Progressing towards tuberculosis elimination in the European Union and European Economic Area.

Progressing towards tuberculosis elimination in the European Union and European Economic Area. Euro Surveill. 2015;20(11) Authors: van der Werf MJ, Antoine D PMID: 25811642 [PubMed - as supplied by publisher]
Source: Euro Surveill - Category: Infectious Diseases Authors: Tags: Euro Surveill Source Type: research

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CLINICS IN CHEST MEDICINE
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
Children carry a significant tuberculosis disease burden in settings with poor epidemic control and high levels of transmission. Even in high-resource settings, the diagnosis of tuberculosis in children can be challenging, but an accurate diagnosis can be achieved by adopting a systematic approach. This review outlines the general principles of tuberculosis prevention in children, including epidemic control, infection control, contact tracing and preventive therapy, and vaccination; diagnosing pediatric tuberculosis, including specimen collection and microbiological confirmation, highlighting key differences from adults; a...
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
This article provides an overview of the latest published strategies for clinical and programmatic management of drug-resistant TB.
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
Tuberculosis (TB) has now surpassed HIV as the leading infectious cause of death, and treatment success rates are declining. Multidrug-resistant TB, extensively drug-resistant TB, and even totally drug-resistant TB threaten to further destabilize disease control efforts. The second wave in TB drug development, which includes the diarylquinoline, bedaquiline, and the nitroimidazoles delamanid and pretomanid, may offer options for simpler, shorter, and potentially all-oral regimens to treat drug-resistant TB. The “third wave” of TB drug development includes numerous promising compounds, including less toxic versi...
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
Traditional tuberculosis (TB) infection control focuses on the known patient with TB, usually on appropriate treatment. A refocused, intensified TB infection control approach is presented. Combined with active case finding and rapid molecular diagnostics, an approach called FAST is described as a convenient way to call attention to the untreated patient. Natural ventilation is the mainstay of air disinfection in much of the world. Germicidal ultraviolet technology is the most sustainable approach to air disinfection under resource-limited conditions. Testing and treatment of latent TB infection works to prevent reactivatio...
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
Exciting clinical results from 2 clinical TB vaccine trials were published in 2018. These, plus promising preclinical candidates form a healthy pipeline of potential vaccines against the leading cause of death from a single infectious agent. The only licensed vaccine, the BCG, continues to be an important tool in protecting against severe forms of TB in children, but has not stopped the diseases causing 1.3 million deaths per year. This review provides an overview of the current TB vaccine pipeline, highlighting recent findings, describes work relating to epidemiologic impact of vaccines, and discusses the future of TB vaccine development.
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
Treatment of latent tuberculosis infection (LTBI) is an important component of TB control and elimination. LTBI treatment regimens include once-weekly isoniazid plus rifapentine for 3 months, daily rifampin for 4 months, daily isoniazid plus rifampin for 3 –4 months, and daily isoniazid for 6–9 months. Isoniazid monotherapy is efficacious in preventing TB disease, but the rifampin- and rifapentine-containing regimens are shorter and have similar efficacy, adequate safety, and higher treatment completion rates. Novel vaccine strategies, host immuni ty-directed therapies and ultrashort antimicrobial regimens for ...
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
Diagnosing latent tuberculosis (TB) infection (LTBI) is important globally for TB prevention. LTBI diagnosis requires a positive test for infection and negative evaluation for active disease. Current tests measure an immunologic response and include the tuberculin skin test (TST) and interferon-gamma release assays (IGRAs), T-SPOT.TB and QuantiFERON. The IGRAs are preferred in bacille Calmette-Gu érin–vaccinated populations. The TST is still used when cost or logistical advantages over the IGRAs exist. Both TST and IGRAs have low positive predictive values. Tests that differentiate the TB spectrum and better p...
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
This article focuses on preferred regimens of drug-susceptible tuberculosis under current guidelines by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America and World Health Organization. In addition, topics including patient centered care, poor treatment outcomes, and adverse effects are also discussed.
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
The World Health Organization Supranational TB Reference Laboratory Network (SRLN) has served as the backbone for TB drug-resistance surveillance and diagnosis since 1994 and remains a key WHO programme for antimicrobial resistance (AMR) surveillance at the global level. SRLN is a great technical resource for proficiency testing to ensure accuracy of drug-susceptibility testing, scale-up, capacity development in countries and provides unique support to the reliable detection of drug resistance. Technical assistance from individual SRLs has been supported by a variety of mechanisms but funding for the SRLN has become increasingly challenging.
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
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