MDR-TB Treatment & Prevention
CDC NPIN TB-update: Week of February 20 to February 26, 2011
TB-Related News and Journal Items Weekly Update Week of February 20 to
February 26, 2011
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CDC provides the TB-Related News and Journal Items Weekly Update as a
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do not confirm the accuracy of the data in the articles that are abstracted.
Providing synopses of key scientific articles and lay media reports on TB
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Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press
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however, copies may not be sold. For those items reproduced from the first
section of the TB weekly update, the CDC HIV/Hepatitis/STD/TB Prevention
News Update should be cited. For any other items in the TB weekly update,
you may cite the CDC TB-Related News and Journal Items Weekly Update.
This Week's Contents
TB-Related Announcements <#12e5de0607095e41_H1>
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News
Update<#12e5de0607095e41_H2>
Headlines <#12e5de0607095e41_H3>
Journal Articles <#12e5de0607095e41_H4>
Job Announcements <#12e5de0607095e41_H5>
Upcoming Conferences, Trainings, and Other Events <#12e5de0607095e41_H6>
TB-Related Announcements
*1. CDC Announces 2011 World TB Day Campaign *
CDC, Division of Tuberculosis Elimination (DTBE)
Each year, we recognize World TB Day on March 24th. World TB Day provides an
opportunity to communicate about TB-related problems and solutions and to
support worldwide TB-control efforts. The U.S. theme for World TB Day 2011
remains the same as last year’s theme, "TB Elimination: Together We Can!"
The Division of Tuberculosis Elimination (DTBE) has developed several
resources in English and Spanish to assist you in developing your own
messages and materials.
World TB Day Website
The CDC World TB Day website contains a variety of resources including Web
tools, posters, and a list of domestic and international World TB Day
events.
http://www.cdc.gov/tb/WorldTBDay/ (English)
http://www.cdc.gov/tb/events/WorldTBDay/default_es.htm (Spanish)
Posters
Two posters are available with the 2010/2011 theme. A new poster will be
available for distribution in late February. Check back at the DTBE Website
for the new poster. Posters from last year with the same theme are currently
available for order at http://wwwn.cdc.gov/pubs/tb.aspx. PDF versions of
both posters are available at:
http://www.cdc.gov/tb/events/WorldTBDay/poster.htm (English)
http://www.cdc.gov/tb/events/WorldTBDay/poster_es.htm (Spanish)
Web buttons are graphical elements used to share messages by linking to a
website for additional information. The World TB Day buttons link to the CDC
World TB Day website. Buttons and instructions about how to post the buttons
on your website are available at:
http://www.cdc.gov/tb/events/WorldTBDay/WebResources.htm (English)
http://www.cdc.gov/tb/events/WorldTBDay/WebResources_es.htm (Spanish)
For more information, contact Ijeoma Agulefo at or (404)
639-8783.
* *
*2. UNITAID seeks applicants for membership in its Advisory Group on Funding
Priorities *
Stop TB Partnership, February 16, 2011
UNITAID’s mission is to facilitate access to treatment for HIV/AIDS,
malaria, and TB for people in developing countries by leveraging price
reductions of quality drugs and diagnostics, which currently are
unaffordable for most developing countries, and to accelerate the pace at
which they are made available. The Advisory Group on Funding Priorities is
an independent expert panel that assists in identifying potential priority
niches of high-market and public health impact to be funded by UNITAID. For
more information about applying for membership, visit
http://www.unitaid.eu/en/Advisory-Group-on-Funding-Priorities.html . *The
deadline is March 20, 2011.*
*3. Roadmap for scaling up MDR-TB treatment now available in five additional
languages*
Stop TB Partnership, February 15, 2011
The Global Drug Facility (GDF) has published its roadmap for scaling up
MDR-TB treatment in five additional languages. First released in November
2010, the roadmap outlines progress GDF has made to date, what still needs
to be done, and where high-level advocacy could help GDF to further scale up
its activities. Over the past three years, GDF has nearly tripled the number
of countries to which it supplies quality-assured MDR-TB medicines. To
ensure that future demand for drugs is met and a sustainable market is
created, GDF is introducing a series of measures, including a tiered market
allocation system, improved forecasting, a rotating stockpile, and an
advanced financing mechanism. "Roadmap for MDR-TB Scale-up: Increasing
Access to MDR-TB Drugs through Innovation and Action" is available in the
languages of Arabic, Chinese, English, French, Russian, and Spanish. To
access each language version, visit
http://www.stoptb.org/news/announcements/2011/a11_002.asp.
* *
*4. Call for Expression of Interest for Anti-TB Medicines Evaluation*
Stop TB Partnership, February 3, 2011
Expression of Interest (EOI): First Global Fund and Global Drug Facility
Invitation to manufacturers of first-, second-, and third-line
anti-tuberculosis medicines to submit an EOI for product evaluation by the
Expert Review Panel (ERP)
Submission deadline: March 31, 2011
The purpose of this call for EOI is to invite submissions of first-,
second-, and third-line anti-tuberculosis product dossiers for review by the
ERP, for which there are less than 3 products of the same formulations that
are WHO-prequalified, SRA-approved, or ERP-reviewed available in the global
market.
The Global Fund and the Global Drug Facility (GDF) are using the same ERP
process as described at
http://www.theglobalfund.org/en/procurement/pharmaceutical/ under “A, B and
ERP-reviewed products.” The synchronization of the dossier review process
for non-WHO prequalified or non-SRA authorized TB products has been accepted
by the WHO, GDF, and the Global Fund. This should minimize duplication of
work for manufacturers and ERP members.
Thus, information submitted to, and the information and advice provided by,
the ERP in connection with this invitation will be shared with and used by
GF and GDF for procurement and supply management purposes.
For full information, visit
http://www.stoptb.org/assets/documents/gdf/drugsupply/PSM_EoiAntiTbERP_RFP_en...
.
*5. World TB Day Campaign 2011 Is Now Live*
Stop TB Partnership, January 24, 2011
2011 is the second year of the two-year campaign of the Stop TB Partnership,
*On the move against tuberculosis,* whose goal is to galvanize innovation in
TB care and research. It is inspired by the ambitious new objectives and
targets of the Global Plan to Stop TB 2011-2015: Transforming the
Fight-Towards Elimination of Tuberculosis, which was launched by the Stop TB
Partnership in October 2010. This new plan for the first time identifies all
the research gaps that need to be filled to bring rapid TB tests, faster
treatment regimens, and a fully effective vaccine to market, and, therefore
to the people who need them.
"It is with great pleasure that we launch the campaign for World TB Day,
which has special meaning for me this year since I will observe it for the
first time in my new role as Executive Secretary of the Stop TB
Partnership," says Dr. Lucica Ditiu. "My hope is that all preparations will
be done keeping in mind those affected by tuberculosis, the people most in
need of our successful actions."
The campaign focuses on recognizing individuals - doctors, nurses, managers,
patients, activists, advocates, and researchers around the world - who have
found new ways to fight and stop TB in different settings, and can serve as
an inspiration to others. The campaign challenges us to look at the fight
against TB in an entirely new way: that every step we take should be a step
that counts for people, and will lead us toward TB elimination.
The campaign site includes downloadable slogans, a helpful guide in all six
official languages of the World Health Organization (Arabic, Chinese,
English, French, Russian, and Spanish) for planning a World TB Day event;
and a template for developing posters with the slogan *On the move against
tuberculosis*.
The World TB Day 2011 campaign web site is at
http://www.stoptb.org/events/world_tb_day/2011/ .
For more information, contact the Senior Communications Adviser, Judith
Mandelbaum-Schmid. E-mail , or call +41 22 791 2967.
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News Update
*1. TB Suspected at George Washington University *
Washington Post, February 16, 2011, by Daniel de Vise
A person affiliated with George Washington University has a suspected case
of active TB disease, according to a health alert sent out to the community
on Feb. 15. The D.C. Department of Health has identified others who are
thought to have had close contact with the person. They “are being contacted
jointly by Student Health Services and DOH, via e-mail, and are being
provided specific instructions on how to receive a TB risk and symptom
assessment and a TB skin test,” the alert stated. “There is no need for the
larger university community to take any specific medical precautions or
actions at this time,” it said. “Nonetheless, we think it is important for
you to be aware that this event has occurred, and that we are in regular
contact with DOH to coordinate efforts.”
*2. Canada Fails Nunavut in Fighting TB: Journal *
CBC News, February 14, 2011
Last year, Nunavut recorded the largest TB outbreak in the territory’s
10-year history. At least 100 new active cases were registered in 2010,
primarily among adolescents and young adults, suggesting active
transmission. The Nunavut TB rate is 62 times the Canadian average. “This is
happening at rates we see in the developing world,” said Dr. Matthew
Stanbrook, a respirologist at Toronto Western Hospital and co-author of a
new report on the situation. “We are a rich, developed nation that has the
resources to solve the problem in Nunavut if we choose to employ them.” TB
has not been eliminated from Inuit communities since arriving with whaling
crews in the 19th century. After the Second World War, Inuit were moved from
traditional hunting camps to government-provided, one-room houses or cramped
shacks, creating a breeding ground for TB, sociologists say. Between 1953
and 1961, 5,240 Inuit were sent south for TB treatment; the entire
population of the eastern Arctic was only about 11,500. Many never returned
or lost contact with their families, a memory that hinders current treatment
efforts, said Stanbrook. “If you don’t trust the public health officials,
you’re not going to disclose symptoms that seem like TB,” Stanbrook said.
“That really has frustrated efforts to address this epidemic.” Substandard
housing, poverty, and high rates of smoking and second-hand smoke exposure
continue to fuel the epidemic, the editorial said. Last month, the federal
health minister announced $800,000 (US $813,000) for Taima TB, a new
door-to-door program to test for latent TB in Nunavut communities. Minister
Leona Aglukkaq also announced $100 million (US $102 million) to build 1,000
new housing units. “When we have the wealth that this country has, there’s
no excuse for not using all our resources to cure a curable epidemic
disease,” said Stanbrook. The editorial, “Tuberculosis in Nunavut: A Century
of Failure,” was published in the Canadian Medical Association Journal
(2011; doi:10.1503/cmaj.11060).
Headlines
*1. Alarming TB Death Rate among Toronto Homeless (Canada)*
Toronto Sun, www.torontosun.com, February 17, 2011, by Sharon Lem,
According to Dr. Kamran Khan, an infectious disease physician and scientist
at St. Michael’s Hospital in Toronto, Canada, homeless persons diagnosed
with TB in Toronto have a high mortality rate of 20 percent. This rate is
three to four times higher than that of the normal population. Dr. Khan, the
lead author of a 10-year study of the homeless in Toronto, found that one in
five homeless persons with TB died within a year of diagnosis. He said that
it is imperative that ventilation systems be set up in shelters to prevent
the spread of the disease. The second major finding of the study is that the
face of the TB population is changing and is more diverse, as 40 percent of
patients are immigrants. This also raises the risk of dangerous
drug-resistant strains entering the shelter system. He further noted that TB
treatment can be complicated by inadequate housing, substance dependence,
language barriers, mental health problems, and the stigma of TB. This
article was published online in the journal, *Emerging Infectious
Diseases*2011 Mar; DOI: 10.3201/eid1703.100833.
*2. Aid Group Engages N. Korea in Fight against TB (North Korea)*
Korea Times, www.koreatimes.co.kr, February, 21, 2011, by Kim Young-jin
The Eugene Bell Foundation recently cured its first multidrug-resistant TB
(MDR TB) patients in North Korea. Dr. Stephen Linton, founder of the Eugene
Bell Foundation, had been traveling to North Korea to treat TB for over 10
years when caregivers realized that first-line drugs were not helping some
patients. Dr. Linton took sputum from the patients to South Korea, where the
problem was analyzed as MDR TB. The number of persons needing the test kept
increasing, and now the program accommodates about 600 patients at six
specialized centers in the northwest. He explained that the process
requires the cooperation of North Korea, especially its health authorities.
The government agreed to the recommendation that treatment take place in
centrally-located MDR TB centers. Linton stated that he depends on the
continued permission from both North and South Korea to continue the work,
as drugs are purchased and shipped under South Korean law, and sputum is
tested in the South. The Eugene Bell Foundation, a US-based aid
organization, was founded by Stephen Linton to commemorate the 100th year of
the arrival of his great grandfather, the Reverend Eugene Bell, a Southern
Presbyterian missionary, in South Korea.
*3. Brunswick Co. Settles Jail TB Case (North Carolina) *
WWAY News Channel, www.wwaytv3.com / February 17, 2011, by Katie Harden
An individual who had been incarcerated in the Brunswick County, North
Carolina, jail has settled his lawsuit with the county for a lump sum of
$2,250. The former inmate, who claimed that he had contracted TB in jail,
accepted the settlement rather than continue the pending lawsuit. Huey
Marshall, Brunswick County Attorney, commented that paying the settlement
was a less expensive decision for the county.
*4. Notre Dame Researchers Discover Dual-Action Compound for Potential
Treatment of Tuberculosis and Malaria (United States) *
South Bend Tribune, www.southbendtribune.com, February 21, 2011, from
University of Notre Dame
Researchers at the University of Notre Dame, Indiana, have discovered a
method of attacking TB and malaria. The researchers synthesized an iron
transport molecule attached to an antibiotic that the TB bacterium would
ingest. The peroxide drug, artemisinin, an antimalarial agent, is not
effective alone against TB because the TB cell membrane is difficult to
penetrate. The chemistry created by the cell’s effort to use the iron in the
transporter enables the drug to destroy the TB bacterium. The research
demonstrates the use of “Trojan Horse” drug design and its use to target
both malaria and TB. Since the molecule may be too complex for commercial
medicinal use, researchers are investigating ways to make simplified
versions. The article was authored by Marvin Miller, the George and
Winifred Clark Chair in Chemistry, and Michael Ferdig, Associate Professor
of Biological Sciences at the University of Notre Dame, in collaboration
with researchers from Duke University, the National Institutes of Health,
and the Liebniz Institute for National Product Research and Infection
Biology in Germany. The article was published in the *Journal of the
American Chemical Society;* 133 (7) 2076–2079, 2011.
*5. Local Lab Working on New Testing Method of TB and STDs (Canada)*
St. Catharines Standard, www.stcatharinesstandard.ca , February 23, 2011
Norgen Biotek Corp. in Thorold, Ontario, Canada, has received more than
$800,000 from Canada’s federal government to develop a new type of STD and
TB test. According to Dr. Yousef Haj-Ahamd, president of the company, the
funding from the National Research Council’s industrial research assistance
program will be used to create diagnostic kits, similar to pregnancy test
style kits, to test for disease using the patient’s urine or saliva. He
explained this type of testing is needed in rural communities and developing
countries where clinical laboratories or electricity are not available. Dr.
Haj-Ahamd acknowledged that the kits are a few years away from being ready
for market.
*6. Mutated Immune Gene Increases TB Risk for African Americans (United
States)*
Baylor College of Medicine, www.bcm.edu, February 17, 2011, by Glenna
Picton,
According to researchers from Baylor College of Medicine (BCM) and the
Methodist Hospital Research Institute, a mutated immune system gene
increases the risk of developing TB in African Americans who are infected by
the TB bacteria. Dr. Katherine Y. King, an instructor in the Department of
Pediatrics-Infectious Disease at BCM, and colleagues investigated who would
be more at risk of developing TB. The researchers determined the genotype
(the genetic sequence) for the IRGM1 gene and the nearby area of the genome
for 370 African Americans and 177 Caucasians with TB disease and compared
them to the genotypes of 180 African Americans and 110 Caucasians who did
not have TB disease. Results show that African Americans with TB disease
were more likely to carry a specific mutation in the IRGM1 gene. The gene
has single nucleotide polymorphisms or single letter changes in the genetic
code in two places, along with a deletion of genetic material in an area
near the gene. The mutations in the gene increased the risk of developing TB
for African Americans who carry the gene. It is suggested that determining
who is at greatest risk can reduce widespread preventive TB treatment and
focus attention on those who most need it. The research was published in *PLoS
ONE* 6(1): e16317. doi:10.1371/journal.pone.0016317.
*7. US $350,000 Grant for Local Drive on TB (The Philippines)*
Manila Bulletin, www.mb.com.ph, February 17, 2011
The Japanese government has released US $350,000 funding to assist the
government of the Philippines in the fight against TB. The Japanese Embassy
in Manila announced that around 530,000 urban low-income residents of
Payatas in Quezon City, and Tondo, Manila, will benefit from the grant. It
covers three phases of a TB control project in underprivileged urban areas
of Manila. The Japan Anti-TB Association (JATA), a Japanese non-governmental
organization, conducted an annual workshop with the Manila Health
Department, the Quezon City Health Department, and partner organizations, as
part of the phase three project.
Journal Articles
*1.* The American Journal of Tropical Medicine and Hygiene. 2011 Jan; Volume
84, Number 1: 30-7. *Addressing Institutional Amplifiers in the Dynamics and
Control of Tuberculosis Epidemics;* Basu, S., Stuckler, D., McKee, M.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21212197>
TB outbreaks originating in prisons, mines, or hospital wards can spread to
the larger community. Recent proposals have targeted these high-transmission
institutional amplifiers by improving case detection, treatment or reducing
the size of the exposed population. However, what effects these alternative
proposals may have is unclear. The researchers mathematically modeled these
control strategies and found case detection and treatment methods
insufficient in addressing epidemics involving common types of institutional
amplifiers. Movement of persons in and out of amplifiers fundamentally
altered the transmission dynamics of TB in a manner not effectively
mitigated by detection or treatment alone. Policies increasing the
population size exposed to amplifiers or the per-person duration of exposure
within amplifiers potentially worsened incidence, even in settings with high
rates of detection and treatment success. However, reducing the total
population size entering institutional amplifiers significantly lowered TB
incidence and the risk of propagating new drug-resistant TB strains.
*2.* Chest. 2010 Dec; Volume 138, Number 6: 1456-63. *Recent Advances in
Testing for Latent TB;* Schluger, N.W., Burzynski, J.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21138881>
After more than a century of relying on skin testing for the diagnosis of
latent TB infection, clinicians now have access to blood-based diagnostics
in the form of interferon γ release assays (IGRAs). These tests are
generally associated with higher sensitivity and specificity for diagnosis
of latent TB infection. This article reviewed the indications for testing
and treatment of latent TB infection in the overall context of a TB control
program and described how IGRAs might be used in specific clinical settings
and populations, including people having close contact with an active case
of TB, the foreign born, and health-care workers.
*3.* European Review for Medical and Pharmacological Sciences. 2010 Oct;
Volume 14, Number 10: 845-53. *Management of Central Nervous System
Tuberculosis in Children: Light and Shade; *Buonsenso, D., Serranti, D.,
Valentini, P.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21222370>
Pediatric TB of the central nervous system (CNS-TB) is a severe form of
extrapulmonary TB. It is most common in children between 6 months and 4
years of age. CNS-TB can present as meningitis and/or tuberculoma. In both
situations, brain damage results from a cytokine-mediated inflammatory
response, which causes vasculitis, obstructive hydrocephalus, and cranial
nerve palsy. Tumor necrosis factor alpha (TNF-alpha) is an important
cytokine in this response. The prognosis of tuberculous meningitis (TBM)
correlates most closely with the clinical stage of illness at the time
treatment is started. Most patients in the 1st stage have a good outcome,
whereas the management of patients in the 2nd and 3rd stage is still a
clinical challenge, and the few patients who survive have permanent severe
disabilities. Due to the important role of inflammation in CNS-TB
pathogenesis, corticosteroids are routinely used in TBM or tuberculomas, in
order to reduce death and disabling residual neurological deficits among
survivors. Nevertheless, not all patients show a good response to standard
anti-inflammatory treatment. Thalidomide is a drug with pleiotropic effects:
it appears to downregulate production of TNF-alpha and other proinflammatory
cytokines. Due to its anti-inflammatory effects, thalidomide has been
evaluated as an adjunctive drug in the management of difficult-to-treat
CNS-TB. A literature review was carried out based on MEDLINE/pubmed database
(1997/2010) searching for the following descriptors: corticosteroids and
tuberculous meningitis (limits: review, all child); thalidomide and
tuberculosis treatment; and tuberculous meningitis; and CNS-TB; and brain
abscess; and TB clinical trial. This study presents a literature review on
the use of corticosteroids and thalidomide in the treatment of CNS-TB. The
Cochrane review for randomized-controlled trials evaluating the use of
steroids in TBM showed significantly reduced overall mortality, reduced
death, and severe residual disability in children. Regarding the use of
thalidomide, a randomized controlled trial published in 2004 did not support
the use of adjunctive high-dose thalidomide therapy in the treatment of TBM
in children, but results from four case reports, one clinical trial, and one
placebo-controlled trial suggested the use of thalidomide in CNS-TB not
responding to standard therapy. "Adjuvant" treatment with dexamethasone
improved survival in patients with TBM but probably did not prevent
disability. Thalidomide should not be used for routine treatment, but it may
be helpful as a "salvage therapy" in patients with TBM and tuberculomas not
responding to anti-TB drugs and high dose corticosteroids. More studies
should evaluate its role as it was not completely conclusive in this study.
*4.* The International Journal of Tuberculosis and Lung Disease. 2010 Dec;
Volume 14, Number 12: 1538-47. *Tuberculosis Regimen Change in High-Burden
Countries;* Wells, W.A., Konduri, N., Chen, C., Lee, D., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21144238>
Experience with past TB regimen changes can guide future regimen changes. To
explore the process, major players, and procedural success factors for
recent public sector TB regimen changes, the researchers conducted 166
interviews of country stakeholders in 21 of the 22 TB high-burden countries
(HBCs). Stakeholders described 40 distinct regimen changes for
drug-susceptible TB. Once countries committed to considering a change, the
average timing was ~1 year for decision-making and ~2 years for roll-out.
Stakeholders more often cited concerns that were program-based (e.g.,
logistics and cost) rather than patient-focused (e.g., side effects), and
patient representatives were seldom part of decision making. Decision-making
bodies in higher-income HBCs had more formalized procedures and fewer
international participants. Pilot studies focused on logistics were more
common than effectiveness studies, and the evidence base was often felt to
be insufficient. Once implementation started, weaknesses in drug management
were often exposed, with additional complications if local manufacturing was
required. Best practices for regimen change included early engagement of
budgeting staff, procurement staff, regulators, and manufacturers. Future
decision makers will benefit from strengthened decision-making bodies,
patient input, early and comprehensive planning, and regimens and evidence
that address local, practical implementation issues.
*5.* The International Journal of Tuberculosis and Lung Disease. 2010 Dec;
Volume 14, Number 12: 1530-7. *Pediatric Tuberculosis Immigration Screening
in High-Immigration, Low-Incidence Countries;* Alvarez, G.G., Clark, M.,
Altpeter, E., Douglas, P., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21144237>
TB screening in migrant children, including immigrants, refugees, and asylum
seekers, is an ongoing challenge in low TB incidence countries. Many
children from high TB incidence countries harbor latent TB infection (LTBI),
and some have active TB disease at the point of immigration into host
nations. Young children who harbor LTBI have a high risk of progression to
TB disease and are at a higher risk than adults of developing disseminated
severe forms of TB with significant morbidity and mortality. Many countries
have developed immigration TB screening programs to suit the needs of
adults, but have not focused much attention on migrant children. This study
compared the TB immigration medical examination requirements in children in
selected countries with high immigration and low TB incidence rates and
presented a descriptive study of TB immigration screening programs for
systematically selected countries. Of 18 eligible countries, 16 responded to
the written survey and telephone interview. No two countries had the same
approach to TB screening among migrant children. It is concluded that the
optimal evidenced-based manner in which to screen migrant children requires
further research.
*6.* The International Journal of Tuberculosis and Lung Disease. 2010 Dec;
Volume 14, Number 12: 1518-24. *Beyond Accuracy: Creating a Comprehensive
Evidence Base for TB Diagnostic Tools;* Mann, G., Squire, S.B., Bissell, K.,
Eliseev, P., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21144235>
The need for a strong and comprehensive evidence base to support decision
making with regard to the implementation of new and improved diagnostic
tools and approaches has been highlighted by a number of stakeholders
including members of the New Diagnostics Working Group (NDWG) and the
Subgroup for Introducing New Approaches and Tools of the Stop TB
Partnership. To compile such evidence in a systematic manner, the
researchers have developed an impact assessment framework (IAF) which links
evidence on inputs to outcomes. The IAF comprises five interconnected
layers: effectiveness analysis, equity analysis, health systems analysis,
scale-up analysis, and policy analysis. It can be used by new diagnostics
developers and other interested research teams to collect as much
policy-relevant data as possible prior to, during, and after the
demonstration phase of tool development. The evidence collated may be used
by international and national policy makers to support adoption,
implementation, and scale-up decisions. The TREAT TB (Technology, Research,
Education and Technical Assistance for TB) initiative uses the IAF in its
operational research and field evaluations of new tools and approaches for
TB diagnosis. It has also been incorporated into the NDWG's recent
publication: “Pathways to Better Diagnostics for Tuberculosis: A Blueprint
for the Development of TB Diagnostics.” This article describes the IAF and
the process of improving it and suggests next steps in overcoming the
challenges in its implementation.
*7.* The International Journal of Tuberculosis and Lung Disease. 2011 Feb;
Volume 15, Number 2: 257-62. *Mortality Before or During Treatment among
Tuberculosis Patients in North Carolina, 1993-2003;* Nguyen, L.T., Hamilton,
C.D., Xia, Q., Stout, J.E.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21219691>
This study investigated the demographic and behavioral risk factors
associated with death among tuberculosis (TB) patients in North Carolina. A
retrospective cohort was conducted of all TB patients reported in North
Carolina, 1993-2003 (inclusive). A surveillance dataset based upon Report of
Verified Case of Tuberculosis (RVCT) records was cross-linked with the
National Death Index (NDI) to confirm date of death and capture additional
deaths. Among 5,311 TB patients, 181 died before initiation of TB treatment,
and 540 died before completion of TB treatment. Increasing age,
miliary/meningeal disease, and HIV infection were associated with increased
risk of death before treatment, during early treatment (initial 8 weeks),
and later in TB treatment. In addition to these factors, excess alcohol use
(HR 1.62, 95%CI 1.13-2.32) and residence in a nursing home (HR 1.65, 95%CI
1.20-2.29) were associated with a significantly increased risk of death
during the first 8 weeks of treatment. Many of the deaths in TB patients
occurred in the most vulnerable populations, such as the elderly or those
with HIV infection, and may be attributable to delayed diagnosis and poor
functional status.
*8.* The International Journal of Tuberculosis and Lung Disease. 2011 Feb;
Volume 15, Number 2: 251-6, i. *Serum Procalcitonin in Pulmonary
Tuberculosis;* Rasmussen, T.A., Søgaard, O.S., Camara, C., Andersen, P.L.,
et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21219690>
This study evaluated the level and prognostic value of procalcitonin (PCT)
in a West African outpatient cohort with pulmonary TB (PTB). Patients were
clinically scored (TB score), grouped into severity classes (SCs) upon
diagnosis, and followed for 12 months. Patients were categorized by
comparisons of severity class (SC I+II or SC III) and levels of PCT and
C-reactive protein (CRP) at diagnosis. The researchers included 218 patients
in the study. Fifty healthy volunteers from the study area were used as
controls. The association with TB score was explored using Spearman's rank
correlation test. Survival curves stratified after baseline levels of PCT
and CRP were compared using the log-rank test. PCT and CRP levels were low,
but were significantly higher in patients than in controls (P < 0.001), and
were higher for SC III compared to SC I+II patients (P = 0.021 for PCT, P <
0.001 for CRP). HIV status did not influence results. The researchers found
positive correlations between both PCT and CRP and TB score. There was a
significantly increased risk of mortality with increasing baseline PCT (P =
0.01), whereas high CRP did not predict mortality rate (P = 0.887). In West
African PTB patients, PCT levels were low but increased significantly with
increasing severity of disease, and can predict mortality risk.
*9.* Journal of Korean Medical Science. 2011 Jan; Volume 26, Number 1:
33-41. Epub 2010 Dec 22. *Treatment Outcome and Mortality among Patients
with Multidrug-Resistant Tuberculosis in Tuberculosis Hospitals of the
Public Sector; *Jeon, D.S., Shin, D.O., Park, S.K., Seo, J.E., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21218027>
This study evaluated treatment outcome, mortality, and predictors of both in
patients with multidrug-resistant TB (MDR TB) at 3 TB referral hospitals in
the public sector of Korea. The researchers included MDR TB patients treated
at 3 TB referral hospitals in 2004 and retrospectively reviewed their
medical records and mortality data. Of 202 MDR TB patients, 75 (37.1%) had
treatment success and 127 (62.9%) poor outcomes. Default rate was high
(37.1%, 75/202), comprising 59.1% of poor outcomes. Male sex (adjusted odds
ratio [aOR], 2.91; 95% confidence interval [CI], 1.13-7.49), positive smear
at treatment initiation (aOR, 5.50; 95% CI, 1.22-24.90), and extensively
drug-resistant TB (aOR, 10.72; 95% CI, 1.23-93.64) were independent
predictors of poor outcome. The all-cause mortality rate was 31.2% (63/202)
during the 3-4 years after treatment initiation. In conclusion, the
treatment outcomes of patients with MDR TB at the 3 TB hospitals are poor,
which may reflect the current status of MDR TB in the public sector of
Korea. A more comprehensive program against MDR TB needs to be integrated
into the National Tuberculosis Program of Korea.
*10.* Journal of Microbiology, Immunology, and Infection. 2010 Dec; Volume
43, Number 6: 464-9. *Spinal Tuberculosis in Non-HIV-Infected Patients: 10
Year Experience of a Medical Center in Central Taiwan;* Weng, C.Y., Chi,
C.Y., Shih, P.J., Ho, C.M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21195972>
TB is an endemic disease in Taiwan and usually affects the lung. Spinal TB
accounts for 1-3% of all TB infections. This study investigated the clinical
manifestations, management, outcomes, and drug susceptibility of *Mycobacterium
tuberculosis* in non-HIV-infected patients with spinal TB. From January 1998
to December 2007, the researchers retrospectively reviewed the medical
charts of adult patients with a diagnosis of spinal TB. Only those with
positive culture results and/or characteristic pathologic findings were
enrolled. Demographic data, clinical manifestations, and susceptibility to
anti-TB drugs were reviewed and analyzed. During the study period, 38
patients (23 men, 15 women) mean age 68 years, with spinal TB were
identified. The median duration of symptoms was 60 days (range, 3-720 days).
Amongst the 38 patients, back pain (100%) was the most common clinical
symptom, followed by weakness (53%) and numbness (26%). The lumbar spine (15
patients, 39%) was the most commonly involved site, followed by the thoracic
spine (14 patients, 37%). Concomitant pulmonary TB was found in 12 patients
(32%). Three patients (8%) had concurrent bacterial or fungal infections.
Almost all of the patients (35 patients, 92%) were successfully treated with
surgery and anti-TB medications. The erythrocyte sedimentation rate was
followed up in 16 patients before and after therapy and a significant
decline was observed after treatment (p = 0.004). No mortality was related
to spinal TB. Insidious clinical course and ambiguous manifestations of
spinal TB often delay and hinder the accuracy of diagnosis of spinal TB. In
addition to pyogenic osteomyelitis, spinal TB should be included in the
differential diagnosis especially in elderly patients with chronic back pain
accompanied by elevated erythrocyte sedimentation rate, and those living in
a TB endemic area.
*11.* Neuroimmunomodulation. 2010; Volume 17, Number 5: 333-9. Epub 2010 Apr
17. *Changes in Cerebrospinal Fluid Cytokine Expression in Tuberculous
Meningitis Patients with Treatment;* Kashyap, R.S., Deshpande, P.S.,
Ramteke, S.R., Panchbhai, M.S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20407285>
The prevalence of tuberculous meningitis (TBM) is very high in developing
areas of the world. Inflammation and cytokine patterns produced by T
lymphocytes play an important role in susceptibility to infections. The
inflammatory response and production of cytokines in the cerebrospinal fluid
(CSF) of patients with TBM are well documented. Conversely, little is known
about the role of pro- and anti-inflammatory cytokines in the CSF of TBM
patients. This study estimated the level of proinflammatory cytokine and
anti-inflammatory cytokine levels in CSF samples from TBM patients. To study
this, in vivo levels of IL-2 and IFN-gamma (proinflammatory cytokines), and
IL-10 (anti-inflammatory cytokine) in the CSF of 60 adult TBM patients and
50 age- and sex-matched non-TBM controls were measured. These cytokines were
estimated in the CSF of TBM patients before and after starting treatment.
High levels of pro-inflammatory cytokines as compared to anti-inflammatory
cytokines were found in TBM patients before treatment. However, CSF samples
from TBM patients after treatment showed elevated levels of
anti-inflammatory and low levels of pro-inflammatory cytokines. The
researchers hypothesized that an increase in anti-inflammatory cytokines
during treatment may indicate a favorable response.
*12.* Pakistan Journal of Pharmaceutical Sciences. 2011 Jan; Volume 24,
Number 1: 81-5. *Anti-Mycobacterial Activity of Garlic (Allium sativum)
against Multi-Drug Resistant and Non-Multi-Drug Resistant Mycobacterium
tuberculosis;* Hannan, A., Ikramullah, M., Usman, M., Hussain, S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21190924>
Emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR)
TB throughout the developing world is very disturbing in the present
scenario of TB management. There is a fundamental need to explore
alternative anti-TB agents. Hence, natural plants should be investigated to
understand their antimicrobial properties and safety. Garlic (*Allium
sativum*) is a natural plant that possesses a variety of biological
properties such as anti-tumor, anti-hyperlipedemic and anti-microbial etc.
The present study evaluated the antibacterial activity of garlic against
non-MDR and MDR isolates of *M. tuberculosis*. A total of 20 clinical
isolates of MTB including 15 MDR and 5 non-MDR were investigated. Ethanolic
extract of garlic was prepared by maceration method. Minimum inhibitory
concentration (MIC) was performed by using 7H9 middle brook broth dilution
technique. MIC of garlic extract ranged from 1 to 3 mg/ml; showing
inhibitory effects of garlic against both non-MDR and MDR *M.
tuberculosis*isolates. Alternate medicine practices with plant
extracts including garlic
should be considered to decrease the burden of drug resistance and cost in
the management of diseases. The use of garlic against MDR TB may be of great
importance regarding public health.
*13.* PLoS One. 2010 Dec 29; Volume 5, Number 12: e14459. *Long Delays and
Missed Opportunities in Diagnosing Smear-Positive Pulmonary Tuberculosis in
Kampala, Uganda: A Cross-Sectional Study; *Sendagire, I, Schim Van der
Loeff, M., Mubiru, M., Konde-Lule, J., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21206746>
Early detection and treatment of TB cases are the hallmark of successful TB
control. The researchers conducted a cross-sectional study at public primary
health facilities in Kampala city, Uganda, to quantify diagnostic delay
among pulmonary TB (PTB) patients, assess associated factors, and describe
trajectories of patients' health care seeking. Semi-structured interviews
were conducted with new smear-positive PTB patients (≥15 years) registered
for treatment. Between April 2007 and April 2008, 253 patients were studied.
The median total delay was 8 weeks (IQR 4-12), median patient delay was 4
weeks (inter-quartile range [IQR] 1-8), and median health service delay was
4 weeks (IQR 2-8). Long total delay (>14 weeks) was observed for 61/253
(24.1%) of patients, long health service delay (>6 weeks) for 71/242
(29.3%), and long patient delay (>8 weeks) for 47/242 (19.4%). Patients who
knew that TB was curable were less likely to have long total delay (adjusted
odds ratio [aOR] 0.28; 95%CI 0.11-0.73) and long patient delay (aOR 0.36;
95%CI 0.13-0.97). Being female (aOR 1.98; 95%CI 1.06-3.71), staying for more
than 5 years at current residence (aOR 2.24 95%CI 1.18-4.27), and having
been tested for HIV before (aOR 3.72; 95%CI 1.42-9.75) was associated with
long health service delay. Health service delay contributed 50% of the total
delay. Ninety-one percent (231) of patients had visited one or more health
care providers before they were diagnosed, for an average (median) of 4
visits (range 1-30). All but four patients had systemic symptoms by the time
the diagnosis of TB was made. Diagnostic delay among TB patients in Kampala
is common and long. This reflects patients waiting too long before seeking
care and health services and waiting until systemic symptoms are present
before examining sputum smears, which results in missed opportunities for
diagnosis.
*14.* PLoS One. 2010 Dec 28; Volume 5, Number 12: e15206. *Performance of
Three LED-Based Fluorescence Microscopy Systems for Detection of
Tuberculosis in Uganda;* Albert, H., Manabe, Y., Lukyamuzi, G., Ademun, P.,
et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21203398>
Direct smear microscopy using Ziehl-Neelsen (ZN) staining is the mainstay of
TB diagnosis in most high burden countries, but is limited by low
sensitivity in routine practice, particularly in HIV prevalence settings.
The researchers compared the performance of three commercial light emitting
diode-(LED)based microscopy systems (Primostar™ iLED, Lumin™ and AFTER®) for
fluorescent detection of *Mycobacterium tuberculosis* with ZN microscopy on
slides prepared from sputum of TB suspects. Examination time for LED-based
fluorescent microscopy (LED FM) and ZN slides was also compared, and a
qualitative user appraisal of the LED FM systems was carried out. LED FM was
between 5.6 and 9.4% more sensitive than ZN microscopy, although the
difference was not statistically significant. There was no significant
difference in the sensitivity or specificity of the three LED FM systems,
although the specificity of Fraen AFTER was somewhat lower than that of the
other LED FM methods. Examination time for LED FM was 2 and 4 times less
than for ZN microscopy. LED FM was highly acceptable to Ugandan
technologists, although differences in operational performance of the three
systems were reported. LED FM compares favorably with ZN microscopy, with
equivalent specificity and a modest increase in sensitivity. Screening of
slides was substantially quicker using LED FM than ZN, and LED FM was rated
highly by laboratory technologists. Available commercial systems have
different operational characteristics which should be considered prior to
programmatic implementation.
*15.* PLoS Pathogens. 2010 Dec 23; Volume 6, Number 12: e1001237. *Hypoxia
Induces an Immunodominant Target of Tuberculosis Specific T Cells Absent
from Common BCG Vaccines;* Gideon, H.P., Wilkinson, K.A., Rustad, T.R., Oni,
T., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21203487>
*M. tuberculosis* (MTB) species-specific antigenic determinants of the human
T cell response are important for immunodiagnosis and vaccination. As
hypoxia is a stimulus in chronic TB infection, the researchers analyzed
transcriptional profiles of MTB subject to 168 hours of hypoxia to test the
hypothesis that upregulation by hypoxia might result in gene products being
recognized as antigens. The researchers identified upregulation of two
region of difference (RD) 11 (Rv2658C and Rv2659c), and one RD2 (Rv1986)
absent from commonly used BCG strains. In MTB infected persons, the IL-2
ELISpot response to Rv1986 peptides was several times greater than the
corresponding IFN-γ response to the reference immunodominant ESAT-6 or
CFP-10 antigens. The IL-2 response was confined to two epitopic regions
containing residues 61-80 and 161-180. The biggest population of IL-2
secreting T cells was single cytokine positive central memory T cells. The
IL-2 response to live MTB bacilli lacking Rv1986 was significantly lower
than the response to wild type or mutant complemented with Rv1986. In
addition, the IL-2 response to Rv1986 was significantly lower in HIV-TB
coinfected persons than in HIV uninfected persons, and significantly
increased during antiretroviral therapy. These findings demonstrate that
Rv1986 is an immunodominant target of memory T cells and is therefore of
relevance when considering the partial efficacy of currently used BCG
vaccines and provide evidence for a clinical trial comparing BCG strains.
Job Announcements
*All job announcements will be posted for two months. Please notify us if a
job is filled before the end of the two-month posting period, and we will
remove the job announcement. Thank you. *
*1. Deputy Director for Field Projects, TB Team, HIV/TB Global Team
(Tracking code 4477)*
*Sponsor: PATH*
Location: Washington DC
PATH is an international, nonprofit organization that creates sustainable,
culturally relevant solutions, enabling communities worldwide to break
longstanding cycles of poor health. PATH's mission is to improve the health
of people around the world by advancing technologies, strengthening systems,
and encouraging healthy behaviors. PATH is seeking a Deputy Director for TB
field projects with experience managing USAID projects, excellent
organizational and leadership skills, strong writing and reporting skills,
and TB expertise to provide program management support to PATH's growing TB
portfolio within the HIV/TB Global Program. S/he will report to the TB Team
Leader. The location of this position is Washington, DC.
To apply or learn more about the position, please follow this link:
http://ow.ly/3WQ8G
* *
*2. Stop TB Advocacy Officer - Washington (DC)-based *
*Sponsors: RESULTS Educational Fund; Stop TB Partnership Secretariat*
Location: Washington, DC
The Stop TB Partnership (TBP) Coordinating Board endorsed the enhancement of
the TBP’s advocacy influence, including strategy, coordination,
communications, support, and leadership engagement. The Board mandated TBP
to clearly define the responsibilities and the budget implications of a
Washington-based position, and to open discussions with partners regarding
the creation of such a position within their organization.
These discussions have resulted in the proposed grant to RESULTS Educational
Fund (REF) as partial funding for a Stop TB Advocacy Officer—additional to
the staff currently working at REF on TB advocacy—to be hosted at their
offices in Washington, DC. The grant will be for an initial period of 1
year. Subject to results achieved and availability of funds, a similar
arrangement may be considered subsequently.
For more information, including the objectives of this position, duties,
qualifications, experience, and skills, interested applicants should e-mail
. Applications will be reviewed on a rolling basis,
so early submission is recommended. No phone calls please, qualified
candidates will be contacted.
*3. Training and Consultation Specialist *
*Sponsor: New Jersey Medical School Global Tuberculosis Institute*
Job Number: 10NS963549
Location: Newark, New Jersey
The New Jersey Medical School Global TB Institute is currently accepting
applications for a Training and Consultation Specialist.
The primary purpose of the Training and Consultation Specialist position is
to develop, implement, and evaluate educational programs and materials
related to TB to meet the needs of health care professionals and TB
patients. These activities will be consistent with the goals and objectives
of the CDC funded Regional Training and Medical Consultation Centers
initiative, or with other national or international TB control
projects. These programs may include training courses, lectures, symposia,
preceptorships, and enduring materials, including curricula and self study
materials. Responsibilities will include developing and implementing
training courses for TB Program staff and developing patient and provider
educational materials for use in domestic and international
settings. Previous experience in international TB training and education is
desired.
More information and an online application are available at:
http://umdnj.hodesiq.com/job_detail.asp?JobID=2194623&user_id=
*4. Director, Tuberculosis Programs (Tracking code 4307) *
*Sponsor: PATH*
Location: Hanoi, Vietnam
PATH seeks a dynamic and experienced public health professional to lead and
manage its increasingly large and complex portfolio of TB Control projects;
represent PATH to donors, partners, and government agencies;, and serve as a
member of PATH Vietnam’s senior management team.
With support from the Global Fund to Fight AIDS, TB and Malaria and the
United States Agency for International Development (USAID) and in
partnership with the National TB Program, PATH is expanding its TB control
program in Vietnam with two major initiatives. The Global Fund project is
designed to scale up technical components and partnerships to increase TB
control impact while the USAID-funded project will reduce diagnostic delays,
increase case detection, and improve adherence to TB treatment through
strengthened stakeholder involvement in TB control activities at the
district, provincial, and national levels. The Global Fund project will
implement a public-private partnership model for TB case detection, and both
projects will strengthen capacity for advocacy, communication, and social
mobilization toward the goal of eliminating TB as a public health threat.
Reporting to the Country Program Leader, the incumbent will oversee a
combined budget of nearly nine million USD and 24 staff, including six
direct reports.
Specific responsibilities include:
(1) Project Leadership, Management and Oversight:
- Assume strategic leadership and direct planning, implementation, and
management for Global Fund project and oversight for USAID TB project,
including strategic support for program objectives, key interventions, and
evaluation strategies.
- Liaise with Global TB program staff integrating TB work in Vietnam with
overall PATH strategy for TB Control.
- Oversee rapid start-up of project activities for each initiative: hiring
staff and initiating and building relationships with key stakeholders.
- Develop and coordinate the annual budgeting process for each project;
ensure prudent management of project funds; coordinate each project’s
accounting, monitoring, and reporting systems, including establishing
internal control systems in accordance with PATH’s standard operating
procedures.
- Represent PATH to donors, partners, and government agencies, and oversee
coordination activities with the National TB Program.
- Support the Country Program Leader in managing all donor-related
compliance matters, ensuring that project teams achieve project goals and
objectives according to donor expectations and within approved project
budgets.
- Work with staff to develop strategy for each project and identify
issues/challenges for effective implementation of work plan activities.
- Oversee preparation of required reports to Headquarters and donors.
- Maintain updated technical knowledge in TB and related public health
topics to be able to provide vision and input to strategy development and
technical assistance to project staff.
(2) PATH Representation:
- On delegation, serve as the PATH representative to donors, collaboration
institutions, other potential clients and partners, and the press.
- Serve as a member of the senior management team contributing to strategic
policy and program directions and decisions.
- Represent PATH on national working groups and task forces as appropriate
and maintain contacts with other organizations engaged in TB control
activities.
- Identify and participate in new business opportunities and activities for
PATH including proposal writing.
If interested, forward resume to Sue Wallace. E-mail , or
apply online at http://www.path.org.
Upcoming Conferences, Trainings, and Other Events Find up-to-date
information on TB-related conferences, US training opportunities, and other
events at the DTBE Monthly Calendar<http://www.cdc.gov/tb/events/default.htm>
. 1. Targeted Testing and Treatment of Latent TB Infection: An Online
Presentation (60 minutes)
Sponsor: The Francis J. Curry National Tuberculosis Center
This slide presentation is presented by L. Masae Kawamura, M.D., TB
Controller of the San Francisco Department of Public Health and co-principal
investigator of the Francis J. Curry National TB Center/UCSF. Dr. Kawamura
explores the diagnosis and treatment of LTBI, including: the rationale for
TB screening and what is meant by "targeted testing," risk factors for TB,
the tuberculin skin test and new interferon gamma release assays (IGRAs),
current LTBI treatment guidelines, and how to counsel and motivate patients.
This slide presentation with streaming audio provides information on how to
effectively target test for TB as well as how to treat latent TB infection
(LTBI). A question and answer guide, a printable PowerPoint slide file, and
other useful resources are also included as supplemental materials.
For more information, visit
http://www.nationaltbcenter.ucsf.edu/testing_ltbi/ .
*2. Practical Solutions for TB Infection Control: Infectiousness and
Isolation *
Sponsor: Francis J. Curry National Tuberculosis Center
Location: Online Course
Length: 60 minutes
This 60-minute Flash presentation with streaming audio provides information
on how to determine whether a TB patient is infectious and demonstrates
practical ways to prevent TB transmission in the clinic, in transit, and in
the patient's home. Throughout the training, interactive questions allow
participants to test and apply what has been learned. At the end of the
presentation, there is a list of additional resources that includes links to
further written information as well as links to the Regional Training and
Medical Consultation Centers (RTMCCs).
For further assistance, contact Francis J. Curry National Tuberculosis
Center. E-mail ; telephone (415) 502-4600;
or fax (415) 502-4620.
For a course description, visit
http://www.nationaltbcenter.ucsf.edu/tbicweb/ .
*3. Medical Management of Tuberculosis: An Online Presentation*
Sponsor: Francis J. Curry National Tuberculosis Center
Length: 30 minutes
Credit: 0.5 contact hour CME/CNE
This slide presentation with streaming audio will provide information on how
to manage treatment of TB. A question and answer guide, a printable
PowerPoint slide file, and other useful resources are also included as
supplemental reading materials. This 30-minute lecture, conducted by Dr.
Karen Smith, covers the general principles of TB treatment, the drugs used
to cure TB, alternative regimens, monitoring, and potential adverse
reactions to therapy. It targets audiences of clinicians and health care
professionals.
For a course description or to receive continuing medical education (CME) or
continuing nursing education (CNE) contact hours, please visit
http://www.nationaltbcenter.edu/med_mgmt/ .
*4. Legal Interventions in TB Control: A Web-Based Seminar *
Sponsor: New Jersey Medical School Global Tuberculosis Institute
Location: Web-Based Seminar
This web-based seminar, presented by the Global TB Institute, was originally
held on September 11, 2007 and explored successful and innovative approaches
to implementing legal interventions in TB control programs in the US.
Experts shared legal and ethical considerations, as well as hands-on
experiences, practical steps, and legal tools that can be used to improve
outcomes of case management, treatment outcomes, and contact investigations.
Points were illustrated using lectures and case presentations
Please follow the link below to view this web-based seminar:
http://www.umdnj.edu/globaltb/audioarchives/legal.htm .
*5. TB Case Management and Contact Investigation Intensive*
Sponsor: Francis J. Curry National Tuberculosis Center
Dates: March 15 – 18, 2011
Location: San Francisco, California
This course is intended for physicians, nurses, and other licensed medical
care providers who manage patients with TB or who are at risk for TB. Topics
covered include: Epidemiology of TB; Fundamentals of TB case management;
Completion of care; TB contact investigation; The role of the laboratory;
Medical management of TB; Quality assurance in TB control programs; Targeted
testing for TB; Treatment of latent TB infection (LTBI); Culture, community,
and TB care; Working with special populations; and Interviewing skills.
There is no fee for this course. Enrollment is limited, and pre-registration
is required.
For more information, contact Jennifer Kanouse, Program Manager. E-mail
; phone (415) 502-2712; or access the Web
site at
http://www.nationaltbcenter.ucsf.edu/training/tbcmcimar11.cfm.
*6. Mass Media and Communications*
*Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)*
Dates: March 21 – 25, 2011
Location: Singapore
Communication exchange has never been so easily accessible and so critical
to the success of a national health program. Gain a greater understanding of
how effective communications strategies can help promote TB and HIV programs
and further disseminate important health messages to the public. During this
course participants will receive training on how to write a professional
press release, develop useful promotional tools, conduct media outreach, and
discover how to build positive public awareness around an organization’s
work. Learning directly from experts working in mass communications,
participants will engage in class exercises, discussions, and real-life
simulations that demonstrate how skillful use of the media and
communications can propel any health program to excellence.
To register or receive more information, email or visit
http://www.union-imdp.org/courses/mass-media-communications . Late
applications accepted on a space-available basis.
*7. TB Cohort Review*
Sponsor: Heartland National TB Center
Date: March 23, 2011
Location: Phoenix, Arizona
Registration deadline: March 10, 2011
The goal of this training is to introduce health care workers to the TB
Cohort Review process through CDC guidelines, case examples, and group
exercises. Using interactive lectures as well as case presentations and
group exercises, participants will be able to list elements of a cohort
review; identify key participants and their role, prepare for and conduct a
practice cohort review; demonstrate an actual cohort review, and analyze the
data to understand outcomes and programmatic follow-up. There is no charge
to attend this workshop, but pre-registration is mandatory. Space is limited
to 35 participants. Register at http://www.heartlandntbc.org/training.asp .
Continuing education credits are available.
For more information, contact Jessica Quintero. E-mail
;
call (210) 531-4568; or access the Web site at
http://www.heartlandntbc.org/training/brochure_phoenix_az_23_mar_2011.pdf .
*8. TB in Corrections *
Sponsor: Heartland National TB Center
Date: March 24, 2011
Location: Phoenix, Arizona
Registration deadline: March 10, 2011
This course is designed for the registered nurse and other health care
professionals who are tasked with the management of TB in correctional
facilities at the local, state, and federal level. The goal of this training
is to enhance the knowledge of TB prevention and control measures within the
correctional setting.
There is no charge to attend this workshop, but pre-registration is
mandatory. Space is limited to 35 participants. Register at
http://www.heartlandntbc.org/training.asp . Continuing education credits are
available.
For more information, contact Jessica Quintero. E-mail
;
telephone (210) 531-4568; or access the Web site at
http://www.heartlandntbc.org/training/brochure_phoenix_az_24_mar_2011.pdf.
*9. Critical Care and Pulmonary Medicine: An Update and Review*
Sponsor: American Medical Seminars, Inc.
Dates: March 28 – April 1, 2011
Location: Sarasota, Florida
Following this course, the participant should be able to assess the common
presentation and patient complaints for the various pulmonary disorders
described; implement a diagnostic work-up appropriate for each presented
disorder, considering a practical and cost-effective approach; employ a
cost-effective method of treatment, follow-up, and long-term care when
indicated. This activity is expected to result in improved competence in
making an appropriate diagnosis and providing effective treatment and
referral or follow-up care with the overall goal of improving patient
outcomes. The emphasis will be on aligning physician behavior with current
guidelines and evidence-based medicine, as indicated within each topic’s
specific objectives, with a focus on diagnosis, treatment, and when to
refer.
To receive regular registration rate, fees must be received or postmarked at
least 30 days prior to program start date. Registration fee: Regular -
$745/Physician; $645/Non Physician; Late - $795/Physician; $695/Non
Physician. Continuing education credits are available.
For more information contact the American Medical Seminars, Inc., E-Mail:
; Phone: (941) 388-1766; Toll Free: (866) ams4cme
(866-267-4263); Fax: (941) 365-7073; or access the Web site:
http://www.ams4cme.com/www/LiveSeminars/SEMLA-2520110328.aspx .
*10. TB Intensive *
Sponsor: Heartland National Tuberculosis Center
Dates: April 6 – 8, 2011
Location: San Antonio, Texas
Application Deadline: March 14, 2011
This three day course targets physicians and nurse experts who are actively
engaged in the management of patients with, or at risk of, TB. The goal of
the course is to enhance the expertise of providers to improve the
prevention, treatment, and management of patients with TB.
There is no fee, but enrollment is limited to 25 participants.
Pre-registration is required. Continuing education credits are available.
For more information, contact Mary Long, Heartland National TB Center.
E-mail ; phone (210) 531-4545; or access the Website at
http://www.heartlandntbc.org/training.asp .
*11. The Denver TB Course*
Sponsor: National Jewish Health
Dates: April 13 – 16, 2011
Location: Denver, Colorado
The purpose of this course is to present knowledge about the management of
TB to general internists, public health workers, infectious diseases and
chest specialists, registered nurses, and other healthcare providers who
will be responsible for the management and care of patients with TB. This
event includes the following course highlights: Transmission and
pathogenesis of adult and pediatric TB; MDR TB and XDR TB; Screening for and
treatment of latent TB infection; Factors influencing infections of TB;
Planning TB control programs with particular emphasis on organization of
outpatient chemotherapy; TB and HIV co-infection; and Mycobacteriology
Laboratory Tour.
Continuing education credits are available.
For more information contact Nicole Austin Ross, National Jewish Health,
E-mail: ;
Phone: (303) 398-1110; Fax: (303) 270-2239; or access the Web site:
http://www.njhealth.org/TBCourse.
*12. Influencing, Networking and Collaboration *
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: April 25 – 30, 2011
Location: Singapore
Application deadline: March 25, 2011
Creating partnerships and networks is an important element to the success of
a TB program. Participants in this course will learn how relationship
building and developing strong partnerships can boost health program
results. The course will address the following key topics: Creating
empowered teams and moving away from the command and control structure,
facilitating large stakeholders meeting and managing conflict, negotiating
and partnering with stakeholders within health programs, and building
consensus within large groups of distinct and diverse personalities.
Application deadline: March 25, 2011. Late applications accepted on a
space-available basis. To register, email .
For more information, Email: ; or view the
brochure at
http://union-imdp.org/files/resources/Brochure-2011-Union-IMDP.pdf .
*13. 2011: What Do We Know About LTBI? *
Sponsor: Francis J. Curry National Tuberculosis Center
Date: April 27, 2011
Location: Sacramento, California
Application deadline: March 25, 2011
The Francis J. Curry National TB Center announces a training seminar to be
conducted in association with the California TB Controllers Association
(CTCA). The one-day didactic and case-based seminar on 2011: What Do We Know
About LTBI? will take place in Sacramento, CA on Wednesday, April 27, 2011.
The course objectives will include: (1) explain the key differences between
LTBI and TB disease to assure that appropriate therapies are administered to
patients and appropriate strategies are employed to ensure positive patient
outcomes; (2) depending on their situation, utilize the best method for
diagnosing LTBI to ensure timely, accurate results; (3) apply the current
guidelines for the treatment of LTBI to decrease patients’ chances of
progression to TB disease; (4) apply monitoring recommendations for patients
on treatment for LTBI to prevent adverse effects of anti-TB medications; (5)
employ current targeted testing and prevention strategies, understanding
population and medical risk factors of disease progression to best prevent
at risk populations from progressing to TB disease; (6) compare different
LTBI treatment regimens, including those currently under FDA review, to
determine the most appropriate regimen for differing patient populations;
(7) compare how large HMOs and community FQHCs implement LTBI screening
policies and evaluate their providers and use this information to enhance
the public/private care partnership for optimum patient outcomes; and (8)
assist community providers to create effective LTBI screening and treatment
and monitoring strategies. This training is intended for physicians, nurses,
TB program managers, and other licensed medical care providers who manage
LTBI patients.
There is no fee for this course. Continuing education credits are available.
Enrollment is limited and pre-registration is required. To apply, complete
and submit the application form by March 25, 2011. This training will be
conducted in association with the 45th Annual California TB Controllers
Association (CTCA) Educational Conference to be held April 28-29, 2011.
Separate pre-registration is required for CNTC and CTCA events.
For a complete course description and application information, visit:
http://www.nationaltbcenter.ucsf.edu/training/ltbi2011.cfm.
*14. 45th Annual California TB Controllers Association (CTCA) Educational
Conference*
Sponsor: California Tuberculosis Controllers Association (CTCA)
Dates: April 28 – 29, 2011
Location: Sacramento, California
Abstract submission deadline: March 4, 2011
The overall goals of this Conference are: (1) Explore the impact that health
care reform will have on TB control and prevention programs in California;
(2) Explore new developments in technology and diagnostics that can reduce
resources for TB control activities; (3) Strategize and prioritize TB
control activities to respond to the current economic climate; (4)
Strengthen programmatic components of local TB control programs; (5) Improve
the clinical skills of providers who diagnose and treat patients with TB;
(6) Network and consult with TB control colleagues.
Continuing education credits are available.
For more information, visit: http://ctca.org/conferences/index.html.
*15. Implementing the Stop TB Strategy: Skills for Managers and
Consultants*
Sponsors: WHO Collaborating Center for Tuberculosis and Lung Disease. World
Health Organization.
Dates: May 2 - 14, 2011
Location: Sondalo, Italy
Application deadline: February 28, 2011
The overall goal of the training course is to further develop the necessary
skills to plan, implement, and evaluate a TB control program, based on the
WHO-recommended Stop TB Strategy in the era of MDR-/XDR TB and HIV. The
training course uses innovative approaches, being centered around Fictitia,
a fictitious country in which all consultancy activities take place. The
training is interactive and exercise- based, being a mixture of
presentations, exercises, workshops, site visits, and role plays based on
data from Fictitia.
Enrolment limit: 23-24 participants per course. Course fee: 2.600 Euros.
Payment deadlines: March 30, 2011.
For complete details, queries and application forms, contact Lia D’Ambrosio
at , or visit the Web site at
http://training.stoptb.it/page8/page4/page4.html.
* *
* *
*16. Overcoming Barriers to TB Control: the Role of Advocacy, Communication,
and Social Mobilization (ACSM) *
Sponsor: WHO Collaborating Center for Tuberculosis and Lung Disease,
Tradate, Italy. PATH, USA.
Dates: June 7 – 14, 2011
Location: Sondalo, North Italy
Application deadline: March 15, 2011
ACSM is now firmly on the global TB control agenda as an essential
cross-cutting approach to
supporting the six elements of the Stop TB Strategy. Most countries have
endorsed the Stop TB
Strategy, but many national TB programs are not yet investing resources in
ACSM strategically or
engaging communities fully in TB care and prevention and may not have local
capacity to
implement planned ACSM activities.
The primary goal of the workshop is to build ACSM skills at the national and
local levels to support the sustained contribution of ACSM interventions to
significant TB control program improvements.
Enrolment is limited to 23 to 24 participants. Course fee: 1.900 Euros.
Payment deadline: May 15, 2011.
For more information, including the application forms, contact Lia
D’Ambrosio. E-mail lia.dambrosio@fsm,it; or access the Website at
http://training.stoptb.it/page8/page9/page9.html.
*17. Leading Management Teams*
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: June 27 – July 9, 2011
Location: Bangkok, Thailand
Application deadline: May 25, 2011
Bringing measurable changes within a TB program requires a comprehensive
approach to performance management. Participants in this course will learn
how to more effectively guide groups of personnel through advanced
management training by examining their own leadership styles. Key topics the
course addresses include: (1) Creating measurable results in a TB program
through long-term planning; (2) Leading changes in a health organization
that build greater staff commitment, competence, and confidence; (3)
Achieving higher success rates through enhanced team performance; and (4)
Developing team members through coaching and mentoring.
Late applications accepted on a space-available basis. To register, E-mail
.
For more information, E-mail: ; or visit the
Web site: http://www.union-imdp.org/courses/leading-management-teams.
*18. Strategic Planning and Innovation*
Dates: August 15 – 20, 2011
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Location: Singapore
Application deadline: July 10, 2011
Leading teams that work within critical areas of health care is a
considerable challenge for any national TB program manager who is expected
to develop and adhere to strategies for a country’s health projects.
Participants in this course will learn to foresee potential difficulties and
confidently meet them by developing successful health program strategies.
This course will help them to become stronger leaders within their health
organizations The course focuses on creating a learning organization that
has the capacity to identify key issues blocking organizational progress –
whether operational, strategic, or policy-related. Key topics the course
addresses: (1) learning how to lead a participative strategic planning
activity within your TB program, (2) developing a focused approach to
strategy implementation, (3) expanding your operations by creatively using
simple tools and techniques, and (4) strengthening health systems through
exploration of innovative and creative practices.
Late applications accepted on a space-available basis. To register, e-mail
.
For more information, e-mail ; or visit the
Web site at http://www.union-imdp.org/courses/strategic-planning-innovation
.
*19. Budget Planning and Project Management*
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: September 19 – October 1, 2011
Location: Bangkok, Thailand
Application deadline: August 20, 2011
Developing and managing budgets is an essential quality to a well managed TB
program. Participants in this course will receive advanced training in
budget development and project management, which will increase their
confidence in the creation and management of budgets for national health
programs.
Application deadline: August 20, 2011. Late applications accepted on a
space-available basis. To register, E-mail .
For more information, E-mail: ; or visit the
Web site at
http://www.union-imdp.org/courses/budget-planning-project-management.
* *
* *
*20. The Denver TB Course *
Sponsor: National Jewish Health
Dates: October 12 – 15, 2011
Location: Denver, Colorado
The purpose of this course is to present knowledge about the management of
TB to general internists, public health workers, infectious diseases and
chest specialists, registered nurses, and other healthcare providers who
will be responsible for the management and care of patients with TB. This
event includes the following course highlights: Transmission and
pathogenesis of adult and pediatric TB; MDR TB and XDR TB; Screening for and
treatment of latent TB infection; Factors influencing TB infections;
Planning TB control programs with particular emphasis on organization of
outpatient chemotherapy; TB and HIV co-infection; and Mycobacteriology
Laboratory Tour.
Continuing education credits are available.
For more information contact Nicole Austin Ross, National Jewish Health,
E-mail: ;
Phone: (303) 398-1110; Fax: (303) 270-2239; or access the Web site:
http://www.njhealth.org/TBCourse.
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