MDR-TB Treatment & Prevention
Fwd: [tb-update] Week of August 29 to September 4, 2010
Started by Sophie Beauvais on 03 Sep 2010
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Date: Fri, Sep 3, 2010 at 1:44 PM
Subject: [tb-update] Week of August 29 to September 4, 2010
TB-Related News and Journal Items Weekly Update Week of August 29 to
September 4, 2010
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CDC provides the TB-Related News and Journal Items Weekly Update as a
public service only. This update is a compilation of TB-related articles
published for the benefit and information of people interested in TB, and we
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
does not constitute CDC endorsement. This update may also include
information from CDC and other government agencies, such as background on
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 Announcement <#12ad8e930f7488cb_H1>
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News
Update<#12ad8e930f7488cb_H2>
Headlines <#12ad8e930f7488cb_H3>
Journal Articles <#12ad8e930f7488cb_H4>
Job Announcements <#12ad8e930f7488cb_H5>
Upcoming Conferences, Trainings, and Other Events <#12ad8e930f7488cb_H6>
TB-Related Announcement
*1. Global Drug Facility Seeks Expressions of Interest from Anti-TB Drug
Manufacturers *
Stop TB Partnership, July 15, 2010
The Global Drug Facility (GDF) has issued two invitations to manufacturers
of anti-TB medicines to submit an expression of interest for product
evaluation by an expert review panel (ERP).
The first, issued jointly with the Global Fund to Fight AIDS, TB and
Malaria, invites submissions of product dossiers on first-line drugs for
which there are less than three products of the same formulations that are
WHO-prequalified, SRA-approved, and available worldwide.
Read more at:
http://www.theglobalfund.org/documents/psm/GF_EOI_AntiTB_FV.pdf.
The second invitation is to manufacturers of second- and third-line anti-TB
drugs for which there are less than three products of the same formulations
that are WHO-prequalified, SRA-approved, and available in the global market.
Read more at:
http://www.stoptb.org/assets/documents/gdf/drugsupply/GDF_%20%20EoI%20for%20S...
.
The deadline for submission for expressions of interest in both categories
is *September 15, 2010**, *5:00 p.m. Geneva time.
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News Update
*1. North Dakota Doctor May Have Exposed Dozens to Tuberculosis *
Associated Press, August 27, 2010
A doctor in the Sanford Health system’s Fargo, North Dakota, region has been
diagnosed with active TB disease, and efforts are underway to contact dozens
of patients and workers who may have been exposed. Sanford Health intends to
offer TB testing to 77 patients and 43 employees who were in contact with
the doctor between July 1 and Aug. 16. The North Dakota Department of Health
is assisting Sanford Health. For more information, visit
http://north.sanfordhealth.org/about/newsroom/meritcarenews/news_view_article....
*2. Kenyan Court Sentences 2 TB Patients to 8 Months *
Associated Press, August 21, 2010, by Tom Odula
A judge has invoked a rarely used law to sentence two treatment-noncompliant
TB patients to eight months in prison. According to Joseph Sitienei, chief
of the public health and sanitation ministry’s TB and lung disease section,
the men were taken into custody recently and sent to Kapsabet prison to make
sure they take their medications. Incomplete treatment can result in the
development of multidrug-resistant TB (MDR TB). The number of Kenyans with
MDR TB has grown from 82 in 2007 to 150 in 2010. “If you look at the risk
these people pose to those who have problems with their immune systems, then
you can see this is a bush fire that actually needs to [be] put out
immediately,” Sitienei said. Despite the government’s free diagnosis and
treatment programs, TB kills about 200 Kenyans a day.
*3. Tuberculosis Reported at MTA Site *
Wall Street Journal, August 21, 2010, by Chris Herring
At least one Metropolitan Transportation Authority worker has been diagnosed
with TB, the New York City Health Department said August 20, adding that its
investigation might turn up more cases. In addition to the confirmed case,
the department said it was aware of a suspected case at the same site, which
it did not identify. Health workers were planning to visit the site to
educate employees there about the disease.
* *
*4. Inflammatory Disease Drugs Could Hold TB Treatment Key *
Edmonton Journal, July 30, 2010, by Charlie Fidelman, Montreal Gazette;
Postmedia News
Research by American and Canadian scientists suggests how the mechanism
behind the anti-inflammatory drugs used to treat diseases such as rheumatoid
arthritis might be important in the treatment of TB. The research in *Nature
Immunology* describes how TB manipulates the process of cell death, or
necrosis, allowing TB to escape and reproduce. Anti-inflammatory drugs may
be able to help contain TB bacteria within the host’s cell walls. Once the
cells induce their own death in the immune response called apoptosis, TB
bacteria would be unable to escape outside the cells walls, and therefore
unable to reproduce and re-infect the host. The research describes the
cellular pathway by which TB inhibits the progression of cell death in
apoptosis and avoids activating the body’s natural defenses. “We’ve
discovered a mechanism that could be very important for immune response,”
said author Maziar Divangahi, of McGill University in Montreal. “We do have
drugs that target that pathway. We need to test them. That’s the next step,”
Divangahi said. Early treatment with anti-inflammatory drugs may be
effective in coaxing the body’s immune system to launch an attack against
TB, Divangahi said. “It would be like arming yourself in advance of TB
contact.” The report, “Eicosanoid Pathways Regulate Adaptive Immunity to
Mycobacterium tuberculosis,” was published in *Nature
Immunology*2010;11(8):751-758.
Headlines
*1. Global Drug Facility and Partners Will Scale up MDR-TB Treatment with
UNITAID Funding (Switzerland)*
Stop TB Partnership, www.stoptb.org, August 26, 2010
A joint initiative between the Global Drug Facility (GDF), the Green Light
Committee (GLC), the Global Fund to Fight AIDS, Tuberculosis and Malaria
(the Global Fund), and UNITAID will result in greater access to treatment
for MDR TB patients in India. This is part of the MDR TB Scale Up
initiative, which aims to increase the number of patients receiving
second-line drugs and to affect market dynamics through improvement in
price, quality, and delivery. The first UNITAID grant of US $20.8 million
approved in 2007 was increased to US $37.6 million in July 2009. The purpose
of the grant is to improve the supply of drugs to treat MDR TB in 17
countries and achieve price reductions of between 5 to 25 percent for
second-line TB drugs, subject to a sufficient number of quality assured
sources being available. All the countries receiving this assistance are
using MDR TB treatment programs approved by the Green Light Committee. The
budget increase will cover 9,850 treatments in India and a total of 15,606
treatments in 18 countries. UNITAID, GLC, the Global Fund, and GDF will
collaborate to implement the initiative. This initiative supports the global
commitment to fight MDR TB agreed on at the Ministerial Meeting of High MDR
and XDR TB Burden Countries held in Beijing, China, in April of 2009.
India has the highest TB burden and more MDR TB cases than any country in
the world.
*2. WHO and New Zealand Government Need to Revise TB Policies (New Zealand)*
Top News, http://topnews.co.uk, August 29, 2010
Professor Philip Hill, Director, University of Otago Center for
International Health, New Zealand, contends that policies adopted by the
World Health Organization (WHO) are faulty and that New Zealand’s policies
concerning testing and treating TB are worsening. He believes that policy
makers should revise policies, as they have not studied the biology of TB
properly. It was confirmed that TB was completely exterminated in Otago;
however, four cases have been identified in the past two years, and two
cases are pending. The Southern District Health Board stated that the
confirmed cases in Otago involved foreign residents. According to the
Ministry of Health 2003 statistics, 69 percent of TB patients in New Zealand
were foreign born. Professor Hill is concerned about the New Zealanders who
are at risk of developing TB.
*3. Gene Profiles May Predict TB Prognosis (United Kingdom)*
Science News, www.usnews.com, August 19, 2010, by Tina Hesman Saey
An international consortium of researchers has provided profiles of genetic
activity showing how the immune system deals with TB. The researchers tested
blood from TB patients, persons with latent TB infection, and healthy
persons in London. Based on gene activity profiles in their blood, the
researchers were able to categorize persons into the correct groups of
active disease, latent disease, and no disease. Persons with active TB
disease had 393 genes with activity different from that of healthy people.
The TB signature disappeared when patients were treated with antibiotics.
The results were replicated in another group of patients from Cape Town,
South Africa. Findings show that genes turned on by a protein known as Type
1 interferon become active in the neutrophils of people with TB disease.
TB’s molecular signature was distinct from the profiles of blood taken from
people with autoimmune disease such as lupus, and from those with other
infectious diseases. According to Matthew Berry of MRC National Institute
for Medical Research, London, and a coauthor of the study, about 10 to 25
percent of people with latent TB infections had signatures similar to those
of people with active disease, indicating that individuals with that profile
may develop active disease even if they have latent disease at the time of
testing. It is felt that the findings may help identify who is at risk of
developing TB disease and could spare those who may not get active disease
from having to take antituberculosis drugs. The study was published in the
journal *Nature* 466, 973-977, doi:10.1038/nature09247.
*4. Workshop for Doctors on TB Care Held (India)*
The Times of India, http://timesofindia.indiatimes.com, August 24, 2010
A workshop titled “Public Private Mix: Achieving International Standards of
TB Care,” was organized by Population Services International (PSI), in
collaboration with the Revised National TB Control Program (RNTCP) for
doctors at Yermal Bada in Udupi, Karnataka, India. The facilitators were the
district TB officer and Abhilash Philip, Area Program Manager of PSI. A
total of 15 doctors from the private sector attended. The workshop was part
of an integrated health project focusing on HIV/AIDS, TB, and diarrhea
prevention for a population of 57,000 individuals in 11 villages in Udupi.
The purpose of the project is to adopt safer sexual health practices in
project areas for HIV prevention, improve TB care-seeking behaviors, and
improve hygiene and diarrhea prevention practices. PSI stated that to reach
the TB case detection targets, stop the spread of drug-susceptible TB, and
prevent multidrug-resistant TB, the RNTCP has embraced the objectives of the
Global Plan to Stop TB, which include engaging all health care providers in
TB control.
*5. Ireland Comes under Fire after 200 Children Require TB Test (Ireland)*
IrishCentral.com, http://www.irishcentral.com, August 24, 2010, by April
Drew
Dr. Joseph Keane, a respiratory physician and professor, commented that in
Ireland the issue of TB occupies a low place on the political agenda. His
comment was in response to confirmation by the Health Service Executive
(HSE) of the Republic of Ireland that over 200 children in a County Cork
school would be tested for TB after three students in the school were
diagnosed with TB disease. He noted that this was due to the country’s
decision to ignore the increase in latent TB and do nothing to prevent it
from becoming active in people. Dr. Keane stated that Ireland has
approximately 480 cases of TB every year, and the numbers are increasing.
Keane suggested preventing the spread of TB by monitoring vulnerable groups
such as the homeless and those who have emigrated from countries with a high
prevalence of the disease. The students have started antituberculosis drugs
under the care of a pediatric specialist.
*6. Drug-Resistant TB Worries Mayor (Botswana)*
Mmegionline, www.mmegi.bw, August 25, 2010, by Isaac Pinielo
Shadreck Nyeku, Mayor of Francistown, Botswana, expressed concern about the
number of drug-resistant patients in the city. At a full council meeting,
Nyeku divulged that of 261 TB patients being treated in Francistown, 10 have
multidrug-resistant TB (MDR TB), and one patient has extremely
drug-resistant TB (XDR TB). Nyeku noted that TB is the leading health
problem in the country, next to HIV/AIDS, and that the government was using
the DOTS program, which he considered the most effective strategy in TB
control. He acknowledged that the development of MDR TB may have resulted
from factors such as travel costs and the long distances patients travel to
access health care, lack of family and community support, and defaults not
reported on time at health facilities because of staff shortages. Nyeku then
described the proposed government’s community TB care strategy, in which the
patient receives medication at home from a community or family member. He
explained that the family and community play a major role in expanding DOTS
availability as close as possible to the patient. According to Nyeku, the
Health Department is in the process of strengthening the implementation of
the strategy by training community leaders to solicit support.
*7. Strike: TB Patients Sent Home (South Africa)*
News 24.com, www.news24.com, August 31, 2010
The Health Department of the Eastern Cape, South Africa, was forced to
temporarily discharge over 140 patients from Port Elizabeth’s Jose Pearson
and East London’s Fort Grey TB hospitals, where patients with MDR and XDR TB
are isolated, as well as Mdantsane’s Nkqubela Hospital. for patients with
drug-susceptible TB. Sizwe Kupelo, Health Department spokesperson, stated
that because of the public service strike, there were no nurses to care for
the patients. The patients were given a two-week pass to go home, and the
health department had engaged nongovernmental organizations (NGOs) to
continue treatment locally. Mr. Kupelo reassured the communities and
families that the patients were not contagious. Only patients who were
terminally ill remained at the hospitals. He explained that the striking
staff had prevented the hiring of temporary workers. Kupelo warned that the
strike would continue to disrupt the provinces’ health services even after
it ended, as there was a massive backlog in payments to service providers.
The department pleaded with providers not to cut services, but to wait until
things were back to normal. He also foresaw a backlog with drug
distribution. So far, there have been six deaths resulting from the strike.
Journal Articles
*1.* AIDS. 2010 Jul 31;24(12):1849-55. *Tuberculosis Risk Factors and
Mortality for HIV-Infected Persons Receiving Antiretroviral Therapy in South
Africa; *Komati, S., Shaw, P.A., Stubbs, N., Mathibedi, M.J., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20622529>
This study determined important risk factors for and impact of TB on
survival in HIV-infected patients starting antiretroviral therapy (ART) in
South Africa. Prospective trial of 1,771 HIV-infected patients with either
CD4 cell count less than 200 cells/microl or a prior AIDS-defining illness,
enrolled in a randomized trial of four antiretroviral regimens. Data were
collected from patient records. A history of TB at study entry was reported
by 27% of patients and correlated with poor baseline health status. A
history of TB at baseline was associated with subsequent TB and death during
ART, but was not itself an independent risk factor for poor outcome. TB was
diagnosed during ART in 14% of patients and was more frequent during the
first 3 months. TB during therapy was independently associated with
increased hazard of other AIDS-defining events and death, regardless of when
during ART TB occurred. ART that consistently suppressed circulating viremia
reduced but did not eliminate TB risk. In HIV-infected patients who started
ART at low CD4 cell counts, TB at baseline was a predictor of death, but was
not independent of other factors indicating poor baseline health status. TB
during follow-up was, in contrast, an independent predictor of death even
after adjustments for baseline risk factors, including CD4 cell count and
viral load. Virologic failure during ART was associated with a 55% increase
in risk of TB. Thus, TB is a major marker for poor outcome both at baseline
and during ART and is not completely eliminated by fully suppressive ART.
*2.* American Journal of Preventive Medicine. 2010 Aug; Volume 39, Number 2:
157-63. *Active Tuberculosis and Recent Overseas Deployment in the U.S.
Military; *Mancuso, J.D., Tobler, S.K., Eick, A.A., Keep, L.W.
Click here for PubMed abstract: Pub
Med<http://www.ncbi.nlm.nih.gov/pubmed/20621263>
The risk of active TB disease resulting from military deployment to endemic
areas is unknown. It has typically been assumed that the risk of TB
approximates the risk among local nationals in that country. This nested
case-control study assessed the putative association of overseas deployment
with active TB disease among active-component US military service members.
Deployment histories and other exposures among 578 active TB disease cases
and 2,312 controls matched on year of entry into service and length of
service between 1990 and 2006 were compared in 2009 using multivariate
conditional logistic regression. Multiple imputation methods were used to
account for missing data. The matched OR of active TB disease for military
deployers as compared to nondeployers was 1.18 (95% CI=0.91, 1.52). A
significant association of deployments of 90-179 days was found, but this
was inconsistent with the overall negative result. Significant associations
were seen with foreign birth and nonwhite racial or ethnic groups. Overseas
stationing in Korea was also found to be associated with active TB disease.
No strong or consistent association was found between active TB disease and
deployment, but an association was seen with long-term residence in
TB-endemic countries (Korea). The strongest risk factors for active TB
disease in the US military population were found to exist prior to accession
into military service. These conclusions were robust in sensitivity
analysis.
*3.* BMC Infectious Diseases. 2010 Apr 30; Volume 10:107. *Risk of Latent TB
Infection in Individuals Employed in the Healthcare Sector in Germany: A
Multicentre Prevalence Study; *Schablon, A., Harling, M., Diel, R.,
Nienhaus, A.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20429957>
Health care workers are still recognized as a high-risk group for latent TB
infection (LTBI). Therefore, the screening of people employed in the health
care sector for active TB and LTBI is fundamental to infection control
programs in German hospitals. This study determined the prevalence and
putative risk factors of LTBI. The researchers tested 2,028 employees in the
health care sector with the QuantiFERON-Gold In-tube (QFT-IT) test between
December 2005 and May 2009, either in the course of contact tracing or in
serial testing of TB high-risk groups following German OSH legislation. A
positive IGRA was found in 9.9% of the health care workers (HCWs). Nurses
and physicians showed similar prevalence rates (9.7% to 9.6%). Analyzed by
occupational group, the highest prevalence was found in administration staff
and ancillary nursing staff (17.4% and 16.7%). None of the individuals in
the trainee group showed a positive IGRA result. In the different workplaces
the observed prevalence was 14.7% in administration, 12.0% in geriatric
care, 14.2% in technicians (radiology, laboratory, and pathology), 6.5% in
admission ward staff and 8.3% in the staff of pulmonary/infectious disease
wards. Putative risk factors for LTBI were age (>55 years: OR14.7, 95% CI
5.1-42.1), being foreign-born (OR 1.99, 95% CI 1.4-2.8), TB in the
individual's own history (OR 4.96, 95% CI 1.99-12.3) and previous positive
TST results (OR 3.5, 95% CI 2.4-4.98). The researchers observed no
statistically significant association with gender, BCG vaccination,
workplace or profession. The prevalence of LTBI in low-incidence countries
depends on age. The researchers found no positive IGRA results among
trainees in the health care sector. Incidence studies are needed to assess
the infection risk. Pre-employment screening might be helpful in this
endeavour.
*4.* Canadian Respiratory Journal. 2010 May-Jun; Volume 17, Number 3: 51-4.
*The Ontario Universal Typing of Tuberculosis (OUT-TB) Surveillance
Program--What It Means to You; *Bolotin, S., Alexander, D., Guthrie, J.,
Drews, S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20617215>
TB is a serious disease that is transmitted primarily by the airborne route.
Effective disease control and outbreak management requires the timely
diagnosis, isolation, and treatment of infected individuals with active
disease; contact tracing to identify secondary cases likely to benefit from
treatment of latent infection; and laboratory identification or confirmation
of epidemiologically linked cases. TB genotyping enables the
comparison of *Mycobacterium
tuberculosis* complex (MTBC) strains and the identification of cases that
may or may not be linked. The increased availability of molecular methods
for genotyping has allowed for greater discrimination of MTBC strains and
greatly enhanced understanding of TB transmission patterns. To improve TB
surveillance and control in Ontario, the Public Health Laboratories of the
Ontario Agency for Health Protection and Promotion introduced the Ontario
Universal Typing of TB (OUT-TB) Surveillance Program. The first isolate from
every new TB case will be genotyped with two rapid molecular methods:
spoligotyping and mycobacterial interspersed repetitive unit-variable-number
tandem repeat typing. MTBC isolates with nonunique genotypes and, thus,
potentially linked to other TB cases, will also be genotyped by IS6110
restriction fragment length polymorphism analysis. By providing TB control
programs using these new genotyping tools, and using traditional and new
case investigation methods (eg, social network analysis), this new program
will provide a clearer picture of TB in Ontario, and permit more effective
use of public health resources and improve disease control.
*5.* The International Journal of Tuberculosis and Lung Disease. 2010 Aug;
Volume 14, Number 8: 1066-8. *Large-Scale Public-Private Partnership for
Improving TB-HIV Services for High-Risk Groups in India; *Kane, S., Dewan,
P.K., Gupta, D., Wi, T., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20626954>
In India, the Revised National Tuberculosis Control Program and a
large-scale HIV prevention project partnered to deliver enhanced TB
screening services for HIV high-risk groups. Between July 2007 and September
2008, 134 non-governmental organizations (NGOs) operating 412 clinics and
community-based outreach services, screened 124,371 high-risk individuals
and referred 3,749 (3.01%) for TB diagnosis. Of these, 849 (23%) were
diagnosed with TB. India has converted this model into national policy
through a public-sector funded TB-HIV partnership scheme for NGOs serving
high-risk groups.
*6.* The International Journal of Tuberculosis and Lung Disease. 2010 Jul;
Volume 14, Number 7: 847-51. *Efficient Mycobacterial DNA Extraction from
Clinical Samples for Early Diagnosis of Tuberculosis; *Kumar, M., Sharma,
S., Ram, A.B., Khan, I.A.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20550767>
Polymerase chain reaction (PCR) detection of *Mycobacterium tuberculosis* in
clinical samples requires the use of an extraction method that can
efficiently lyse mycobacterial cells and recover small amounts of DNA. This
study evaluated the use of a benzyl-alcohol guanidine hydrochloride (DNA
extraction) method (GuHClM) on blood samples. GuHClM was evaluated in
quantitatively spiked blood samples with *M. tuberculosis*. The researchers
assessed the insertion sequence (IS) 6110 region of *M. tuberculosis* to
evaluate the efficacy of the method. The method was also applied on 102
clinical samples from individuals suspected of having TB and compared with
smear microscopy of sputum specimens and the results of cultures. This
method reproducibly detected as low as 4-6 bacilli. Of 102 clinical samples,
84 were HIV negative, while 18 were HIV-positive. Among the HIV-negative
individuals, 58.3% were TB-positive using PCR, while respectively 47.6% and
45.2% were sputum-and culture-positive. Among the HIV-positive individuals,
55.6% were PCR-positive, whereas only 38.9% were sputum-positive and 50%
were culture-positive. These results demonstrate that the identification of
mycobacteria by PCR using GuHClM is very sensitive and therefore may have
wide utility in the diagnosis of TB.
*7.* The International Journal of Tuberculosis and Lung Disease. 2010 Jul;
Volume 14, Number 7: 841-6. *Rapid Detection of Immunoglobulin G
against Mycobacterium
tuberculosis Antigens by Two Commercial ELISA Kits; *Ben Selma, W., Harizi,
H., Marzouk, M., Ben Kahla, I., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20550766>
This study assessed the clinical usefulness of the commercial Pathozyme-Myco
G (Myco G) and Pathozyme TB complex plus enzyme-linked immunosorbent assay
(ELISA) kits for the rapid diagnosis of active TB disease and to distinguish
between active TB disease and non-TB pulmonary diseases in Tunisian
patients. Immunoglobulin G mediated humoral immune response against
mycobacterial antigens (38 kDa and lipoarabinomannan, Myco G; 16 and 38 kDa,
Patho) was evaluated in a group of active TB disease patients (128
smear-positive pulmonary and 33 extra-pulmonary samples) and in a control
group (107 patients with non-tuberculous lung disease and two with leprosy).
Active TB disease cases were confirmed by *Mycobacterium
tuberculosis*culture from clinical samples. The sensitivity of the
Myco G test was 71% in
active TB disease (pulmonary and extra-pulmonary), while the specificity was
100%. The Patho test showed a sensitivity of 43.5% with a specificity of
96.3%. A combination of both tests showed a sensitivity of 81% and a
specificity of 96.3%. Both ELISA tests were simple and easy to perform.
Their combined use led to an increase in the diagnostic accuracy of active
TB disease and its discrimination from non-TB pulmonary diseases. They could
therefore be used as screening tools in poorly equipped laboratories in
TB-endemic regions.
*8.* The International Journal of Tuberculosis and Lung Disease. 2010 Jul;
Volume 14, Number 7: 834-40. *Evaluation of QuantiFERON-TB Gold In-Tube in
Human Immunodeficiency Virus Infection and in Patient Candidates for
Anti-Tumour Necrosis Factor-Alpha Treatment; *Sauzullo, I., Mengoni, F.,
Scrivo, R., Valesini, G., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20550765>
This cross-sectional study at four out-patient clinics in a single referral
center in Italy, evaluated the performance of QuantiFERON-TB Gold In-Tube
(QFT-GIT) in HIV-iinfected adults and in patients with immune-mediated
inflammatory diseases (IMIDs) who are candidates for anti-tumor necrosis
factor-alpha (TNF-alpha) treatment. A total of 402 immunocompromised
patients were enrolled, including 207 HIV-infected individuals and 195 IMID
patients scheduled for anti-TNF-alpha treatment. Tuberculin skin test (TST)
and QFT-GIT were performed. For active TB disease, test results were
compared with microbiological, histopathological, and clinical diagnoses. In
HIV-infected patients, the level of agreement between the tests was 68% and
QFT-GIT sensitivity was 66% (95%CI 47-82). The researchers found a large
proportion of indeterminate QFT-GIT results (33.4%), which correlated with
CD4 count < 200 cells/microl (P < 0.0001). The degree of agreement with TST
was higher in IMID patients (81.6%). Factors associated with discordant
positive TST and negative QFT-GIT results were bacille Calmette-Guérin
vaccination (P = 0.0001), previous TB (P = 0.0001), and agricultural work (P
= 0.0005). The performance of QFT-GIT varied between different types of
immunocompromised patients. Interferon-gamma release assays should not be
used to confirm or rule out a diagnosis of active TB disease in HIV-infected
adults. As there were no cases of active TB disease in the IMID subgroup, it
was difficult to determine which test performs better in this population.
*9.* The International Journal of Tuberculosis and Lung Disease. 2010 Jul;
Volume 14, Number 7: 828-33. *Intra-Assay Reliability and Robustness of
QuantiFERON(R)-TB Gold In-Tube Test in Zambia; *Shanaube, K., De Haas, P.,
Schaap, A., Moyo, M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20550764>
Interferon-gamma (IFN-gamma) release assays (IGRAs), such as the
QuantiFERON-TB Gold In-Tube test (QFT-GIT), are becoming a preferred method
for diagnosis of TB infection in many industrialized countries. However,
data on the effectiveness of IGRAs in high TB-HIV endemic and
resource-limited settings, such as Zambia, are limited. This study
determined the intra-assay reliability and robustness of QFT-GIT in a field
setting in Zambia. During July-October 2007, 109 adult smear-positive TB
patients were recruited to determine QFT-GIT reliability and the effect of a
24-hour delay in incubation. Two simulated laboratory experiments were also
performed using 9-14 volunteers, to explore the effect of power outages
during incubation and storage temperature of collection tubes on IFN-gamma
responses. QFT-GIT intra-assay concordance was 91.7% (kappa = 0.8).
Discordance was observed for nine patients, of whom six were HIV-positive.
There was evidence of an association between HIV status and discordant
results (OR 1.98, 95%CI 1.06-3.67, P = 0.03). A 24-hour delay in incubation
changed results for 25 of the 109 (22.9%) patients. Power outages that
altered incubation time reduced IFN-gamma responses. Although QFT-GIT seems
reliable in this setting, the researchers have identified operational
factors that affect its robustness. These factors may influence the
effectiveness of this test in similar resource-limited settings.
*10.* The International Journal of Tuberculosis and Lung Disease. 2010 Jul;
Volume 14, Number 7: 819-27*. Use of the QuantiFERON-TB Gold Test for
Screening Tuberculosis Contacts and Predicting Active Disease; *Yoshiyama,
T., Harada, N., Higuchi, K., Sekiya, Y., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20550763>
This study evaluated the performance of the QuantiFERON(R)-TB Gold (QFT-G)
test for screening TB contacts and estimating their risk of progressing to
active TB disease. Data on clinical progression to active disease were
collected from public health centers 2 years after close contacts of TB
cases had been QFT-G-tested. Among 3,102 contacts observed, 419 were
QFT-G-positive, and isoniazid (INH) treatment was initiated in 323. Twenty
(4.8%) of these 419 developed TB disease. Among 2,683 QFT-G-negative
persons, 19 were diagnosed with TB (0.7%) during the average follow-up
period of 1.6 years. The estimated sensitivity of QFT-G in detecting
contacts who would progress to active TB disease was 51%, or 64% allowing
for the effects of INH treatment. Among the QFT-G-negative contacts, all
those who developed TB disease were contacts of highly infectious cases.
Large-scale tuberculin skin testing was not available. TB incidence among
QFT-G-positive contacts was higher than among QFT-G-negative contacts, but
the number of TB cases among QFT-G-negative contacts is non-negligible,
especially among contacts of highly infectious cases.
*11.* The International Journal of Tuberculosis and Lung Disease. 2010 Jul;
Volume 14, Number 7: 806-18. *Impact of Food and Antacids on the
Pharmacokinetics of Anti-Tuberculosis Drugs: Systematic Review and
Meta-Analysis; *Lin, M.Y., Lin, S.J., Chan, L.C., Lu, Y.C.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20550762>
This study compared the effects of food and antacids on the bioavailability
of first-line antituberculosis drugs. The researchers conducted a systematic
search of electronic databases PubMed (January 1950-May 2009), and the
Cochrane Library database (January 1974-May 2009), including the Cochrane
Center register of controlled trials, and ongoing trials from research
registers using key terms “food,” “antacids,” “meal,” “controlled trial,”
“diet,” and the first-line antituberculosis drugs isoniazid (INH),
rifampicin (RMP), ethambutol (EMB), and pyrazinamide (PZA). Meta-analysis
was performed using RevMan software 5 to assess the impact of food or
antacids on the maximum plasma concentrations (C(max)) and area under the
plasma concentration time curve (AUC) of antituberculosis drugs. Twelve
trials involving 157 patients were included in the meta-analysis. The
overall effects showed that food significantly reduced the C(max) mean
difference (C(max) MD; C(max) MD -1.42, 95%CI -1.56--1.28, P < 0.00001) and
AUC (C(max) MD -3.33, 95%CI -4.05--2.62, P < 0.00001) of INH but antacids
did not. Food also significantly reduced the C(max) MD (C(max) MD -2.47,
95%CI -3.30--1.64, P < 0.00001) but not the AUC of RMP. Antacids had no
effect on the C(max) MD or AUC of RMP. The C(max) and AUC of PZA were
unaffected by both food and antacids. Both food and antacids reduced the
C(max) but not the AUC of EMB. From a pharmacokinetic point of view, it
seems that the better option for patients with gastrointestinal upsets
during chemotherapy would be to add antacids rather than dosing with meals.
*12.* The Southeast Asian Journal of Tropical Medicine and Public Health.
2010 Mar;41(2):378-85. *Tuberculosis: An Eight Year (2000-2007)
Retrospective Study at the University of Malaya Medical Centre (UMMC), Kuala
Lumpur, Malaysia; *Jetan, C.A., Jamaiah, I., Rohela, M., Nissapatorn, V.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20578521>
This was an eight year (2000-2007) retrospective study of TB in patients
admitted to the UMMC. A total of 131 cases were analyzed. Malays constituted
the most cases, (43%), followed by Chinese (22%), Indians (17%), and others
(18%). The majority of cases were within the 21-60 year old age group, which
constituted 69.5% of the total. Males were more commonly affected (65%).
Most cases were reported among Malaysians (83%). The majority of patients
were unemployed (39%), followed by housewives (10%), laborers (9%), students
(8%), shop assistants (7%), and other occupations (27%). The most common
presenting complaints were prolonged productive cough, night sweats, fever,
anorexia, weight loss (57%), hemoptysis (34%), and undifferentiated
symptoms, such as prolonged diarrhea and dysphagia (9%). Sputum was positive
for acid-fast bacilli (AFB) in 89%, but only 69% of cases had abnormal chest
radiographs. The majority of patients (65%) developed no complications. The
most common complications were pleural effusion, pneumothorax, and pulmonary
fibrosis. The majority of patients (82%) suffered either from diabetes
mellitus, hypertension, ischemic heart disease or all 3 conditions.
Regarding risk factors for TB, two were HIV positive and two were
intravenous drug users. The majority of the patients (85%) did not complain
of any side effects from their antituberculosis treatment. Among those who
did complain of side effects, the most common were nausea and vomiting
(41%), drug induced hepatitis (37%), blurring of vision (11%), and skin
rashes (11%). Two cases of death were reported.
*13.* The Southeast Asian Journal of Tropical Medicine and Public Health.
2010 Jan; Volume 41, Number 1: 163-8. *Tuberculosis and MDR-TB in the
Northern Emirates of United Arab Emirates: A 5-Year Study; *Al-Zarouni, M.,
Dash, N., Al Ali, M., Al-Shehhi, F., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20578495>
In this study, the researchers describe the prevalence of TB and occurrence
of multidrug-resistance TB (MDR TB) in a major referral hospital belonging
to the Ministry of Health in Sharjah, United Arab Emirates (UAE). A
retrospective review of the clinical and laboratory records of 1,810
suspected cases of TB was carried out between January 2004 and September
2008. The antimicrobial susceptibility patterns of each *Mycobacterium
tuberculosis* isolate were analyzed. During the study period, 312 *M.
tuberculosis* culture confirmed cases were recorded; 230 were males and 82
were females. The majority of TB cases (36%) were seen among expatriates
from South and Southeast Asian countries. Fifty-one active TB disease cases
(16%) were reported in native people (Emaratis) of the country. The peak age
group was between 16 and 45 years. Among first-line antituberculosis drugs,
resistance to isoniazid was the most common (21%), followed by streptomycin
(14%). MDR TB was found in 15 cases (4.8%). Although the prevalence of TB in
UAE is fairly low, an increasing number of cultures confirmed TB and MDR TB
among native and expatriate patients, necessitating improved vigilance in
case detection, effective management, and prevention of MDR and XDR TB
emergence in the country.
*14.* The Southeast Asian Journal of Tropical Medicine and Public Health.
2009 Nov; Volume 40, Number 6: 1335-46. *Health-Seeking Behavior among
HIV-Infected Patients Treated for TB in Thailand; *Burapat, C.,
Kittikraisak, W., Cain, K.P., Tasaneeyapan, T., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20578470>
In Asia, patients increasingly seek TB treatment in the private sector;
however, few private sector practices follow international TB management
guidelines. The authors conducted a study to measure the frequency and
predictors of seeking TB diagnosis in the private sector among 756
HIV-infected TB patients in four Thai provinces during 2005-2006. Of
enrolled patients, 97 (13%) first sought care at a private provider and 83
(11%) at a pharmacy. In multivariable analysis, the only factor
independently associated with seeking care at a private provider was having
a high TB stigma score. Factors independently associated with seeking care
at a pharmacy included not knowing that TB can be cured and that TB care can
be provided close to home. Patients reported that the most influential
factor in choosing a provider was confidentiality (468; 62%). Further
research is needed to evaluate whether educating the community about the
confidentiality, availability, and success of curing TB at government health
facilities can promote prompt utilization of public TB treatment services by
HIV-infected patients in Thailand.
*15.* The Southeast Asian Journal of Tropical Medicine and Public Health.
2009 Nov; Volume 40, Number 6: 1264-78. *Multi-Drug Resistant TB and HIV in
Thailand: Overlapping, but Not Independently Associated Risk Factors; *Akksilp,
S., Wattanaamornkiat, W., Kittikraisak, W., Nateniyom, S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20578461>
The HIV and multidrug-resistant TB (MDR TB) epidemics are closely linked. In
Thailand as part of a sentinel surveillance system, the researchers
collected data prospectively about pulmonary TB cases treated in public
clinics. A subset of HIV-infected TB patients identified through this system
had additional data collected for a research study. The researchers
conducted multivariate analysis to identify factors associated with MDR TB.
Of 10,428 TB patients, 2,376 (23%) were HIV-infected; 145 (1%) had MDR TB.
Of the MDR TB cases, 52 (37%) were HIV-infected. Independent risk factors
for MDR TB included aged 18-29 years old, male sex, and previous TB
treatment, but not HIV infection. Among new patients, having an injection
drug use history was a risk factor for MDR TB. Of 539 HIV-infected TB
patients in the research study, MDR TB was diagnosed in 19 (4%); the only
significant risk factors were previous TB treatment and previous hepatitis.
In Thailand, HIV is common among MDR TB patients, but is not an independent
risk factor for MDR TB. Populations at high risk for HIV-young adults, men,
injection drug users - should be prioritized for drug susceptibility
testing.
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. Chief of Party (Tracking Code 4191) *
*Sponsor: PATH*
Position Type: Full-Time/Regular
Location: Kinshasa, Congo, the Democratic Republic of the
Job Description:
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.
With USAID support, PATH will support the National TB Program and other key
TB partners in the Democratic Republic of the Congo to implement and
scale-up an ambitious set of activities to improve performance on specific
components of the Stop TB Strategy in four provinces and four large cities
across the DRC.
PATH is seeking a Project Director/Chief of Party who will have technical
and management responsibility for ensuring the overall achievement of
results and coordination with USAID/DRC, the National TB Program, National
AIDS Control Program, USAID implementing partners, and other key
stakeholders. The individual will be responsible for the successful
implementation of the project and for providing general program and
technical direction as well as completion of required reports.
Required Experience:
Advanced degree (MS, MPH, MD, and/or PhD) in a relevant field plus a minimum
of 10 years of experience in implementation and management of international
health development projects, specifically with TB and HIV/AIDS components.
Experience as a Chief of Party in Sub-Saharan Africa highly desirable.
Specific job responsibilities, required skills, and to apply: Please visit
PATH’s website at: PATH: Chief of
Party<http://hostedjobs.openhire.com/epostings/submit.cfm?fuseaction=app.jobinfo&id=23&jobid=298453&company_id=15780&version=1&source=ONLINE&JobOwner=1012596&level=levelid2&levelid2=24928&parent=Africa%20%3B%3B%3BPublic%20Health&startflag=3>
*2. Three New Job Positions *
*Sponsor: PATH, Tuberculosis Team, HIV/AIDS & Tuberculosis Global Program*
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.
Based within the HIV/TB Global Program, PATH's TB portfolio consists of a
dynamic and growing set of both global and country-focused technical
assistance projects and short-term assignments. Such projects include
supporting DOTS expansion and quality improvement, laboratory strengthening,
surveillance, TB/HIV service integration, infection control, programmatic
management of drug-resistant TB, public-private sector collaboration, and
advocacy, communication, and social mobilization.
PATH is currently seeking a Sr. Technical Officer, Project Administrator,
and one Technical Officer to join the TB team. Please see below for a brief
description of each position. For additional information and to apply
online, please visit the employment website at
http://www.path.org/employment.php and search for the corresponding
position. PATH is dedicated to diversity and is an equal opportunity
employer.
*(i) Project Administrator (PADM) (4184)*
Location: Washington, DC
The new Project Administrator will provide financial and contractual
management for several activities within the TB Team’s portfolio, including
those in the Democratic Republic of the Congo. PATH is seeking candidates
who have at least 5 years of experience with grants and contract
administration and are fluent in French.
See Job Details<http://hostedjobs.openhire.com/epostings/submit.cfm?fuseaction=app.jobinfo&jobid=298446&company_id=15780&version=1&source=ONLINE&jobOwner=988958&aid=1>
*(ii) Sr. Technical Officer (4187)*
Location: TBD
The Senior Technical Officer will provide high-level technical expertise and
leadership for the TB Team’s growing portfolio.
See Job Details<http://hostedjobs.openhire.com/epostings/submit.cfm?fuseaction=app.jobinfo&jobid=298449&company_id=15780&version=1&source=ONLINE&jobOwner=988958&aid=1>
*(iii) Technical Officer (4188)*
Location: TBD
The DRC Technical Officer will provide management support to PATH TB
activities in the Democratic Republic of the Congo. PATH is seeking
candidates with experience managing USAID projects, excellent organizational
and leadership skills, fluency in French, and TB expertise.
See Job Details<http://hostedjobs.openhire.com/epostings/submit.cfm?fuseaction=app.jobinfo&jobid=298450&company_id=15780&version=1&source=ONLINE&jobOwner=988958&aid=1>
*3. Technical Officer *
*Sponsor: WHO Stop TB Department, TB Strategy and Operations*
Vacancy Notice No: HQ/10/STB/FT251
Location: Geneva Switzerland
The WHO Stop TB Department aims to guide the global response to the TB
epidemic and facilitate partnerships; provide evidence-based norms,
standards, and policies; support Member States in adapting and adopting the
Stop TB Strategy within strengthened health systems; measure global
progress, monitor and assess national program performance, financing, and
impact; and, enable progress across the continuum of TB research, linked
within a wider health research strategy. The WHO Stop TB Strategy aims to
achieve: universal access to quality diagnosis and patient-centered
treatment; reduce the human suffering and socioeconomic burden associated
with TB; protect vulnerable populations from TB, TB/HIV, and drug-resistant
TB; support development of new tools and enable their timely and effective
use; and protect and promote human rights in TB prevention, car, and
control. Within STB, the Stop TB Strategy (TBS) team is responsible for
improving TB control within strengthened health system by developing new
evidence-based strategies and policies that support the
implementation of the Stop TB Strategy and supporting their timely adoption
by Member States and partners.
Description of duties:
1. Facilitate the operations of the Global Project through the revision and
implementation of drug resistance survey protocols, and management of drug
resistance surveillance data.
2. Coordinate technical assistance activities in the area of drug resistance
surveillance in order to ensure optimal use of resources.
3. Coordinate collection of standardized drug resistance surveillance data
in collaboration with the UNITAID/GLI project for global laboratory capacity
strengthening.
4. Facilitate periodical analysis and publication of global data on
anti-tuberculosis drug resistance.
5. Coordinate activities of the Advisory Body to the Global Project.
6. In collaboration with the GLI Secretariat strengthen links between
national laboratories and the Supranational Reference Laboratory network for
national-level capacity building for drug resistance surveillance.
7. Facilitate the activities of the Subgroup on Research of the Working
Group on Multi-Drug Resistant Tuberculosis and operational research
activities in the Team.
8. Perform other duties as required.
A written test and interviews may be used as a form of screening.
Online applications are strongly encouraged to enable WHO to store your
profile in a permanent database.
Please visit WHO's e-Recruitment website at
http://www.who.int/employment/en/ . The system provides instructions for
online application procedures.
All applicants are encouraged to apply online as soon as possible after the
vacancy has been posted and well before the deadline stated in the vacancy
announcement.
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. 16th Annual Four Corners TB & HIV Conference
NEW*
Sponsors: Arizona Department of Health Services. New Mexico Department of
Health. Navajo Nation. American Lung Association of Arizona. Indian Health
Service (USPHS). New Mexico AIDS Education and Training Center. Heartland
National TB Center. Colorado Department of Public Health & Environment.
Dates: October 19 – 20, 2010
Location: Flagstaff, Arizona
The agenda for this conference includes: TB and Diabetes; TB Risks with TNF
Antagonist and Other Immunosuppressants; American Indian/Alaska Native
Populations TB Descriptive Epidemiology; TB Outbreak on the Reservation;
PACT Project: DOT Methodology Partners in Health, Navajo Nation Diabetes &
HIV; Opt-Out Testing: TB/HIV Screening (Why Opt-Out Testing is Important);
New HIV Screening Guidelines; TB T-Spot: The Maricopa County Experience
(Moving from TST to T-Spot Testing); Cohort Review and Program Evaluation;
Contact Investigations; TB Radiology; Updates on Molecular Diagnostics; Drug
Resistant TB: MDR Colorado Case; HIV Highlight: Treating the Antiretroviral
Experienced Patient; Hepatitis C, Testing for Hepatitis C and HIV
Co-infection; and Mortality Review: New Mexico Native Americans.
Registration fee: $75.
For more information, contact Kelly Szymanski, American Lung Association in
Arizona, 102 W. McDowell Road, Phoenix, AZ 85003. Phone (602) 258-7505;
E-mail ; or access the Web site at
http://www.lungcolorado.org/fourcornerstb/index.htm .
*2. The TB Cohort Review Process NEW*
Sponsors: The Charles P. Felton National Tuberculosis Center. The Government
of the District of Columbia, Department of Health Bureau of Tuberculosis
Control. University of Medicine & Dentistry of New Jersey (UMDNJ). New
Jersey Medical School Global Tuberculosis Institute. UMDNJ-Center for
Continuing and Outreach Education.
Dates: November 17 – 18, 2010
Location: Washington, DC
The purpose of this one and one-half-day course is to provide TB program
leaders, managers, and clinicians with the necessary knowledge and skills to
lead TB cohort reviews in their program areas. The course covers principles
of the TB cohort review process, guidance from the Centers for Disease
Control and Prevention (CDC) regarding this requirement in the cooperative
agreement, impact of cohort reviews, and planning for implementation in
local program areas. The format includes lectures; observation of an actual
cohort review; group discussions; individual and group exercises; use of
computers to enter, analyze, and report cohort data; and an outline for
planning for adaptation and implementation.
Registration fee: $50 must be received prior to the course. Continuing
education credits are available.
For more information, contact Bill Bower. E-mail ; phone
(646) 448-0945 or (917) 882-0657; or access the Web site at
http://www.umdnj.edu/globaltb/courses/brochures/tbcohort-fall-2010.html .
3. 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/ .
*4. Medical Management of TB: An Online Presentation (30 minutes) *
Sponsor: The Francis J. Curry National Tuberculosis Center
This slide presentation is presented by Karen Smith, M.D., M.P.H., Public
Health Officer for Napa County Public Health in Napa, California. Dr. Smith
covers the basic information that every nurse case-managing a TB patient
must understand, including the four basic TB drugs, the role they play in TB
treatment, and the adverse reactions most commonly associated with them;
alternative regimens; and how to monitor patients. Dr. Smith also briefly
discusses drug-resistant TB and extrapulmonary TB. This slide presentation
with streaming audio provides information on how to manage treatment of TB.
A question and answer session, a printable PowerPoint slide file, and other
useful resources are also included as supplemental materials.
For more information visit: http://www.nationaltbcenter.ucsf.edu/med_mgmt/ .
*5. 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. Email ; telephone (415) 502-4600;
or fax (415) 502-4620.
For a course description, visit
http://www.nationaltbcenter.ucsf.edu/tbicweb/ .
*6. 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/
*7. 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
*8. Conference on Modern Microbiological Diagnostics of Tuberculosis *
Sponsors: Antitubercular Clinic of Primorsky Region. Health Department of
Primorsky Region. Novosibirsk Scientific Research Institute of Tuberculosis.
Vladivostok State Medical University.
Dates: September 8 – 9, 2010
Location: Vladivostok, Russia
The conference participants include leading experts from Russian scientific
research institutes for TB and pulmonology, antitubercular establishments
FEFD and SFD, as well as specialists from foreign institutes and
international organizations, conducting research in this area. The
scientific program will focus on improvement of the quality of
microbiological diagnostics of TB, improvement of methods of detection and
identification, and determination of drug sensitivity of TB activators.
Discussion will include issues such as application of modern microbiological
methods and provision of information in the laboratories of antitubercular
establishments.
For more information contact Anna Panova, Manager of Bacteriological
Laboratory, C.M.D., E-mail: .
* *
*9. Comprehensive Clinical TB Course*
Sponsor: Southeastern National Tuberculosis Center
Dates: September 13 – 16, 2010
Location: Lantana, Florida
This four-day training program will familiarize the clinician with all
aspects of TB infection, disease, and clinical care, using an
interdisciplinary and interactive approach. Course objectives are
accomplished through a combination of didactic lectures and interactive case
management discussions. The course is conducted at A.G. Holley Hospital, one
of the last free-standing TB sanatoriums in the United States.
Registration Fee: $300. Continuing education credits are available.
For more information, including registration, e-mail
or visit: http://sntc.medicine.ufl.e
du/Training.aspx <http://sntc.medicine.ufl.edu/Training.aspx> .
*10. Tuberculosis Clinical Intensive *
Sponsor: The Francis J. Curry National Tuberculosis Center (CNTC)
Dates: September 21 – 23, 2010
Location: San Francisco, California
This course is for physicians and other licensed medical professionals who
diagnose and treat TB. The course will cover: epidemiology of TB; diagnosis,
management, and treatment of TB; transmission and pathogenesis; TB and HIV
coinfection; TB targeted testing and laboratory testing; pediatric TB;
treatment of latent TB infection; multiple drug resistance; legal and
ethical issues in TB control; and TB radiology.
Enrollment is limited and pre-registration is required. There is no fee for
this course. Continuing education credits are available.
For more information contact the Francis J. Curry National Tuberculosis
Center, E-mail: ; Phone: (415) 502-4600; Fax:
(415) 502-4620; or access the Web site:
http://www.nationaltbcenter.edu/training/tb_clinical_intensive.cfm .
*11. The Second Global Forum on TB Vaccines: A Framework for Introducing
Improved TB Vaccines to the World Community*
Sponsor: Aeras Global TB Vaccine Foundation
Dates: September 21 – 24, 2010
Location: Tallinn, Estonia
This international conference promises to be the premiere TB vaccine meeting
of 2010. New TB vaccines hold the promise of preventing TB globally and
overcoming the challenges of drug-resistant TB and TB/HIV coinfection. This
scientific conference will include international experts chairing sessions
on: Basic Research, Applied Research, Clinical Studies on TB Vaccines,
Manufacturing, Regulation and Vaccine Access, Partnerships, and
Communication & Coordination. Participants will review progress on TB
vaccines over the past ten years, assess challenges, propose solutions, and
reframe the global agenda for TB vaccines for the next decade.
For more information, contact Mike Brennan at Aeras Global TB Vaccine
Foundation, by e-mailing ; phoning (301) 547-2959; or
visiting http://www.tbvaccine2010.org/.
Online registration is at http://www.tbvaccine2010.org/Register.html .
*12. Northeast TB Controllers Conference *
Sponsors: Maryland Center for TB Control and Prevention. Baltimore City
Health Department TB Control Program. Howard Community College
Dates: September 23 – 24, 2010
Location: Annapolis, Maryland
Registration deadline: September 10, 2010
The Northeast TB Controllers Educational Conference will be held in
Annapolis, Maryland on September 23-24, 2010, at the Westin Annapolis.
Conference activities will include formal presentations on Thursday,
September 23, followed by focused educational sessions and training on
Friday, September 24. The first day of the conference will consist of formal
presentations on a variety of topics, including recent research,
epidemiology, and local PCSI activities. On the second day, separate
breakout sessions will be held for TB controllers, medical and other
provider staff, and epidemiologists. The Northeast Regional Training and
Medical Consultation Center will be hosting a separate TB case management
training on September 24 for nurses. Registration for this training must be
done through the NJ Medical School Global TB Institute.
Conference fee is $85.
For questions, contact Nickolette Patrick at , or call
(617) 279-2240 x262.
Detailed course information and online registration will be available at
http://www.edcp.org/tb/calendar.cfm .
* *
*13. Understanding and Managing Latent TB Infection *
Sponsor: Heartland National TB Center
Date: October 5, 2010
Location: Arnold, Missouri
Application Deadline: September 21, 2010
This previously scheduled course has been moved to October 5, 2010 and is
intended for local health department nurses and DOT workers who are tasked
with the responsibility to identify and manage patients with, or at risk of,
latent TB infection (LTBI). The course will enhance their ability to
differentiate LTBI from TB disease and competently manage and treat LTBI
patients. In addition, the last part of the course will include a hands-on
skill building session on the tuberculin skin test.
There is no fee, but enrollment is limited. Pre-registration is required.
Continuing education credits are available.
For more information, contact Elizabeth Mauldin, Heartland National TB
Center. E-mail
; phone (210) 531-4580; or access the Web site at
http://www.heartlandntbc.org/training.asp .
*14. TB Case Management and Contact Investigation Intensive *
Sponsor: The Francis J. Curry National Tuberculosis Center (CNTC)
Dates: October 12 – 15, 2010
Location: San Francisco, California
Application deadline: August 30, 2010
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. This
course covers many aspects of TB case management and contact investigation,
including epidemiology of TB, medical management of TB, targeted testing for
TB, treatment of latent TB infection (LTBI), and more.
Enrollment is limited, and pre-registration is required. A few days after
the application deadline, applicants will receive a letter indicating
whether or not their application is approved. Directions will be included
with acceptance letters. There is no fee for this course. Continuing
education credits are available.
For more informatio , contact Jennifer Kanouse, Program Manager. E-mail:
; phone (415)502-2712; or access the Web
site at http://www.nationaltbcenter.edu/training/tbcmcioct10.cfm .
*15. Advanced TB Nurse Case Management *
Sponsor: Heartland National TB Center
Date: October 19, 2010
Location: St. Paul, Minnesota
This course is intended for TB program managers, TB nurse case managers, and
local health department nurses responsible for the management of patients
with, or suspected of, TB. This is not an introductory course. It is
recommended that nursing participants attend a Nurse Case Management course
before attending this training or have extensive experience managing TB
patients.
There is no fee, but enrollment is limited. Pre-registration is required.
Continuing education credits are available.
For more information, contact Jessica Quintero, Heartland National TB
Center, E-mail:
; Phone: (210) 531-4568; or access the Web site at
http://www.heartlandntbc.org/training.asp .
*16. TB Nurse Case Management *
Sponsor: Heartland National TB Center
Dates: November 3 – 5, 2010
Location: San Antonio, Texas
Application Deadline: October 13, 2010
This two-and-a-half-day training targets public health TB nurses and program
managers who are actively engaged in the case management, identification,
and treatment of patients with TB infection or disease. This course will
provide an in-depth coverage of the evaluation, treatment, and case
management of medically and psychosocially difficult-to-treat patients.
Participants will be able to competently diagnose and manage latent TB
infection and TB disease; monitor response to treatment; perform drug
toxicity assessments; identify and manage foreign-born and persons at risk
for TB; diagnose and manage TB in pediatric, HIV-positive, and correctional
patients; perform case review and quality assurance; balance
responsibilities for public health with patient’s needs; assess adequate
infection control measures; and prevent non-compliance through use of DOT
and enablers. In addition, the last part of the course will include a
hands-on skill building session on the tuberculin skin test.
There is no fee, but enrollment is limited. Pre-registration is required.
Continuing education credits are available.
For more information, contact Jessica Quintero, Heartland National TB
Center. E-mail ; phone (210) 531-4568; or access
the Web site at http://www.heartlandntbc.org/training.asp .
* *
* *
*17. 41st Union World Conference on Lung Health *
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: November 11 - 15, 2010
Location: Berlin, Germany
The Union announces that the 41st Union World Conference on Lung Health,
organized by the International Union Against Tuberculosis and Lung Disease,
will be hosted in Berlin, Germany, from November 11 to 15, 2010. Scientific
sessions selected for this year’s program intend to highlight innovation in
TB, HIV, and lung health, setting a course for future health solutions. As a
link from the past to present, and the central role of research, the theme
of the conference is “Tuberculosis, HIV and lung health: from research and
innovation to solutions”. The 41st Union World Conference will also provide
the opportunity to demonstrate continued commitment to the Year of the Lung,
which was launched on Sunday, December 6, 2009, at the 40th Union World
Conference in Cancun, Mexico. This campaign, organized by the Forum of
International Respiratory Societies (FIRS), seeks to raise awareness that
hundreds of millions of people around the world suffer each year from
treatable and preventable respiratory diseases.
The official languages for this conference are English and French.
Registration for the Conference can be made as of May 2010 using the online
registration service available on the conference website:
http://www.worldlunghealth.org/confBerlin/
The registration fee varies according to the dates registered and membership
status.
For more information, contact The Union, 68 Boulevard Saint-Michel, 75006
Paris, France; E-mail: e-mail address is being
protected from spambots. You need JavaScript enabled to view it for
registration and exhibition, and for scientific
program and abstracts. Telephone (+33) 1 44 32 03 60; fax (+33) 1 53 10 85
54 / (+33) 1 43 29 45 10; or access the website at
http://www.worldlunghealth.org/confBerlin/ .
*18. Late-Breaker Session on Tuberculosis at the 41st World Conference on
Lung Health *
Sponsors: International Union Against Tuberculosis and Lung Disease (The
Union). Centers for Disease Control and Prevention (CDC)
Date: November 15, 2010
Location: Berlin, Germany
The 41st Union World Conference on Lung Health and the Centers for Disease
Control and Prevention (CDC) announce co-sponsorship of a late-breaker
session related to TB. All aspects of TB control, elimination, and research
(including basic and clinical science, epidemiology, social, behavioral,
psychosocial, educational aspects, health care delivery, and public health)
are welcomed for presentation during the late-breaker session. In keeping
with the spirit of a late-breaker session we ask that only new, innovative,
and significant findings that have occurred as of April 1, 2010, or for
which information has just become available, be submitted for late-breaker
presentations in the form of a 1-page electronic file. The late-breaker
session will consist of 8 oral presentations of 10 minutes each, followed by
5 minutes of questions. A small number of travel grants are available for
presenters of accepted abstracts who require funding to attend the
conference. If you intend to request support, an indication of your desire
and rationale for consideration for a travel grant must be submitted with
the abstract. The reviewing committee will be blinded to the request for
travel funds. Submissions should include a cover letter with (i) a statement
that the work has not been previously submitted for consideration to the
general portion of The Union meeting, (ii) the date by which the
work/analysis was mostly complete, (iii) a request and rationale for travel
support if so desired, and (iv) the address, phone and FAX number, and
e-mail address where the submitter may be contacted the week of September 6,
2010.
For more information, contact Ed Nardell (The Union), Phil LoBue (CDC), or
Elsa Villarino (CDC); TB Late-Breaker Session, Division of TB Elimination,
CDC, 1600 Clifton Rd, NE, MS E-10, Atlanta, Georgia 30333 USA; E-mail:
<>; Tel: (404) 639-8123; or Fax: (404)
639-8961; or visit the website:
http://www.cdc.gov/tb/events/unionlatebreaker.htm .
*19. TB: What We Know... and What Lies Below *
Sponsor: The Lung Association
Dates: November 15 – 16, 2010
Location: Toronto, Ontario, Canada
Early-bird registration deadline: October 15, 2010
The goal of this conference is to provide advanced information to health
care providers on the
complexity of tuberculosis management. Conference Objectives include: (1) To
identify current TB management strategies in the context of emerging issues
and co-morbidities; (2) To heighten awareness of the challenges of
preventing and managing TB; and (3) To highlight innovations in TB diagnosis
and care. Health and social service professionals, and others in such fields
as medicine, nursing, public health, community health, institutional health,
communicable disease, and correctional services, working with populations at
high risk of tuberculosis are encouraged to attend.
Watch for the Call for Poster Abstracts which will be available during the
summer months.
A detailed program package and registration form will be distributed in the
early Fall. For registration information, contact .
For more information, visit http://www.on.lung.ca/Page.aspx?pid=439
