Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
14,861
result(s) for
"Tuberculosis - prevention "
Sort by:
Protection by BCG Vaccine Against Tuberculosis: A Systematic Review of Randomized Controlled Trials
Background. Randomized trials assessing BCG vaccine protection against tuberculosis have widely varying results, for reasons that are not well understood. Methods. We examined associations of trial setting and design with BCG efficacy against pulmonary and miliary or meningeal tuberculosis by conducting a systematic review, meta-analyses, and meta-regression. Results. We identified 18 trials reporting pulmonary tuberculosis and 6 reporting miliary or meningeal tuberculosis. Univariable meta-regression indicated efficacy against pulmonary tuberculosis varied according to 3 characteristics. Protection appeared greatest in children stringently tuberculin tested, to try to exclude prior infection with Mycobacterium tuberculosis or sensitization to environmental mycobacteria (rate ratio [RR], 0.26; 95% confidence interval [CI], .18–.37), or infants (RR, 0.41; 95% CI, .29–.58). Protection was weaker in children not stringently tested (RR, 0.59; 95% CI, .35–1.01) and older individuals stringently or not stringently tested (RR, 0.88; 95% CI, .59–1.31 and RR, 0.81; 95% CI, .55–1.22, respectively). Protection was higher in trials further from the equator where environmental mycobacteria are less and with lower risk of diagnostic detection bias. These associations were attenuated in a multivariable model, but each had an independent effect. There was no evidence that efficacy was associated with BCG strain. Protection against meningeal and miliary tuberculosis was also high in infants (RR, 0.1; 95% CI, .01–.77) and children stringently tuberculin tested (RR, 0.08; 95% CI, .03–.25). Conclusions. Absence of prior M. tuberculosis infection or sensitization with environmental mycobacteria is associated with higher efficacy of BCG against pulmonary tuberculosis and possibly against miliary and meningeal tuberculosis. Evaluations of new tuberculosis vaccines should account for the possibility that prior infection may mask or block their effects.
Journal Article
Tuberculosis must fall! : a multisector partnership to address TB in southern Africa's mining sector
Presents key activities, promising practices, and lessons learned to date from the World Bank's Tuberculosis (TB) in the Mining Sector Initiative, an innovative multisectoral, multicountry, public-private regional initiative. It examines how a collaborative platform was established to cover 10 southern African countries, and it details the processes through which multiple countries, ministries, sectors, and partners have been brought together to address the varied dimensions of the epidemic. The case studies in this book highlight the significant progress and achievements made since 2010 in the effort to develop a regional platform for addressing TB in the mining sector in southern Africa. The primary focus of the case studies is how these cooperative regional processes-- at both technical and political levels-- have been designed, implemented, managed, and sustained through various partnerships to complement country-level efforts. The case studies provide an evidence base for practitioners working in TB management in the mining sector. Despite the achievements that have been made and their potential to strengthen TB interventions, critical gaps remain in addressing barriers to access, delivery of quality services, and increased uptake of TB services. The case studies explore these key challenges and gaps, and they offer strategies for replicating successes and addressing complex health-service delivery interventions in other regions around the world. Further action is needed, including better compliance with occupational health and safety standards by mining companies; strengthened community health systems and improved coordination of TB care; increased empowerment and participation of women in the mining sector; and improved tracking and tracing of ex-mineworkers across borders. The aim of the book is to provide helpful models, lessons learned, and recommendations that can be used as a starting point for analyzing the risks, opportunities, incentives, and contexts of regional health cooperation that involves multiple sectors and stakeholders.
Book
Perspectives on Advances in Tuberculosis Diagnostics, Drugs, and Vaccines
Despite concerted efforts over the past 2 decades at developing new diagnostics, drugs, and vaccines with expanding pipelines, tuberculosis remains a global emergency. Several novel diagnostic technologies show promise of better point-of-care rapid tests for tuberculosis including nucleic acid–based amplification tests, imaging, and breath analysis of volatile organic compounds. Advances in new and repurposed drugs for use in multi-drug-resistant (MDR) or extensively drug-resistant (XDR) tuberculosis have focused on development of several new drug regimens and their evaluation in clinical trials and now influence World Health Organization guidelines. Since the failure of the MVA85A vaccine 2 years ago, there have been no new tuberculosis vaccine candidates entering clinical testing. The current status quo of the lengthy treatment duration and poor treatment outcomes associated with MDR/XDR tuberculosis and with comorbidity of tuberculosis with human immunodeficiency virus and noncommunicable diseases is unacceptable. New innovations and political and funder commitment for early rapid diagnosis, shortening duration of therapy, improving treatment outcomes, and prevention are urgently required.
Journal Article
Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis
Although progress has been made to reduce global incidence of drug-susceptible tuberculosis, the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis during the past decade threatens to undermine these advances. However, countries are responding far too slowly. Of the estimated 440 000 cases of MDR tuberculosis that occurred in 2008, only 7% were identified and reported to WHO. Of these cases, only a fifth were treated according to WHO standards. Although treatment of MDR and XDR tuberculosis is possible with currently available diagnostic techniques and drugs, the treatment course is substantially more costly and laborious than for drug-susceptible tuberculosis, with higher rates of treatment failure and mortality. Nonetheless, a few countries provide examples of how existing technologies can be used to reverse the epidemic of MDR tuberculosis within a decade. Major improvements in laboratory capacity, infection control, performance of tuberculosis control programmes, and treatment regimens for both drug-susceptible and drug-resistant disease will be needed, together with a massive scale-up in diagnosis and treatment of MDR and XDR tuberculosis to prevent drug-resistant strains from becoming the dominant form of tuberculosis. New diagnostic tests and drugs are likely to become available during the next few years and should accelerate control of MDR and XDR tuberculosis. Equally important, especially in the highest-burden countries of India, China, and Russia, will be a commitment to tuberculosis control including improvements in national policies and health systems that remove financial barriers to treatment, encourage rational drug use, and create the infrastructure necessary to manage MDR tuberculosis on a national scale.
Journal Article
Zoonotic tuberculosis in human beings caused by Mycobacterium bovis—a call for action
Mycobacterium tuberculosis is recognised as the primary cause of human tuberculosis worldwide. However, substantial evidence suggests that the burden of Mycobacterium bovis, the cause of bovine tuberculosis, might be underestimated in human beings as the cause of zoonotic tuberculosis. In 2013, results from a systematic review and meta-analysis of global zoonotic tuberculosis showed that the same challenges and concerns expressed 15 years ago remain valid. These challenges faced by people with zoonotic tuberculosis might not be proportional to the scientific attention and resources allocated in recent years to other diseases. The burden of zoonotic tuberculosis in people needs important reassessment, especially in areas where bovine tuberculosis is endemic and where people live in conditions that favour direct contact with infected animals or animal products. As countries move towards detecting the 3 million tuberculosis cases estimated to be missed annually, and in view of WHO's end TB strategy endorsed by the health authorities of WHO Member States in 2014 to achieve a world free of tuberculosis by 2035, we call on all tuberculosis stakeholders to act to accurately diagnose and treat tuberculosis caused by M bovis in human beings.
Journal Article
Tuberculosis prevalence in China, 1990–2010; a longitudinal analysis of national survey data
China scaled up a tuberculosis control programme (based on the directly observed treatment, short-course [DOTS] strategy) to cover half the population during the 1990s, and to the entire population after 2000. We assessed the effect of the programme.
In this longitudinal analysis, we compared data from three national tuberculosis prevalence surveys done in 1990, 2000, and 2010. The 2010 survey screened 252 940 eligible individuals aged 15 years and older at 176 investigation points, chosen by stratified random sampling from all 31 mainland provinces. All individuals had chest radiographs taken. Those with abnormal radiographs, persistent cough, or both, were classified as having suspected tuberculosis. Tuberculosis was diagnosed by chest radiograph, sputum-smear microscopy, and culture. Trained staff interviewed each patient with tuberculosis. The 1990 and 2000 surveys were reanalysed and compared with the 2010 survey.
From 1990 to 2010, the prevalence of smear-positive tuberculosis decreased from 170 cases (95% CI 166–174) to 59 cases (49–72) per 100 000 population. During the 1990s, smear-positive prevalence fell only in the provinces with the DOTS programme; after 2000, prevalence decreased in all provinces. The percentage reduction in smear-positive prevalence was greater for the decade after 2000 than the decade before (57% vs 19%; p<0·0001). 70% of the total reduction in smear-positive prevalence (78 of 111 cases per 100 000 population) occurred after 2000. Of these cases, 68 (87%) were in known cases—ie, cases diagnosed with tuberculosis before the survey. Of the known cases, the proportion treated by the public health system (using the DOTS strategy) increased from 59 (15%) of 370 cases in 2000 to 79 (66%) of 123 cases in 2010, contributing to reduced proportions of treatment default (from 163 [43%] of 370 cases to 35 [22%] of 123 cases) and retreatment cases (from 312 [84%] of 374 cases to 48 [31%] of 137 cases; both p<0·0001).
In 20 years, China more than halved its tuberculosis prevalence. Marked improvement in tuberculosis treatment, driven by a major shift in treatment from hospitals to the public health centres (that implemented the DOTS strategy) was largely responsible for this epidemiological effect.
Chinese Ministry of Health.
Journal Article
The multistage vaccine H56 boosts the effects of BCG to protect cynomolgus macaques against active tuberculosis and reactivation of latent Mycobacterium tuberculosis infection
It is estimated that one-third of the world's population is infected with Mycobacterium tuberculosis. Infection typically remains latent, but it can reactivate to cause clinical disease. The only vaccine, Mycobacterium bovis bacillus Calmette-Guérin (BCG), is largely ineffective, and ways to enhance its efficacy are being developed. Of note, the candidate booster vaccines currently under clinical development have been designed to improve BCG efficacy but not prevent reactivation of latent infection. Here, we demonstrate that administering a multistage vaccine that we term H56 in the adjuvant IC31 as a boost to vaccination with BCG delays and reduces clinical disease in cynomolgus macaques challenged with M. tuberculosis and prevents reactivation of latent infection. H56 contains Ag85B and ESAT-6, which are two of the M. tuberculosis antigens secreted in the acute phase of infection, and the nutrient stress-induced antigen Rv2660c. Boosting with H56/IC31 resulted in efficient containment of M. tuberculosis infection and reduced rates of clinical disease, as measured by clinical parameters, inflammatory markers, and improved survival of the animals compared with BCG alone. Boosted animals showed reduced pulmonary pathology and extrapulmonary dissemination, and protection correlated with a strong recall response against ESAT-6 and Rv2660c. Importantly, BCG/H56-vaccinated monkeys did not reactivate latent infection after treatment with anti-TNF antibody. Our results indicate that H56/IC31 boosting is able to control late-stage infection with M. tuberculosis and contain latent tuberculosis, providing a rationale for the clinical development of H56.
Journal Article
Saving Sickly Children
Known as \"The Great Killer\" and \"The White Plague,\" few diseases influenced American life as much as tuberculosis. Sufferers migrated to mountain or desert climates believed to ameliorate symptoms. Architects designed homes with sleeping porches and verandas so sufferers could spend time in the open air. The disease even developed its own consumer culture complete with invalid beds, spittoons, sputum collection devices, and disinfectants. The \"preventorium,\" an institution designed to protect children from the ravages of the disease, emerged in this era of Progressive ideals in public health.In this book, Cynthia A. Connolly provides a provocative analysis of public health and family welfare through the lens of the tuberculosis preventorium. This unique facility was intended to prevent TB in indigent children from families labeled irresponsible or at risk for developing the disease. Yet, it also held deeply rooted assumptions about class, race, and ethnicity. Connolly goes further to explain how the child-saving themes embedded in the preventorium movement continue to shape children's health care delivery and family policy in the United States.
eBook
Analysis of nationwide adverse event reports on Isoniazid and Rifampin in tuberculosis prevention and treatment in South Korea
Individuals with latent tuberculosis infection (LTBI) are at risk of progressing to active tuberculosis (TB), which remains a significant cause of death globally. Although various antiTB medications—rifampin and isoniazid—exist for treating for both LTBI and active TB, pharmacovigilance studies evaluating their adverse effects are especially scare for LTBI. Given the continued status of South Korea as having the highest TB incidence among Organization for Economic Cooperation and Development countries, this study examines drug-related adverse events (AEs) and identifies novel signals associated with rifampin or isoniazid in TB prevention and treatment in South Korea using the national AE reporting system. Analyzing data from the Korea Institute of Drug Safety and Risk Management-Korea Adverse Event Reporting System Database (KIDS-KAERS DB, 2301A0006) between 2017 and 2021, we observed that rifampin was frequently listed as a suspected drug in AE reports. Serious adverse events (SAEs), including life-threatening events and hospitalizations, were observed in LTBI as well as active TB cases when rifampin was the suspected drug. Novel signals, including QT prolongation and acne, were also identified, underscoring the importance of AE monitoring in LTBI or active TB treatment.
Journal Article