi, Geoffrey S Gottlieb
BACKGROUND: The WHO guidelines for the management of advanced HIV disease recommend a package of care consisting of rapid initiation of antiretroviral therapy (ART), enhanced screening and diagnosis of tuberculosis (TB) and cryptococcal meningitis, co-trimoxazole prophylaxis, isoniazid preventive therapy (IPT), fluconazole pre-emptive therapy, and adherence support. The goals of this study were to determine the prevalence of advanced HIV disease among individuals initiating ART in Senegal, to identify predictors of advanced disease, and to evaluate adherence to the WHO guidelines...
March 15, 2019: BMC Infectious Diseases
Michael J Peluso, Neo Tapela, John Langeveldt, Margaret E Williams, Kagiso Mochankana, Kebonye Motseosi, Brian Ricci, Adam Rodman, Cecil Haverkamp, Miriam Haverkamp, Rosa Maoto, Rebecca Luckett, Detlef Prozesky, Oathokwa Nkomazana, Tomer Barak
BACKGROUND: Medical internship is the final year of training before independent practice for most doctors in Botswana. Internship training in Botswana faces challenges including variability in participants' level of knowledge and skill related to their completion of medical school in a variety of settings (both foreign and domestic), lack of planned curricular content, and limited time for structured educational activities. Data on trainees' opinions regarding the content and delivery of graduate medical education in settings like Botswana are limited, which makes it difficult to revise programs in a learner-centered way...
April 30, 2018: Annals of Global Health
Ankur Gupta-Wright, Yukari C Manabe
Implementation science uses methods to promote the scaling up and use of evidence-based practices by health systems to improve quality and outcomes. Its use is vital to maximise the efficiency of limited resources for health care in tropical settings. HIV and tuberculosis (TB) are two of the major causes of morbidity and mortality in sub-Saharan Africa, and globally. Although effective treatments are widely available, lack of diagnosis remains a large barrier to accessing treatment, particularly in resource-limited settings...
March 2019: Clinical Medicine: Journal of the Royal College of Physicians of London
Kathleen R Page, Shannon Doocy, Feliciano Reyna Ganteaume, Julio S Castro, Paul Spiegel, Chris Beyrer
The economic crisis in Venezuela has eroded the country's health-care infrastructure and threatened the public health of its people. Shortages in medications, health supplies, interruptions of basic utilities at health-care facilities, and the emigration of health-care workers have led to a progressive decline in the operational capacity of health care. The effect of the crisis on public health has been difficult to quantify since the Venezuelan Ministry of Health stopped publishing crucial public health statistics in 2016...
March 11, 2019: Lancet
J Lai, Z Dememew, D Jerene, A Abashawl, B Feleke, A M Teklu, A Ruff
SETTING: Sixty-seven government health facilities providing tuberculosis (TB) and human immunodeficiency virus (HIV) services across Ethiopia. OBJECTIVE: To examine clinician barriers to implementing isoniazid preventive therapy (IPT) among people living with HIV. DESIGN: A cross-sectional study to evaluate the provider-related factors associated with high IPT coverage at the facility level. RESULTS: On bivariate analysis, the odds of high IPT implementation were lower when clinicians felt patients were negatively affected by the side effects of IPT (OR 0...
March 1, 2019: International Journal of Tuberculosis and Lung Disease
K H Phyo, M M Oo, A D Harries, S Saw, T K Aung, J Moe, S S Thuya, Y Y Mon, A C Min, N N Naing, M S Kyi, S T Aung, H N Oo
SETTING: Two human immunodeficiency virus (HIV) clinics providing antiretroviral therapy (ART), Mandalay, Myanmar. OBJECTIVE: To assess prevalent TB at enrolment, incident TB during follow-up and associated risk factors in adult people living with HIV (PLHIV) between 2011 and 2017. DESIGN: Cohort study using secondary data. RESULTS: Of 11 777 PLHIV, 2911 (25%) had prevalent TB at or within 6 weeks of enrolment. Independent risk factors for prevalent TB were being male or single/widowed, daily alcohol consumption, CD4 count 200 cells/μl and anaemia...
March 1, 2019: International Journal of Tuberculosis and Lung Disease
N T T Kyaw, A M V Kumar, K W Y Kyaw, S Satyanarayana, M J Magee, A C Min, J Moe, Z Z Aung, T K Aung, M M Oo, K T Soe, H N Oo, S T Aung, A D Harries
SETTING: Myanmar, a country with a high human immunodeficiency virus-tuberculosis (HIV-TB) burden, where the tuberculin skin test or interferon-gamma release assays are not routinely available for the diagnosis of latent tuberculous infection. OBJECTIVE: To assess the effect of isoniazid (INH) preventive therapy (IPT) on the risk of TB disease and mortality among people living with HIV (PLHIV). DESIGN: A retrospective cohort study of routinely collected data on PLHIV enrolled into care between 2009 and 2014...
March 1, 2019: International Journal of Tuberculosis and Lung Disease
T Q Lo, L Matlhare, K Mugisha, T D Lere, A Ho-Foster, R Boyd, J Cavanaugh, R Ncube, A P Steenhoff, T Arscott-Mills
SETTING: Diagnosing pediatric tuberculosis (TB) is difficult; to improve diagnosis , gastric aspiration (GA) was performed in 121 Botswana health facilities. OBJECTIVE: To describe treatment initiation and outcomes in children with a positive GA result and those treated empirically. METHODS: Children with smear or culture-positive GA or those clinically diagnosed were referred for anti-tuberculosis treatment. Treatment initiation and outcomes were assessed from February 2008 to December 2012 using name-based matching algorithms of the GA database; treatment initiation was captured in the electronic TB registry...
March 1, 2019: International Journal of Tuberculosis and Lung Disease
B Crabtree-Ramírez, C Jenkins, K Jayathilake, G Carriquiry, V Veloso, D Padgett, E Gotuzzo, C Cortes, F Mejia, C C McGowan, S Duda, B E Shepherd, T R Sterling
BACKGROUND: Tuberculosis (TB) diagnosis in human immunodeficiency virus (HIV) positive persons is difficult, particularly in resource-limited settings. The relationship between TB culture status and mortality in HIV-positive persons treated for TB is unclear. METHODS: We evaluated HIV-positive adults treated for TB at or after their first HIV clinic visit in Argentina, Brazil, Chile, Honduras, Mexico or Peru from 2000 to 2015. Anti-tuberculosis treatment included 2 months of isoniazid, rifampicin (RMP)/rifabutin (RBT), pyrazinamide ± ethambutol, followed by continuation phase treatment with isoniazid + RMP/RBT...
March 1, 2019: International Journal of Tuberculosis and Lung Disease
P Huangfu, Y V Laurence, B Alisjahbana, C Ugarte-Gil, A-L Riza, G Walzl, R Ruslami, D A J Moore, M Ioana, S McAllister, K Ronacher, R C Koesoemadinata, D Grint, S Kerry, J Coronel, S T Malherbe, U Griffiths, H M Dockrell, P C Hill, R van Crevel, F Pearson, J A Critchley
BACKGROUND: Diabetes mellitus (DM) is common among tuberculosis (TB) patients and often undiagnosed or poorly controlled. We compared point of care (POC) with laboratory glycated haemoglobin (HbA1c ) testing among newly diagnosed TB patients to assess POC test accuracy, safety and acceptability in settings in which immediate access to DM services may be difficult. METHODS: We measured POC and accredited laboratory HbA1c (using high-performance liquid chromatography) in 1942 TB patients aged 18 years recruited from Peru, Romania, Indonesia and South Africa...
March 1, 2019: International Journal of Tuberculosis and Lung Disease
H A Rashak, H J Sánchez-Pérez, B E Abdelbary, A Bencomo-Alerm, N Enriquez-Ríos, A Gómez-Velasco, A Colorado, M Castellanos-Joya, M H Rahbar, B I Restrepo
We investigated the distribution of comorbidities among adult tuberculosis (TB) patients in Chiapas, the poorest Mexican state, with a high presence of indigenous population, and a corridor for migrants from Latin America. Secondary analysis on 5508 new adult TB patients diagnosed between 2010 and 2014 revealed that the most prevalent comorbidities were diabetes mellitus (DM; 19.1%) and undernutrition (14.4%). The prevalence of DM in these TB patients was significantly higher among middle aged (41-64 years) compared with older adults (⩾65 years) (38...
January 2019: Epidemiology and Infection
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