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Latest & greatest articles for tuberculosis
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on tuberculosis or other clinical topics then use Trip today.
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Symptom screening for active tuberculosis in pregnant women living with HIV. This is a protocol for a Cochrane Review (Diagnostic test accuracy). The objectives are as follows: To assess the accuracy of the four-symptom screen (cough, fever, night sweats, or weight loss) for identifying active TB in pregnant PLHIV who are screened in an outpatient or community setting. To investigate potential sources of heterogeneity of the accuracy of the four-symptom screen between studies including: ART
Chapter 135 – Tuberculosis Chapter 135 - Tuberculosis - CanadiEM Chapter 135 – Tuberculosis In , by Chris Lipp December 14, 2017 Episode 135 of CRACKCast covers Rosen’s 9th edition, Chapter 127, tuberculosis. TB, or not TB, that is the question. This episode will elucidate the early recognition, risk factors, therapy and precautions regarding this worldwide killer. Shownotes – Key concepts Early recognition of patients with risk for TB should begin at ED triage. Patients thought to have active (...) , and gastrointestinal systems. Therapy should be determined based on consultation. The most commonly used agents are INH, RIF, PZA, and EMB. Resistant strains, including MDR-TB and XDR, have been increasing in frequency. Rosen’s In Perspective This is a huge worldwide killer! Mycobacterium tuberculosis (MTB) is an airborne pathogen and easily spreads through talking, coughing and any close indoor contact. Think of: Primary TB infection – often subclinical Reactivation of TB – post-primary infection Think about
Self-administered Versus Directly Observed Once-Weekly Isoniazid and Rifapentine Treatment of Latent Tuberculosis Infection: A Randomized Trial. Expanding latent tuberculosis treatment is important to decrease active disease globally. Once-weekly isoniazid and rifapentine for 12 doses is effective but limited by requiring direct observation.To compare treatment completion and safety of once-weekly isoniazid and rifapentine by self-administration versus direct observation.An open-label, phase 4 (...) randomized clinical trial designed as a noninferiority study with a 15% margin. Seventy-five percent or more of study patients were enrolled from the United States for a prespecified subgroup analysis. (ClinicalTrials.gov: NCT01582711).Outpatient tuberculosis clinics in the United States, Spain, Hong Kong, and South Africa.1002 adults (aged ≥18 years) recommended for treatment of latent tuberculosis infection.Participants received once-weekly isoniazid and rifapentine by direct observation, self
Health extension workers improve tuberculosis case finding and treatment outcome in Ethiopia: a large-scale implementation study Tuberculosis (TB) is a major cause of death in Ethiopia. One of the main barriers for TB control is the lack of access to health services.We evaluated a diagnostic and treatment service for TB based on the health extension workers (HEW) of the Ethiopian Health Extension Programme in Sidama Zone, with 3.5 million population. We added the services to the HEW routines
Lipid Profile in Tuberculosis Patients with and without Human Immunodeficiency Virus Infection Understanding whether the preceding low lipid profile leads to active tuberculosis (TB) or active TB leads to low lipid profile is crucial.Lipid profile concentrations were determined from 159 study participants composed of 93 active TB patients [44 HIV coinfected (HIV+TB+) and 49 HIV negative (HIV-TB+)], 41 tuberculin skin test (TST) positive cases [17 HIV coinfected (HIV+TST+) and 24 HIV negative
Observational study to estimate the changes in the effectiveness of bacillus Calmette Guerin (BCG) vaccination with time since vaccination for preventing tuberculosis in the UK Observational study to estimate the changes in the effectiveness of bacillus Calmette Guerin (BCG) vaccination with time since vaccination for preventing tuberculosis in the UK Observational study to estimate the changes in the effectiveness of bacillus Calmette Guerin (BCG) vaccination with time since vaccination (...) for preventing tuberculosis in the UK Mangtani P, Nguipdop-Djomo P, Keogh R H, Trinder L, Smith P G, Fine P E, Sterne J, Abubakar I, Vynnycky E, Watson J, Elliman D, Lipman M & Rodrigues L C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Mangtani P, Nguipdop-Djomo P, Keogh R H, Trinder L, Smith P G, Fine P E, Sterne J, Abubakar I, Vynnycky E, Watson J
Bronchial Wash Gene Xpert MTB/RIF in Lower Lung Field Tuberculosis: Sensitive, Superior, and Rapid in Comparison with Conventional Diagnostic Techniques Lower lung field tuberculosis (LLF TB) is an atypical presentation of tuberculosis (TB). LLF TB is common, and a proportionate number of non-resolving pneumonia cases are diagnosed to have pulmonary TB.The prospective observational study was conducted during June 2013 to December 2015 in the Department of Pulmonary Medicine, MIMSR Medical (...) of the institutional review board. Consent was taken from the patients before inclusion in the study. Statistical analysis was done using chi-square test.In the present study, 300 (11.53%) cases of LLF TB of total 2600 pulmonary tuberculosis were included, females constitutes 66.66% (200/300) with mean age of 58.4 ± 11.8 years and males constitutes 33.34% (100/300) with mean age of 56.8 ± 10.6 years. Constitutional symptoms were observed as cough in 93% cases, fever in 83% cases, shortness of breath in 72% cases
Do chain pharmacies perform better than independent pharmacies? Evidence from a standardised patient study of the management of childhood diarrhoea and suspected tuberculosis in urban India Pharmacies and drug stores are frequently patients' first point of care in many low-income and middle-income countries, but their practice is often poor. Pharmacy retailing in India has traditionally been dominated by local, individually owned shops, but recent years have seen the growth of pharmacy chains (...) . In theory, lower-powered profit incentives and self-regulation to preserve brand identity may lead to higher quality in chain stores. In practice, this has been little studied.We randomly selected a stratified sample of chain and independent pharmacies in urban Bengaluru. Standardised patients (SPs) visited pharmacies and presented a scripted case of diarrhoea for a child and suspected tuberculosis (TB). SPs were debriefed immediately after the visit using a structured questionnaire. We measured
Evaluation of a Rapid Molecular Drug-Susceptibility Test for Tuberculosis. Fluoroquinolones and second-line injectable drugs are the backbone of treatment regimens for multidrug-resistant tuberculosis, and resistance to these drugs defines extensively drug-resistant tuberculosis. We assessed the accuracy of an automated, cartridge-based molecular assay for the detection, directly from sputum specimens, of Mycobacterium tuberculosis with resistance to fluoroquinolones, aminoglycosides (...) , and isoniazid.We conducted a prospective diagnostic accuracy study to compare the investigational assay against phenotypic drug-susceptibility testing and DNA sequencing among adults in China and South Korea who had symptoms of tuberculosis. The Xpert MTB/RIF assay and sputum culture were performed. M. tuberculosis isolates underwent phenotypic drug-susceptibility testing and DNA sequencing of the genes katG, gyrA, gyrB, and rrs and of the eis and inhA promoter regions.Among the 308 participants who were
Out-of-Pocket Expenditures, Indirect Costs and Health-Related Quality of Life of Patients with Pulmonary Tuberculosis in Thailand Thailand's hospitals may adopt different supervision approaches to improve tuberculosis (TB) treatment adherence.The aim of this study was to compare out-of-pocket (OOP) expenditures, indirect costs, and health-related quality of life (HRQoL) among TB patients who received pharmaceutical care (pharmacist-led patient education and telephone consultation), home visit
High-Dose Vitamin D3 during Tuberculosis Treatment in Mongolia. A Randomized Controlled Trial Existing trials of adjunctive vitamin D in the treatment of pulmonary tuberculosis (PTB) are variously limited by small sample sizes, inadequate dosing regimens, and high baseline vitamin D status among participants. Comprehensive analyses of the effects of genetic variation in the vitamin D pathway on response to vitamin D supplementation are lacking.To determine the effect of high-dose vitamin D3
Isoniazid for preventing tuberculosis in HIV-infected children. Tuberculosis (TB) is an important cause of illness and death in HIV-positive children living in areas of high TB prevalence. We know that isoniazid prophylaxis prevents TB in HIV-negative children following TB exposure, but there is uncertainty related to its role in TB preventive treatment in HIV-positive children.To summarise the effects of TB preventive treatment versus placebo in HIV-positive children with no known TB contact
Integration of Metabolomics and Transcriptomics Reveals a Complex Diet of Mycobacterium tuberculosis during Early Macrophage Infection Nutrient acquisition from the host environment is crucial for the survival of intracellular pathogens, but conceptual and technical challenges limit our knowledge of pathogen diets. To overcome some of these technical roadblocks, we exploited an experimentally accessible model for early infection of human macrophages by Mycobacterium tuberculosis (...) , the etiological agent of tuberculosis, to study host-pathogen interactions with a multi-omics approach. We collected metabolomics and complete transcriptome RNA sequencing (dual RNA-seq) data of the infected macrophages, integrated them in a genome-wide reaction pair network, and identified metabolic subnetworks in host cells and M. tuberculosis that are modularly regulated during infection. Up- and downregulation of these metabolic subnetworks suggested that the pathogen utilizes a wide range of host-derived
Targeting Mycobacterium tuberculosis sensitivity to thiol stress at acidic pH kills the bacterium and potentiates antibiotics Mycobacterium tuberculosis (Mtb) must sense and adapt to immune pressures such as acidic pH during pathogenesis. The goal of this study was to isolate compounds that inhibit acidic pH resistance, thus defining virulence pathways that are vulnerable to chemotherapy. Here, we report that the compound AC2P36 selectively kills Mtb at acidic pH and potentiates
Evaluating cliniciansâ€™ user experience and acceptability of LearnTB, a smartphone application for tuberculosis in India Tuberculosis (TB) is the leading infectious killer, and India accounts for 2.8 of the 10.4 million TB cases that occur each year, making it the highest TB burden country worldwide. Poor quality of TB care is a major driver of the epidemic in India. India's large private, unregulated sector manages over 50% of the TB patients, with studies showing suboptimal diagnosis (...) and treatment in the private sector. Better education of doctors using mobile applications (apps) is a possible solution. While India has seen an explosion of mobile phone services, and while the use of mobile health interventions has been gaining interest, little is known about mHealth around tuberculosis in India.Our study aimed to understand the user experience and acceptability of a smartphone application, LearnTB, amongst private sector academic clinicians in India. This study was conducted amongst 101
Chronic airflow obstruction after successful treatment of multidrug-resistant tuberculosis Cross-sectional studies reveal an association between tuberculosis (TB) and chronic airflow obstruction, but cannot adequately address confounding. We hypothesised that treated pulmonary TB is an independent risk factor for chronic airflow obstruction. The Pulmones Post TB cohort study enrolled participants from Lima, Peru, aged 10-70 years with a history of drug-susceptible (DS)- or multidrug-resistant
An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored
Current and future trends in tuberculosis incidence in New York City: a dynamic modelling analysis After steady decline since the 1990s, tuberculosis (TB) incidence in New York City (NYC) and the United States (US) has flattened. The reasons for this trend and the implications for the future trajectory of TB in the US remain unclear.We developed a compartmental model of TB in NYC, parameterized with detailed epidemiological data. We ran the model under five alternative scenarios representing
Tuberculosis control, and the where and why of artificial intelligence Countries aiming to reduce their tuberculosis (TB) burden by 2035 to the levels envisaged by the World Health Organization End TB Strategy need to innovate, with approaches such as digital health (electronic and mobile health) in support of patient care, surveillance, programme management, training and communication. Alongside the large-scale roll-out required for such interventions to make a significant impact, products
A novel clinical sign in intraocular tuberculosis: Active chorioretinitis within chorioretinal atrophy To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015.The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along (...) with a positive tuberculin skin testing and chest X-ray consistent with tuberculosis. All patients presented with decreased visual acuity ranging from 20/25 to 20/400, anterior chamber reaction, vitritis, multifocal choroiditis and vasculitis. All patients had an area of active chorioretinitis within the zone of pre-existing chorioretinal atrophy, apart from various other signs suggestive of intraocular inflammation. All patients were started on anti-tubercular therapy for a period of 9 months alone