Download or read book Prevalence of Drug resistant Tuberculosis Assessed by Next generation Sequencing written by Salam El Achkar and published by . This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tuberculosis (TB) is the first killer infectious disease, with 10 million new cases estimated worldwide in 2017. TB drug resistance and its diagnosis are particularly problematic. Only 25% of the 450,000 incident multidrug resistant (MDR) TB patients estimated over the same year were diagnosed and treated as such.Although Lebanon is a low-TB burden country, significant challenges exist in terms of disease control. Lebanon is the country hosting the largest refugee population proportionally to its national population worldwide, with 1.5 million Syrian refugees as a consequence of the war in Syria, in addition to large populations of Palestinian refugees and migrant workers. Such populations are particularly vulnerable to risks of TB and emergence of drug resistance. The last national survey on the prevalence of drug resistant TB was done 15 years ago, well before the start of the Syrian crisis in 2011. Even most recent reported rates of MDR TB largely relied on estimates. Second-line drug susceptibility testing (DST) and individualized extensively drug-resistant (XDR) TB treatments were not available in the country.In order to gain a more comprehensive view of the TB situation, we set up the first nationwide study combining phenotypic and extensive molecular testing to determine the prevalence and extent of TB drug resistance in the country. A total of 417 patients were included, corresponding to all confirmed TB cases reported to the national tuberculosis program between June, 2016 and November, 2017. Lowenstein-Jensen and/or MGIT culturing, and molecular testing using GeneXpert MTB/RIF and/or Anyplex MTB/NTM Real-time were used in Lebanon for diagnostic confirmation and DST. In Lille, we evaluated, for the first time on a nationally representative sample, a new deep sequencing assay called Deeplex-MycTB, for extensive drug resistance prediction and genotyping of patient isolates. MIRU-VNTR typing was used in combination for defining molecular clusters, potentially suggestive of endemically circulating or epidemically transmitted TB strains.For the first time in the country, out of the 354 culture positive TB cases with available DST, 3 XDR cases, resistant to at least rifampicin (RIF), isoniazid (INH), kanamycin (KAN)/amikacin (AMI) and levofloxacin (LFX) were detected, in addition to 5 MDR (resistant to at least RIF, INH) cases and one RIF mono-resistant case. Among the remaining cases, 3.4% (12/354) had resistance to INH and streptomycin (SM), 3.4% (12/354) mono-resistance to INH, 0.3% (1/354) mono-resistance to ethambutol (EMB), 8.5% (30/354) mono-resistance to streptomycin (SM), while 81.9% (290/354) were susceptible to all 4 first line drugs. While none of MDR and XDR TB cases were found in molecular clusters, a large cluster comprising 36 other patients was identified, suggestive of a highly endemic or actively transmitted drug susceptible strain.A total of 4184 out of 4407 (94.9%) possible phenotypes could be predicted by Deeplex-MycTB for 339/348 (97.4%) analyzable samples, of which 1282/1380 (92.9%) matched the available phenotypic results. Based on detectable resistance determinants, INH, RIF, EMB and SM resistance was concordantly predicted with 90.3%, 100%, 100%, 52.8% sensitivity, respectively, and susceptibility with 99.6%, 100%, 99.4%, 99.6% specificity, respectively. While predicted first and second-line drug resistance matched almost completely the available phenotypic profiles of the 8 MDR and XDR cases, mutations were additionally detected in all of these 8 cases in targets predicting supplementary pyrazinamide and/or ethionamide resistance, not phenotypically tested. Moreover, resistance to fluoroquinolones was also predicted in 34/339 (10%) non-MDR cases, not subjected to LFX DST. Finally, the use of advanced molecular testing allowed us to identify the first 12 (3.4%) zoonotic TB cases identified in the country [...].
Download or read book The use of next generation sequencing for the surveillance of drug resistant tuberculosis written by World Health Organization and published by World Health Organization. This book was released on 2023-10-17 with total page 134 pages. Available in PDF, EPUB and Kindle. Book excerpt: This document provides practical guidance on planning and implementing next-generation sequencing (NGS) technology for the characterization of Mycobacterium tuberculosis complex (MTBC) bacteria. The aim is to detect mutations associated with drug resistance in the context of a surveillance system for tuberculosis (TB). This guide is intended to inform staff of national TB programmes and ministries of health, implementing partners, laboratory managers and technical staff, clinicians, donors, and other stakeholders engaged in the surveillance of drug-resistant TB and TB laboratory strengthening.
Download or read book Use of targeted next generation sequencing to detect drug resistant tuberculosis written by World Health Organization and published by World Health Organization. This book was released on 2023-07-25 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Use of Bedaquiline in the Treatment of Multidrug resistant Tuberculosis written by World Health Organization and published by . This book was released on 2015-04-20 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: WHO estimates that up to half a million new cases of multidrug-resistant tuberculosis (MDR-TB) occur worldwide, each year. Current treatment regimens for MDR-TB present many challenges: treatment lasts 20 months or more, requiring daily administration of drugs that are more toxic, less effective, and far more expensive than those used to treat drug-susceptible TB. Globally, less than half of all patients who start MDR-TB therapy are treated successfully. For the first time in over 40 years, a new TB drug with a novel mechanism of action - bedaquiline- is available, and was granted accelerated approval by the United States Food and Drug Administration in December 2012. There is considerable interest in the potential of this drug to treat MDR-TB. However, information about this new drug remains limited. It has only been through two Phase IIb trials for safety and efficacy. The World Health Organization (WHO) is therefore issuing "interim policy guidance". This interim guidance provides advice on the inclusion of bedaquiline in the combination therapy of MDR-TB in accordance with the existing WHO Guidelines for the Programmatic Management of Drug-resistant TB (2011 Update).
Download or read book Guidelines for the Programmatic Management of Drug Resistant Tuberculosis written by World Health Organization and published by . This book was released on 2015-04-20 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This 2011 update of Guidelines for the programmatic management of drug-resistant tuberculosis is intended as a tool for use by public health professionals working in response to the Sixty-second World Health Assembly's resolution on prevention and control of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis. Resolution WHA62.15, adopted in 2009, calls on Member States to develop a comprehensive framework for the management and care of patients with drug-resistant TB. The recommendations contained in these guidelines address the most topical questions concerning the programmatic management of drug-resistant TB: case-finding, multidrug resistance, treatment regimens, monitoring the response to treatment, and selecting models of care. The guidelines primarily target staff and medical practitioners working in TB treatment and control, and partners and organizations providing technical and financial support for care of drug-resistant TB in settings where resources are limited.
Download or read book Global Tuberculosis Report 2018 written by World Health Organization and published by World Health Organization. This book was released on 2018-11-20 with total page 277 pages. Available in PDF, EPUB and Kindle. Book excerpt: WHO has published a global TB report every year since 1997. The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic and of progress in prevention diagnosis and treatment of the disease at global regional and country levels. This is done in the context of recommended global TB strategies and targets endorsed by WHO?s Member States and broader development goals set by the United Nations (UN). The 2018 edition of the global TB report was released on 18 September in the lead up to the first-ever UN High Level Meeting on TB on 26 September 2018.
Download or read book WHO consolidated guidelines on drug resistant tuberculosis treatment written by World Health Organization and published by World Health Organization. This book was released on 2018-11-07 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tuberculosis (TB) strains with drug resistance (DR-TB) are more difficult to treat than drug-susceptible ones, and threaten global progress towards the targets set by the End TB Strategy of the World Health Organization (WHO). There is thus a critical need for evidence-based policy recommendations on the treatment and care of patients with DR-TB, based on the most recent and comprehensive evidence available. In this regard, the WHO consolidated guidelines on drug-resistant tuberculosis treatment fulfil the mandate of WHO to inform health professionals in Member States on how to improve treatment and care for patients with DR-TB. Between 2011 and 2018, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO treatment guidelines for multidrug- and rifampicin-resistant tuberculosis, 2018 update, issued by WHO in December 2018. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups (GDGs), using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present Consolidated guidelines include a comprehensive set of WHO recommendations for the treatment and care of DR-TB, derived from these WHO guidelines documents. The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, including longer and shorter regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.
Download or read book Multivariable Model Building written by Patrick Royston and published by John Wiley & Sons. This book was released on 2008-09-15 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: Multivariable regression models are of fundamental importance in all areas of science in which empirical data must be analyzed. This book proposes a systematic approach to building such models based on standard principles of statistical modeling. The main emphasis is on the fractional polynomial method for modeling the influence of continuous variables in a multivariable context, a topic for which there is no standard approach. Existing options range from very simple step functions to highly complex adaptive methods such as multivariate splines with many knots and penalisation. This new approach, developed in part by the authors over the last decade, is a compromise which promotes interpretable, comprehensible and transportable models.
Download or read book Laboratory Methods for Clinical and Public Health written by George P. Kubica and published by . This book was released on 1967 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Management of MDR TB written by World Health Organization and published by World Health Organization. This book was released on 2009 with total page 61 pages. Available in PDF, EPUB and Kindle. Book excerpt: Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are increasingly encountered in resource-limited settings. In the context of a national response to MDR- and XDR-TB, health workers in TB clinics (in district hospitals and some accredited health centers) will need to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDR-TB treatment. This Field Guide was created to help health workers carry out these tasks. It is a job aid that medical officers and TB nurses are meant to use frequently during the day for quick reference. It is based on the Emergency Update 2008 of Guidelines for Programmatic Management of Drug-resistant Tuberculosis, and may be considered a companion document to these guidelines. It also draws on the experience of the international health NGO Partners In Health (PIH) in many countries. This module should be introduced to health workers in the context of a training course with a strong emphasis on TB-HIV co-management.
Download or read book Global Tuberculosis Report 2015 written by World Health Organization and published by World Health Organization. This book was released on 2015 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chapter 1. Introduction -- chapter 2. Disease burden and 2015 targets assessment -- chapter 3. TB case notifications and treatment outcomes -- chapter 4. Drug-resistant TB -- chapter 5. Diagnostics and laboratory strengthening -- chapter 6. Addressing the co-epidemics of TB and HIV -- chapter 7. Financing -- chapter 8. Research and development -- Annexes.
Download or read book WHO consolidated guidelines on tuberculosis Module 4 written by World Health Organization and published by World Health Organization. This book was released on 2022-04-30 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt: Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.
Download or read book Disease Control Priorities Third Edition Volume 6 written by King K. Holmes and published by World Bank Publications. This book was released on 2017-11-06 with total page 1027 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Download or read book Global Tuberculosis Report 2014 written by World Health Organization and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Some volumes for 2014 includes CD-ROM for 2014 key indicators.
Download or read book Public Health Mycobacteriology written by Patricia T. Kent and published by . This book was released on 1985 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Global Tuberculosis Report 2016 written by World Health Organization and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This global tuberculosis report is the first to be produced in the era of the SDGs and the End TB Strategy. It provides an assessment of the TB epidemic and progress in TB diagnosis, treatment, and prevention efforts as well as an overview of TB-specific financing and research. It also discusses the broader agenda of universal health coverage, social protection, and other SDGs that have an impact on health. Data was available for 202 countries and territories that account for over 99% of the world's population and TB cases.
Download or read book Tuberculosis and the Tubercle Bacillus written by William R. Jacobs, Jr. and published by John Wiley & Sons. This book was released on 2017-09-01 with total page 1379 pages. Available in PDF, EPUB and Kindle. Book excerpt: Can today's innovative practices and molecular tools tame this ancient disease? One third of the world's population is infected with tuberculosis (TB), with about 10 million new cases annually. To combat TB and its agent, Mycobacterium tuberculosis, the World Health Organization launched The End TB Strategy, which aims to slash the suffering and cost of TB by 2035. This makes the second edition of Tuberculosis and the Tubercle Bacillus, edited by Jacobs, McShane, Mizrahi, and Orme, an extremely valuable resource for scientists and clinicians. The editors have gathered their colleagues from around the world to present the latest on the molecular biology of M. tuberculosis and related species, the host-pathogen interactions that enable invasion, and the host's immune response to M. tuberculosis infection. The basic, clinical, and translational research presented in this book supports the goals of WHO's End TB Strategy by driving toward the development of effective vaccines, rapid molecular diagnostics, and anti-TB drugs. Creating an effective tuberculosis vaccine. Understand the innate and adaptive immune response to M. tuberculosis infection, its study in established animal models, and how this information is being used to develop new vaccines against TB. Formulating new antituberculosis drugs. Learn the challenges and methods for evaluating new drugs in preclinical trials with a focus on drugs that work against "persisters" and those that act on the electron transport complex and ATP synthase of M. tuberculosis. Overcoming the challenges of diagnosing tuberculosis. Review new diagnostic tools that are simple, rapid, affordable, specific, sensitive, and safe, including molecular-based diagnostic methods such as GeneXpert MTB/RIF. Using molecular, genomic, and bioinformatics tools to understand the biology and evolution of Mycobacterium. Explore current research on the molecular mechanisms that M. tuberculosis uses to evade the immune system, enter a state of nonreplicating persistence, and become reactivated. The second edition of Tuberculosis and the Tubercle Bacillus presents the latest research on a microorganism that is exquisitely well adapted to its human host. This pathogen continues to confound scientists, clinicians, and public health specialists, who will all find much valuable information in this comprehensive set of reviews.
