MDR-TB Treatment & Prevention
Fwd: [tb-update] Week of July 11 to July 17, 2010
TB-Related News and Journal Items Weekly Update Week of July 11 to July
17, 2010
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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 releases, and
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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.
TB-Related Announcements
*1. 2010 Images to Stop Tuberculosis Award *
Stop TB Partnership
The deadline for submitting entries for the Stop TB Partnership 2010 Images
to Stop TB Photo Award competition is July 20. Sponsored by the Lilly
MDR-TB Partnership, the goal of the photo award competition is to promote
the creation of outstanding photos depicting the prevention and treatment of
TB.
Photographers are invited to submit their work for consideration. An
international jury of photography experts and representatives from the UN
and other partner organizations will select the winning photographer.
Chairing the jury of experts is internationally renowned photojournalist
Gary Knight. The winner will receive US $5,000 in prize money and a US
$5,000 grant to produce a photo report about TB.
The 2009 award went to David Rochkind of the United States. Mr. Rochkind
made use of the grant to produce a photo report documenting the impact of TB
in Mumbai, India. The report was widely published internationally in March
on sites including the BBC (
http://news.bbc.co.uk/2/hi/in_pictures/8582491.stm ), the Telegraph, the
Global Post, and Newsweek Japan.
Applicants for the 2010 award must submit a portfolio of 10 to 15
photographs depicting health-related issues. All entries must be received at
the Stop TB Partnership by *July 20, 2010*.
Entry rules available at www.stoptb.org/global/awards/images/rules.asp .
*2. Nominations are open for the 2010 Kochon Prize *
Stop TB Partnership, May 10, 2010
The Stop TB Partnership and the Kochon Foundation are pleased to announce
that nominations are open for the 2010 Kochon Prize.
The prize is awarded to persons, institutions, or organizations that have
made a major contribution to stopping TB. The deadline for nominations is
July 31, 2010. More information is available at
http://www.stoptb.org/global/awards/kochon/howtoapply.asp .
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News Update
*1. Case of Tuberculosis Confirmed at Johnson County Community College *
Kansas City Star, July 10, 2010
A Kansas community college has reported a TB case for the second time since
February 2009, health authorities are investigating the case. “The college
staff is working closely with us to ensure that students are informed and
aware of their exposure and testing options,” said Nancy Tausz, Director of
the Johnson County Health Department’s Disease Containment Division. It is
not likely, she said, that the disease was spread through contact at the
college.
Headlines
*1. New TB Cases in N.W.T. Community (Canada)*
CBC (Canadian Broadcasting Corporation) News, www.cbc.ca, July 7, 2010
Four new cases of TB have been confirmed in Déline, Northwest Territories
(NWT), Canada. Health officials say that the new cases were caused by an
individual who had contracted the disease during an outbreak at the end of
2009, but whose disease had not been detected. That one individual infected
three others, making a total of 13 persons with active TB disease in a
community of 500. In addition to these 13, health officials stated that
there are 47 other individuals who are infected with the TB bacteria. Health
officials will screen all the inhabitants of Déline and will treat all who
test positive for TB infection. According to Dr. Kami Kandola, Chief Medical
Officer of the NWT, about half the community has been screened so far.
*2. Iranians Find New Strains of Tuberculosis (Iran)*
Press TB, www.presstv.ir/default.aspx, June 22, 2010
Ali Akbar Velayati, Head of TB and Respiratory Disorders Research Center,
Iran, reported that Iranain researchers have discovered two new
strains of *Mycobacterium
tuberculosis*, which are believed to be resistant to existing treatments.
The two strains were discovered by Dr. Farnian of the Tuberculosis and
Respiratory Disorders Research Center in two separate studies conducted in
collaboration with researchers from Malaysia and Belarus. Velayati also
announced that Iranian scientists have succeeded in producing nano-crystals
that can penetrate the membrane of the drug-resistant TB bacillus. It is
believed that this finding can pave the way for development of new anti-TB
drugs.
*3. Los Alamos National Security and Biomagnetics Diagnostics Partner to
Develop TB Diagnostic Tool (United States)*
Trading Markers.com, www.tradingmarkets.com, July 12, 2010
Biomagnetics Diagnostics, a medical device and biotechnology company,
recently announced an agreement with Los Alamos National Security. In the
agreement, Los Alamos National Laboratory’s (LANL) scientific and
engineering staff will research new potential human TB biomarkers, and
develop a validated assay to detect human TB. LANL staff will use a
currently known biomarker in combination with the waveguide-based optical
biosensor platform to detect disease-causing pathogens. The optical
biosensor was developed at LANL and licensed to Biomagnetics Diagnostics in
late 2009. The collaborative research is designed to hasten to market a
device for diagnosing human TB. The device is based on LANL-developed human
pathogen detection methods. The integrated optical biosensor technology may
decrease the time and expense and increase the sensitivity for detecting
human TB, compared to the present diagnostic methods. The present methods
use DNA signatures and polymerase chain reaction or antibody-based
enzyme-linked immunoabsorbent (ELISA) assays. Although QuantiFERON-TB Gold
IN-Tube and T-SPOT TB tests accelerate diagnosis, they are expensive and
require highly trained personnel and specialized facilities. This new
research holds the promise of producing a device that can be used at the
point of patient care by relatively untrained personnel to diagnose TB in
humans in a matter of minutes, with a cost that is significantly lower than
what is achievable by other currently known methodologies or systems.
*4. Vaccinations Fail to Stem Child TB (Viet Nam)*
Viêt Nam News, http://vietnamnews.vnagency.com.vn, July 13, 2010
Hoang Thanh Van, Manager of Viet Nam’s National Hospital for TB and
Respiratory Diseases Pediatrics Department, noted that vaccination has not
prevented an increase in the number of children contracting TB. She stated
that an average of 40 to 50 children were hospitalized with the disease each
month, compared to the previous figure of 20. The vaccinations were only 70
percent effective. She explained that if three or four adults in a family
have TB, children could be infected, despite being vaccinated. The
hospital’s pediatric department figures show that 40 percent of the patients
have pulmonary TB, 17 percent have TB of the spine, and 10 percent TB of the
meninges. Some children have TB of both the spine and meninges, as well as
pulmonary TB. Hoang Thanh Van explained that children under the age of five
are easily infected.
*5. TB Alliance and DNDi Enter Cross-Disease License Agreement (United
States & Switzerland)*
PharmaLive, http://pharmalive.com, July 7, 2010
The Global Alliance for TB Drug Development has granted the Drugs for
Neglected Diseases Initiative (DNDi) the first-ever royalty-free license
agreement to develop a class of potential anti-TB compounds that show
promise for treating other neglected diseases. Under the agreement, the TB
Alliance grants DNDi rights to develop a series of compounds from the
nitroimidazole class for use against many neglected tropical diseases, such
as Chagas disease, African sleeping sickness, and leishmaniasis. The
partnership will allow DNDi to more thoroughly investigate the compounds for
their ability to treat additional neglected diseases. At present, work is
ongoing with these compounds for the potential to yield new TB drug
candidates. The TB Alliance has built a library of nitroimidazoles in the
attempt to develop the class for TB, and will share its scientific expertise
and specific knowledge of the drug class. The nitroimidazole drug class is
effective in tackling a broad spectrum of bacteria, protozoa, and
occasionally helminths, many of which cause neglected diseases. Over the
next year, the Gates Foundation will provide $1.5 million to DNDi for
preclinical assessments of the compounds, specifically for use against
visceral leishmaniasis.
*6. IHV and Nigeria Partner with the U.S. to Combat Multi-Drug Resistant
Tuberculosis (Nigeria)*
Medical News Today, www.medicalnewstoday.com, July 10, 2010
Dr. Tom Frieden, Director of the US Centers for Disease Control and
Prevention (CDC), toured the multimillion dollar laboratory complex at the
Nigerian National TB and Leprosy Training Center (NTBLTC). The lab was
established by the Institute of Human Virology of the University of Maryland
School of Medicine in Baltimore, Maryland, and the Institute of Human
Virology, Nigeria. The partnership with the United States and Nigeria was
established in 2004 with funding from the CDC and the President’s Emergency
Plan for AIDS Relief (PEPFAR). The laboratory is the first of its kind in
Africa. The high containment laboratory was built in the United States, has
pre-filters to withstand the harsh, dry and dusty winds during the Harmattan
(severe sub-Saharan dust storms), and provides a negatively pressured
laboratory for safe handling of MDR TB cultures and other highly infectious
agents. Dr. Frieden was accompanied by Dr. Kevin DeCock, the incoming CDC
Director for Global Health, and Dr. Nancy Knight, Country Director. Dr.
Frieden commended the partnership for providing the lab training to Nigerian
health care personnel from hospitals and DOTS clinics. Nigeria and
neighboring countries can now provide accurate diagnosis of TB using simple,
improved microscopy techniques. Also, a network has been established to
report TB results, particularly MDR TB from various clinics, and send
samples to the new lab, which has international clearance to research the
disease. Prior to touring the facility, Dr. Frieden led a roundtable
discussion advocating strengthening public health response by establishing
and maintaining surveillance and building epidemiologic and lab capacity.
*7. Thorngrove to Deal with Tuberculosis (Zimbabwe)*
NewsDay, www.newsday.co.zw, July 13, 2010
Health department officials in Zimbabwe have decided that drug-resistant
cases of TB in the southern region of the country will be treated at
Thorngrove Hospital in Bulawayo. The country is preparing to deal with TB
drug resistance by improving laboratory services, refurbishing its
infrastructure, and training health personnel. One challenge facing Zimbabwe
is that the only national TB reference laboratory in Bulawayo is unable to
diagnose drug-resistant TB. Also, it was reported that some patients were
opting out of HIV and TB treatment because they were unable to tolerate the
medicine on empty stomachs. Many people live below the poverty line, which
is about $500 per month, and they cannot afford food. Most people in
Zimbabwe earn about $150 per month. Zimbabwe’s TB detection case rate for
2007 was 42 percent, which is below the World Health Organization (WHO)
target of 70 percent. The treatment success rate was 68 percent, compared to
the WHO target of 85 percent.
*8. Housing Design Can Buffer Spread of TB in Haiti – Campaigners (United
Kingdom)*
Alertnet, www.alertnet.org, July 12, 2010, by Olesya Dmitracova
Haiti has the highest rate of TB in the Americas, and, according to the
World Health Organization (WHO), TB is the country’s second cause of death
after HIV/AIDS. Architecture for Health in Vulnerable Environments (ARCHIVE)
has launched a campaign calling on architects, engineers, health experts,
and the general public to submit low-tech housing designs that could reduce
TB transmission in Haiti. According to Peter Williams, Founder and Executive
Director of ARCHIVE, organizations such as WHO and the World Bank admit that
health and housing are the two main challenges facing Haiti. The slow pace
of reconstruction and the inception of the Atlantic hurricane season have
increased the risk of flooding and landslides in the country. Also, health
workers worry that heavy rains and wet conditions will increase the spread
of infections. ARCHIVE believes that using the right building materials can
lower humidity, improve ventilation, and increase direct sunlight, all of
which reduce the presence of indoor pathogens. Five winning designs selected
by an interdisciplinary panel of judges and the local community will be used
to build five single-family units, and will be showcased in traveling
exhibitions. Williams hopes that the campaign will change how people view
housing and encourage organizations around the world to design and build
houses that can limit disease transmission.
Journal Articles
*1.* The Indian Journal of Tuberculosis. 2009 Oct; Volume 56, Number 4:
185-90. *Perceptions of Tuberculosis Patients about Private Providers before
and after Implementation of Revised National Tuberculosis Control Programme;
*Jaggarajamma, K., Balambal, R., Muniyandi, M., Vasantha, M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20469729>
Most of the persons with chest symptoms in India approach private providers
(PPs) for health care. It has been observed that patients who start
treatment with PPs for TB frequently switch over subsequently to the public
sector. The reasons for this discontinuation and their perceptions of the TB
care provided by the PPs are unknown. This study documented the perceptions
about PPs India's Revised National TB Control Program (RNTCP) and the
reasons for discontinuation of treatment with PPs and subsequent attendance
at a public provider. This was a cross sectional study on patients
registered under the TB program during 1997 and 2005 in rural and urban
areas. During this period patients who were initially diagnosed and treated
for TB in a private clinic and subsequently shifted to public health
facility were considered for the study. A semi-structured interview schedule
was used to collect the factors related to patient's perceptions on PPs, the
factors responsible for initiating treatment with PPs, reasons for
discontinuing treatment with PPs, and their willingness to continue
treatment from government health facilities were collected. This data was
compared with data collected in 1997 before implementation of the RNTCP. A
total of 1,000 and 1,311 TB patients were registered during 1997 and 2005
respectively. Among them, 203 (20%) and 104 (8%) patients were identified as
having been initially diagnosed and started on TB treatment by PPs and
subsequently shifted to government health facilities. There were significant
changes in reasons for selecting PPs between the two periods: being
convenient (47% vs 10%; p < 0.001), quality care (41% vs 19%; p < 0.001),
motivated by others (49% vs 19%; p < 0.001), confidentiality (19% vs 9%; p <
0.05) and known doctor (6% vs 28%; p < 0.001) respectively. Financial
problems were the most common reason for discontinuation of treatment in
both periods. The use of sputum test for diagnosing TB by PPs was
significantly increased after RNTCP implementation. This study suggests that
slowly perceptions of patients have changed toward PPs, and RNTCP has begun
to gain acceptance amongst patients in terms of convenience,
confidentiality, and personal care.
*2.* The Indian Journal of Tuberculosis. 2009 Oct; Volume 56, Number 4:
174-84. *Bleach Optimization of Sputum Smear Microscopy for Pulmonary
Tuberculosis; *Srikanth, P., Kamesh, S., Daley, P.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20469728>
The Revised National Tuberculosis Control Programme (RNTCP) aims to improve
case detection rates of TB to facilitate prompt recognition and treatment.
The low case detection rates in the program can be directly attributed to
failure to screen patients with suspected TB and the low sensitivity of the
direct smear microscopy method to detect cases among the fraction of
patients that are screened. Apart from low sensitivity, this method also has
other disadvantages including the increased risk of infection transmission
to technicians. There are several methods that can be used to improve
sensitivity, but their applicability in a national program and in resource
limited settings are limited. Bleach processing of sputum smears prior to
microscopy may be a cheap and effective way to improve on the sensitivity of
the direct smear. Four distinctive techniques of sputum smear processing
using bleach are described in the review, with the variations in each
technique, along with the sensitivity. An analysis of reports published
earlier on the bleach method is also presented including a discussion on
when and why the bleach method works.
*3.* The International Journal of Tuberculosis and Lung Disease. 2010 Jun;
Volume 14, Number 6: 745-50. *First National Survey of Mycobacterium
tuberculosis Drug Resistance, Madagascar, 2005-2006; *Ramarokoto, H.,
Ratsirahonana, O., Soares, J.L., Ravaosolo, J., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20487614>
A national survey of *Mycobacterium tuberculosis* resistance was conducted
for the first time in Madagascar between October 2005 and July 2007 to
determine resistance rates among new and previously treated cases of
pulmonary TB. In a cluster sampling representative of the general population
of the country, 1,275 smear-positive TB patients recruited at 34 sites, 926
new patients and 87 previously treated patients underwent drug
susceptibility testing against rifampicin (RMP), isoniazid (INH),
streptomycin and ethambutol on Löwenstein-Jensen medium using the indirect
proportion method. Resistance among new cases was 6.5% (95%CI 4.9-8) and
among previously treated cases it was 11.5% (95%CI 4.8-18.2). Monoresistance
among new cases was 5.8% (95%CI 4.2-7.3), mainly to INH (3.7%).
Multiresistance to INH and RMP was 0.2% (95%CI 0-0.5) among new cases and
3.4% (95%CI 0-7.2) among previously treated cases. No significant difference
was noted with regard to sex or age. The rates of resistance among new and
previously treated cases remain relatively low in Madagascar.
*4.* The International Journal of Tuberculosis and Lung Disease. 2010 Jun;
Volume 14, Number 6: 741-4. *Extra-Pulmonary and Smear-Negative Forms of
Tuberculosis Are Associated with Treatment Delay and Hospitalisation;
*Whitehorn,
J., Ayles, H., Godfrey-Faussett, P.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20487613>
A cross-sectional survey was conducted of newly identified adult patients
with TB recruited at the chest clinic of the University Teaching Hospital in
Lusaka, Zambia, from 2003 to 2004. The study identified factors associated
with delayed treatment or hospitalization. A total of 223 patients were
included in the analysis. Patients with smear-negative disease were 2.6
times more likely to be hospitalized than those with smear-positive disease
(95%CI 1.28-5.30), while patients with extra-pulmonary disease were 3.42
times more likely to be hospitalized than those with pulmonary disease
(95%CI 1.75-6.66). Patients with smear-negative disease were 2.81 times more
likely to have experienced overall delay than those with smear-positive
disease (95%CI 1.20-6.66). This analysis demonstrated that patients with
extra-pulmonary or smear-negative disease are significantly more likely to
be hospitalized. Patients with smear-negative disease are also more likely
to have experienced treatment delay. These data reinforce the urgent need
for more robust diagnostic tests, particularly for smear-negative and
extra-pulmonary disease. As these forms of disease are more likely to be
associated with the HIV, the data support earlier diagnosis and treatment of
HIV infection.
*5.* The International Journal of Tuberculosis and Lung Disease. 2010 Jun;
Volume 14, Number 6: 733-40. *Racial Disparities in Primary and Reactivation
Tuberculosis in a Rural Community in the Southeastern United States;
*O'Donnell,
M.R., Chamblee, S., von Reyn, C.F., Ellerbrock, T.V., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20487612>
Racial disparities in TB disease are substantial in the United States. This
study determined if TB was attributable to primary infection, reactivation
or both. A population-based survey of latent TB infection (LTBI), a
case-control analysis of TB, and a cluster analysis of TB isolates were
performed between 1997 and 2001 in a rural section of a county in central
Florida. Of 447 survey participants, 135 (30%) had LTBI. Black race was
strongly associated with LTBI among US-born (OR 2.6, 95%CI 1.3-5.5) and
foreign-born subjects (OR 4.3, 95%CI 2.2-8.4). Risk factors for TB included
HIV (OR 27.4, 95%CI 10.1-74.1), drug use (OR 4.6, 95%CI 1.7-12.4), and Black
race (OR 3.4, 95%CI 1.2-9.6). The population risk of TB attributable to
Black race was 64%, while that attributable to HIV was 46%. Cluster analysis
showed 67% of TB cases were clustered, but Blacks were not at a
significantly increased risk of having a clustered isolate (OR 2.1, 95%CI
0.12-36.0). Both reactivation TB and recent TB transmission were increased
among Blacks in this community. Therefore, LTBI screening and intensive
contact tracing, both followed by LTBI treatment, will be needed to reduce
TB in Blacks.
*6.* The International Journal of Tuberculosis and Lung Disease. 2010 Jun;
Volume 14, Number 6: 727-32. *Estimating Tuberculosis Case Detection Rate in
Resource-Limited Countries: A Capture-Recapture Study in Egypt; *Bassili,
A., Grant, A.D., El-Mohgazy, E., Galal, A., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20487611>
Most countries endemic and highly endemic for TB still do not have reliable
TB surveillance systems. Indirect estimation of TB incidence is needed to
monitor the performance of the National TB Program (NTP) in the context of
the World Health Organization implementation and impact targets for TB
control. This study estimated the case detection rate (CDR) of all TB cases
and sputum smear-positive TB cases in Egypt in 2007. Record linkage and
three-source capture-recapture analysis of data were collected through
active prospective longitudinal surveillance within the public and private
non-NTP sector in four Egyptian governorates selected by stratified cluster
random sampling. For all TB cases, the estimated CDR of NTP surveillance and
completeness of case ascertainment after record linkage was respectively 55%
(95%CI 46-68) and 62% (95%CI 52-77). For sputum smear-positive TB cases,
these proportions were respectively 66% (95%CI 55-75) and 72% (95%CI 60-82).
This pilot study shows that representative sampling, prospective
surveillance in the non-NTP sector, record linkage, and capture-recapture
analysis can improve CDR estimation. For global, standardized and reliable
use, this methodology should be further developed. Until then, all
resource-limited countries should strengthen their national surveillance
systems in the context of the Stop TB strategy.
*7.* The International Journal of Tuberculosis and Lung Disease. 2010 Jun;
Volume 14, Number 6: 714-9. *Risk of Tuberculosis in Public Transport Sector
Workers, Lima, Peru; *Horna-Campos, O.J., Bedoya-Lama, A., Romero-Sandoval,
N.C., Martín-Mateo, M.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20487609>
Delays from symptom onset to the diagnosis and treatment of smear-positive
pulmonary TB produce possible new cases in persons in close contact with TB
cases, especially in confined spaces such as overcrowded public transport,
which puts other users and transport workers at risk. This study estimated
TB incidence rates in patients of a health micro-network, and the percentage
of transport sector workers among TB and multidrug-resistant TB (MDR TB)
patients. Crude and indirect standardized incidence rates of TB were
calculated from an exhaustive analysis of all clinical histories of incident
patients in a health micro-network between 1 January 2007 and 30 June 2008.
The percentage of transport sector workers and the association between MDR
TB and working in the transport sector were analyzed. Standardized incidence
rates for transport sector workers were 2.7-4.5 times higher than those in
the total working-age male and global population of the micro-network
studied. The association between TB and transport occupation and MDR TB and
transport occupation is high (respectively OR 3.06, 95%CI 2.2-4.2 and OR
3.14, 95%CI 1.1-9.1). These results indicate that the use of informal public
transport is a risk factor for TB infection and an occupational risk in
countries with characteristics similar to those in Peru.
*8.* The International Journal of Tuberculosis and Lung Disease. 2010 Jun;
Volume 14, Number 6: 708-13. *An Analysis of Spatial and Socio-Economic
Determinants of Tuberculosis in Hermosillo, Mexico, 2000-2006;
*Alvarez-Hernández,
G., Lara-Valencia, F., Reyes-Castro, P.A., Rascón-Pacheco, R.A.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20487608>
The city of Hermosillo, in Northwest Mexico, has a higher incidence of TB
than the national average. However, the intra-urban TB distribution, which
could limit the effectiveness of preventive strategies and control, is
unknown. Using geographic information systems (GIS) and spatial analysis,
the researchers characterized the geographical distribution of TB by basic
geostatistical area (BGA), and compared it with a social deprivation index.
Univariate and bivariate techniques were used to detect risk areas.
Globally, TB in the city of Hermosillo is not spatially auto-correlated, but
local clusters with high incidence and mortality rates were identified in
the northwest, central-east, and southwest sections of the city. BGAs with
high social deprivation had an excess risk of TB. GIS and spatial analysis
are useful tools to detect high TB risk areas in the city of Hermosillo.
Such areas may be vulnerable due to low socio-economic status. The study of
small geographical areas in urban settings similar to Hermosillo could
indicate the best course of action to be taken for TB prevention and
control.
*9.* Molecular Microbiology. 2010 Mar; Volume 75, Number 5: 1064-77. *Division
and Cell Envelope Regulation by Ser/Thr Phosphorylation: Mycobacterium Shows
the Way; *Molle, V., Kremer, L.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20487298>
*Mycobacterium tuberculosis* (M. tb) has a complex lifestyle in different
environments and involving several developmental stages. The success of M.
tb results from its remarkable capacity to survive within the infected host,
where it can persist in a non-replicating state for several decades. The
survival strategies developed by M. tb are linked to the presence of an
unusual cell envelope. However, little is known regarding its capacity to
modulate and adapt production of cell wall components in response to
environmental conditions or to changes in cell shape and cell division.
Signal sensing leading to cellular responses must be tightly regulated to
allow survival under variable conditions. Although prokaryotes generally
control their signal transduction processes through two-component systems,
signalling through Ser/Thr phosphorylation has recently emerged as a
critical regulatory mechanism in bacteria. The genome of M. tb possesses a
large family of eukaryotic-like Ser/Thr protein kinases (STPKs). The
physiological roles of several mycobacterial STPK substrates are connected
to cell shape/division and cell envelope biosynthesis. Although these
regulatory mechanisms have mostly been studied in Mycobacterium, Ser/Thr
phosphorylation appears also to regulate cell division and peptidoglycan
synthesis in Corynebacterium and Streptomyces. This review focuses on the
proteins which have been identified as STPK substrates and involved in the
synthesis of major cell envelope components and cell shape/division in
actinomycetes. It is also intended to describe how phosphorylation affects
the activity of peptidoglycan biosynthetic enzymes or cell division
proteins.
*10.* PLoS One. 2010 May 7; Volume 5, Number 5: e10527. *Incident
Tuberculosis during Antiretroviral Therapy Contributes to Suboptimal Immune
Reconstitution in a Large Urban HIV Clinic in Sub-Saharan Africa; *Hermans,
S.M., Kiragga, A.N., Schaefer, P., Kambugu, A., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20479873>
Antiretroviral therapy (ART) effectively decreases TB incidence long-term,
but is associated with high TB incidence rates in the first 6 months. The
researchers determined the incidence and long-term effects of TB during ART
on HIV treatment outcome, and the risk factors for incident TB during ART in
a large urban HIV clinic in Uganda. Routinely collected longitudinal
clinical data from all patients initiated on first-line ART was
retrospectively analyzed. 5,982 patients were included with a median
baseline CD4+ T cell count (CD4 count) of 117 cells/mm(3) (interquartile
range [IQR]; 42, 182). In the first 2 years, there were 336 (5.6%) incident
TB events in 10,710 person-years (py) of follow-up (3.14 cases/100 pyar [95%
CI 2.82-3.49]); incidence rates at 0-3, 3-6, 6-12 and 12-24 months were
11.25 (9.58-13.21), 6.27 (4.99-7.87), 2.47 (1.87-3.36) and 1.02 (0.80-1.31),
respectively. Incident TB during ART was independently associated with
baseline CD4 count of <50 cells/mm(3) (hazard ratio [HR] 1.84 [1.25-2.70], P
= 0.002) and male gender (HR 1.68 [1.34-2.11], P<0.001). After two years on
ART, the patients who had developed TB in the first 12 months had a
significantly lower median CD4 count increase (184 cells/mm(3) [IQR; 107,
258, n = 118] vs 209 cells/mm(3) [124, 309, n = 2166], P = 0.01), a larger
proportion of suboptimal immune reconstitution according to two definitions
(increase in CD4 count <200 cells/mm(3): 57.4% vs 46.9%, P = 0.03, and
absolute CD4 count <200 cells/mm(3): 30.4 vs 19.9%, P = 0.006), and a higher
percentage of immunological failure according to the WHO criteria (13.6% vs
6.5%, P = 0.003). Incident TB during ART was independently associated with
poor CD4 count recovery and fulfilling WHO immunological failure
definitions. Incident TB during ART occurs most often within 3 months and in
patients with CD4 counts less than 50 cells/mm(3). Incident TB during ART is
associated with long-term impairment in immune recovery.
*11.* Salud Publica de Mexico. 2010 Jun; Volume 52, Number 3: 185-9.
*Adjunctive
Micronutrient Supplementation for Pulmonary Tuberculosis; *Armijos, R.X.,
Weigel, M.M., Chacon, R., Flores, L., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20485880>
To assess the effect of micronutrient supplementation on TB patient
outcomes, a randomized, double-blinded, placebo-controlled study was
conducted in pulmonary TB patients undergoing DOTS/ tratamiento acortado
estrictamente supervisado (TAES) at IMSS in Ciudad Juarez, Chihuahua,
Mexico, who were recruited during August 2005-July 2006. Consecutive
patients received zinc and vitamin A supplements or matched placebo for four
months. Dietary intake, blood zinc and vitamin A, immune response
(IFN-gamma,TNF-alpha, and IL-10 mRNA), and sputum smear conversion were
measured. The proportion of micronutrient compared to placebo group subjects
with a negative sputum smear by month 3 was significantly increased (p=
0.03). This occurred subsequent to increased TNF-alpha and IFN-gamma and
decreased IL-10 observed at month 2. Micronutrient supplementation appeared
to accelerate the beneficial therapeutic effect of chemotherapy. The earlier
elimination of bacilli from sputum was associated with improved zinc status
and Th1 immune response. The therapeutic effect of vitamin A was less
evident.
*12.* Travel Medicine and Infectious Disease. 2010 Mar; Volume 8, Number 2:
120-8. Epub 2009 Oct 1. *Three Air Travel-Related Contact Investigations
Associated with Infectious Tuberculosis, 2007-2008; *Kornylo-Duong, K., Kim,
C., Cramer, E.H., Buff, A.M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20478520>
The potential for transmission of *Mycobacterium tuberculosis* during air
travel has garnered considerable attention in the media and among public
health authorities due to high-profile cases of international travelers with
infectious TB. During 2007 and 2008, state and local health officials were
asked to locate and conduct diagnostic follow-up for airline passengers
considered contacts of three travelers, two with multidrug-resistant (MDR)
TB and one considered highly contagious, who undertook air travel while
infectious with TB disease. Public health departments in 21 states located
and evaluated 79 (60%) of the 131 passenger contacts identified; 52 (40%)
were lost to follow-up. Eight (10%) contacts had a history of TB disease or
latent TB infection and were not retested. Sixteen (23%) of 71 contacts
tested had positive TB test results suggesting latent TB infection, 15 of
whom were from countries reporting estimated TB disease rates of greater
than 200 cases/100,000 persons. Passenger contacts' positive test results
may represent prior TB infection acquired in their countries of residence or
may be a result of new TB infection resulting from exposure during air
travel.
*13.* Travel Medicine and Infectious Disease. 2010 Mar; Volume 8, Number 2:
113-9. Epub 2010 Mar 6. *Air Travel by Individuals with Active Tuberculosis:
Reporting Patterns and Epidemiologic Characteristics, Canada
2006-2008; *Scholten,
D., Saunders, A., Dawson, K., Wong, T., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20478519>
Investigations related to TB cases on airline flights have received
increased attention in recent years. In Canada, reports of air travel by
individuals with active TB disease are sent to the Public Health Agency of
Canada (PHAC) for public health risk assessment and contact follow-up. A
descriptive analysis was conducted to examine reporting patterns over time.
Reports of air travel by individuals with active TB disease received by PHAC
between January 2006 and December 2008 were reviewed. Descriptive analyses
were performed on variables related to reporting patterns, characteristics,
and actions taken. The number of reports increased each year with 18, 35,
and 51 reports received in 2006, 2007, and 2008, respectively. Of the 104
total cases, most were male (63%) and born outside of Canada (87%).
Ninety-eight cases (97%) met the criteria for infectiousness and a contact
investigation was initiated for 136 flights. Reports of air travel by
individuals with active TB disease have been increasing annually in Canada
in recent years. Outcomes of the subsequent contact investigations,
including passenger follow-up results and evidence of TB transmission, is
necessary to further evaluate the effectiveness of the Canadian guidelines.
*14.* Travel Medicine and Infectious Disease. 2010 Mar; Volume 8, Number 2:
104-12. Epub 2010 Mar 11. *Tuberculosis Investigations Associated with Air
Travel: U. S. Centers for Disease Control and Prevention, January 2007- June
2008; *Marienau, K.J., Burgess, G.W., Cramer, E., Averhoff, F.M.,et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20478518>
Contact investigations conducted in the United States of persons with TB who
traveled by air while infectious have increased. However, data about
transmission risks of *Mycobacterium tuberculosis* on aircraft are limited.
The researchers analyzed data on index TB cases and passenger contacts from
contact investigations initiated by the US Centers for Disease Control and
Prevention from January 2007 through June 2008. Contact investigations for
131 index cases met study inclusion criteria, including 4,550 passenger
contacts. US health departments reported TB screening test results for 758
(22%) of assigned contacts; 182 (24%) had positive results. Of the 142
passenger contacts with positive TB test results with information about risk
factors for prior TB infection, 130 (92%) had at least one risk factor and
12 (8%) had no risk factors. Positive TB test results were significantly
associated with risk factors for prior TB infection (OR 23; p<0.001). No
cases of TB disease among passenger contacts were reported. The risks of *M.
tuberculosis* transmission during air travel remain difficult to quantify.
Definitive assessment of transmission risks during flights and determination
of the effectiveness of contact-tracing efforts will require comprehensive
cohort studies.
*15.* Travel Medicine and Infectious Disease. 2010 Mar; Volume 8, Number 2:
90-5. Epub 2009 Dec 29. *The International Health Regulations (2005),
Tuberculosis and Air Travel; *Plotkin, B.J., Hardiman, M.C.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20478516>
In 2007, the World Health Organization's (WHO) revised International Health
Regulations (2005) (IHR or Regulations) entered into force across the globe.
The IHR contain a range of binding and advisory provisions for reporting,
health measures, capacity-building, and further procedures to address the
risks of international disease spread in international travel, transport,
and trade. While the prior versions of the Regulations were limited to a
short list of infectious diseases (which did not include TB), the revised
IHR cover virtually all serious internationally transmissible disease risks,
whether biological/infectious, chemical or radionuclear in origin, that meet
certain criteria. These revised Regulations are now generally applicable to
transnational TB transmission, including through air travel. In light of the
great numbers of persons undertaking international travel, the worldwide
geographical coverage of the IHR, and the emergence of extremely drug
resistant TB (XDR TB), these Regulations are an important element in
addressing these (and other) serious international public health risks. This
article describes the relevant provisions in the IHR, and their
applicability in this context.
*16.* Travel Medicine and Infectious Disease. 2010 Mar; Volume 8, Number 2:
84-9. Epub 2009 Mar 28. *Guidance from WHO on the Prevention and Control of
TB during Air Travel; *Martinez, L., Thomas, K., Figueroa, J.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20478515>
Although TB is not highly transmissible, there is a risk of transmission of
infection when close contact occurs between a person with active pulmonary
TB and other passengers for prolonged periods during air travel. The World
Health Organization first published *Tuberculosis and air travel: guidelines
for prevention and control *in 1998, in response to several incidents
involving TB in air travelers, with a second edition in 2006. A further
revision was undertaken to address issues arising from the emergence of
extensively resistant TB (XDR TB), the occurrence of several international
incidents involving TB and air travel, and the entry into force of the
revised International Health Regulations (IHR) in 2007. This article
describes the process followed in preparing the third edition, the special
issues considered and the conclusions reached, with recommendations for
travelers, physicians, public health authorities, and airline companies. New
material includes: (i) additional guidance on the assessment of
infectiousness, and on procedures, roles and responsibilities involved in
the prevention of transmission of infection on board and for dealing with
incidents; (ii) information on basic provisions of the IHR and measures
relevant to incidents involving TB among air travelers; and (iii) a proposed
procedure for carrying out contact investigations.
*17.* West African Journal of Medicine. 2009 Nov-Dec; Volume 28, Number 6:
353-7. *Drug Resistance of Mycobacterium tuberculosis Complex among Newly
Diagnosed Tuberculosis Cases in Burkina Faso; *Diande, S., Sangare, L.,
Kouanda, S., Dingoumda, B.I., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20486091>
In Burkina Faso, there is no recent data about the level of drug resistance
in *Mycobacterium tuberculosis* strains among newly diagnosed TB cases. This
study provides an update of the primary drug resistance of *Mycobacterium
tuberculosis* among patients in Burkina Faso. Mycobacterium strains were
identified in 323 newly diagnosed TB patients between April 2005 and
September 2006, and their susceptibility to isoniazid, rifampicin,
streptomycin, and ethambutol was determined according to the proportions
method. Among these patients, 243 accepted voluntarily to be tested for
antibodies to HIV. The age range of the patients was 11 to 75 years and
included 221 (68.4%) males and 102 (21.6%) females. The isolates included
314 (97.2%) *M. tuberculosis*, eight (0.3%) *M. africanum* and one *M. bovis
*. Thirty-nine (12.4%) of the *M. tuberculosis* strains were resistant, with
7.3% resistant to one drug, 2.9% to two drugs, 0.3% to three drugs, and 1.9%
to four drugs. In total 3.2% of the isolates were multidrug-resistant (MDR).
One isolate of *M. africanum* was resistant to all drugs while the single
strain of *M. bovis* was sensitive to all the drugs. Among the 243 patients
tested for HIV, 77 were positive. However, there was no relationship between
drug resistance and gender, age group or HIV serostatus of the patients. The
resistance rate of *M. tuberculosis* strains to all four drugs tested
(12.4%) and the rate of MDR (3.2%) are high. These results demand an
increased effort by the National Tuberculosis Program to limit the spread of
MDR strains of TB.
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. 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.
*2. Health Education Specialist (Training Specialist III – Job #2761) *
*Sponsor: The Heartland National TB Center (HNTC)*
Location: San Antonio, Texas
Responsibilities:
Performs duties to plan, develop, coordinate, participate in, and evaluate
all aspects of education and training provided by the Center, including
educational design, curriculum development, and development of goals,
objectives, and content; identify educational needs and target audiences;
travel to conduct presentations/workshops; participate in
workgroups/planning committees; prepare narrative/statistical reports; and
write articles. The candidate will be required to travel throughout the HNTC
region and nation. Bachelor’s degree with 5 years experience in related
duties. Experience in lieu of education may be substituted. Three years
experience in initiating health care based education, educational design,
and curriculum development. Masters in health education or public health
preferred. CHES certification preferred.
Competitive Salary + excellent benefits. Apply on-line http://www.uthct.edu/.
For more information on the HNTC project, call 1-800-TEX-LUNG, or visit our
website http://www.heartlandntbc.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. TB Management in HIV Patients: A Webinar Series
NEW*
Sponsor: Heartland National TB Center
Dates: July 27, 2010; August 3, 2010; August 17, 2010
Location: Nationwide, USA
Application Deadline: July 23, 2010
The webinar series is intended for TB program staff and clinical personnel
including physicians, nurses, and other healthcare staff who manage and
treat patients infected with TB and HIV. The series will provide health care
professionals with the knowledge to competently diagnose and manage patients
that are coinfected with TB and HIV. Registration for Part 1 automatically
registers the participant for the whole series.
This webinar includes 3 parts: Part 1: Diagnosis of TB in the HIV Patient -
July 27, 2010; Part 2: Treatment of TB in the HIV Patient - August 3, 2010;
Part 3: Special Topics in the Management of TB in the HIV Patient - August
17, 2010. (Time: 12:00 – 1:30 pm CST).
For more information, contact Robert Granger, Heartland National TB Center.
E-mail
; phone (210) 531-4509; or access the Web site at
http://www.heartlandntbc.org/training.asp .
*2. Understanding and Managing Latent TB Infection
NEW*
Sponsor: Heartland National TB Center
Date: August 24, 2010
Location: Arnold, Missouri
Application Deadline: August 6, 2010
This course 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 .
*3. Handling TB and HIV Co-Infection NEW*
Sponsor: Heartland National TB Center
Dates: September 15 – 16, 2010
Location: Fargo, North Dakota
Application Deadline: August 25, 2010
This course is designed for physicians, nurses, and other health care
workers (counseling nurses, HIV case managers) who manage TB patients
coinfected with HIV. It will enhance the clinician’s knowledge and skills
through an overview of HIV infection, latent TB infection, and TB disease by
discussing diagnosis and treatment; jointly managing HIV and TB drug
therapies; drug side effects and toxicities; and HIV Opt Out policies and
recommendations.
There is no fee, but enrollment is limited. Pre-registration is required.
Continuing education credits are available.
For more information, contact Robert Granger, Heartland National TB Center.
E-mail
; phone (210) 531-4509; or access the Web site at
http://www.heartlandntbc.org/training.asp .
4. 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/ .
*5. 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/ .
*6. Understanding Tuberculosis *
Sponsor: The Tuberculosis Survival Response
Paul (Mayho) Thorn, author of The Tuberculosis Survival Handbook is offering
a half-day workshop to raise awareness of TB among key front-line workers,
and anyone else who comes into contact with the public and clients in the UK
who may be at a higher risk of developing active TB disease.
Do you work with people with alcohol and drug problems; the homeless;
prisoners; or people who live in poverty, poor or overcrowded living
conditions, or have other health issues such as HIV?
Are you concerned about the risks to yourself? Do you need to know more
about the disease?
The outcome of attending the workshop will be a better understanding of TB,
its prevention and treatment. It will provide an insight into the impact of
the disease on individuals and society today, and an informed understanding
of your risks while working with people who may be at a higher risk of
developing active TB disease.
Cost per person £22.50. The Tuberculosis Survival Response can deliver the
workshop to your team at your place of work, or alternatively organize an
external venue. To find out more, e-mail
For more information about this workshop, visit
http://www.understandingtb.org/ .
*7. 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/ .
*8. 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 receiving continuing medical education (CME) or
continuing nursing education (CNE) contact hours, please visit:
http://www.nationaltbcenter.edu/med_mgmt/
*9. 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
*10. How to Teach Tuberculin Skin Testing: A Train-the-Trainer Workshop *
Sponsors: University of Medicine & Dentistry of New Jersey (UMDNJ). New
Jersey Medical School Global Tuberculosis Institute. UMDNJ-Center for
Continuing and Outreach Education
Dates: July 21 - 22, 2010
Location: Newark, New Jersey
This intensive two-day workshop will cover the principles of adult
education, teaching strategies, and planning and conducting a TST Training.
The course includes some lecture sessions; however, the format is highly
interactive with an emphasis on role plays, group exercises, and practice
teaching of course content including TST demonstration.
This workshop is designed for licensed health professionals who are
responsible for training others in tuberculin skin testing (TST).
Participants must be proficient in the technique of administering and
reading the Mantoux tuberculin skin test.
For more information and application, contact DJ McCabe, Email:
, Phone: (973) 972-0978, or visit:
http://www.umdnj.edu/globaltb/courses/brochures/tst2010.html
* *
*11. TB Education and Training Network (TB ETN) Conference *
Sponsor: Centers for Disease Control and Prevention (CDC), Division of
Tuberculosis Elimination (DTBE).
Dates: August 10 – 12, 2010
Location: Atlanta, GA
The 10th annual TB Education and Training Network (TB ETN) Conference, "TB
Education, Training, and Evaluation: Fitting the Pieces Together," will be
held in Atlanta, Georgia, August 10-12, 2010, at the Westin Atlanta
Perimeter North. For a second year, TB ETN and the TB Program Evaluation
Network (TB PEN) will join forces to highlight the common aspects of TB
education, training, and evaluation. The conference will focus on a variety
of topics, including partnerships, social determinants of health, capacity
building, and tools of the trade that enhance TB education, training, and
program evaluation. Conference activities will include skills-based
workshops, informational presentations, and networking opportunities.
10th Anniversary Celebration of TB ETN: TB ETN will be celebrating the 10th
anniversary of bringing TB professionals together to network, share
resources, and build education and training skills. In recognition of this
milestone, a special reception will be held on August 10, 2010, at the
Westin Atlanta Perimeter North, in Atlanta, GA, from 5:00-7:00 pm.
For more information, contact CDC DTBE, 1600 Clifton Rd., NE MS E10,
Atlanta, GA 30333. E-mail ; phone 800-CDC-INFO
(800-232-4636); TTY (888) 232-6348; or access the Web site at
http://www.cdc.gov/tb/education/tbetn/conference.htm .
Registration fee: $50.00/TB ETN members; $75.00/Non-members. Continuing
education credits are available.
*12. Tuberculosis Program Manager's Intensive *
Sponsor: The Francis J. Curry National Tuberculosis Center
Dates: August 17 – 20, 2010
Location: San Francisco, California
This course is for nurses, physicians, and other health professionals
working as TB program managers. The training will cover: role of the program
manager, epidemiology of TB, treatment completion strategies, TB outbreaks,
contact investigation, quality assurance, staff training and budgeting,
infection control, program planning/grants, and program evaluation.
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 at
http://www.nationaltbcenter.ucsf.edu/training/tbpmi10.cfm .
*13. Open Forum 4 — Key Issues in TB Drug Development*
Sponsor: The Global Alliance for TB Drug Development (TB Alliance)
Dates: August 18 – 19, 2010
Location: Addis Ababa, Ethiopia
This two-day Open Forum will be the fourth in a series of meetings aimed to
raise and address key issues in TB drug development, with a special focus on
regulatory affairs.
The Forum will include sessions on the current global TB drug development
portfolio, key issues in the critical path to TB drug registration,
designing pivotal trials, conducting registration trials in high TB burden
countries, challenges in TB drug development for resistant disease, and
developing regimens containing multiple novel agents.
These meetings are designed to bring together regulators, TB drug
developers, and other interested stakeholders, such as TB care providers,
public health policy makers, and community advocates from both major
industrialized and high burden countries. Open Forum 4 will have a special
focus on Africa and the regulatory challenges it faces.
For inquiries about this event, please contact: .
Registration for the event is free and currently open at:
http://www.tballiance.org/events/openforum4.php .
*14. 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> .
*15. Tuberculosis Clinical Intensive *
Sponsor: The Francis J. Curry National Tuberculosis Center (CNTC)
Dates: September 21 – 23, 2010
Location: San Francisco, California
Application deadline: August 5, 2010
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 .
*16. 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
Registration Deadline: September 1, 2010
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 .* *
*17. 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 information , contact Jennifer Kanouse, Program Manager. E-mail
; phone (415)502-2712; or access the Web
site at http://www.nationaltbcenter.edu/training/tbcmcioct10.cfm .
*18. 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/ .
*19. 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
Abstracts submission deadline: July 30, 2010
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. The presentations will be selected
from abstracts submitted to the late-breaker co-chairs by July 30, 2010.
Persons submitting abstracts will be notified of acceptance or rejection of
their abstract by September 3, 2010.
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.
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