MDR-TB Treatment & Prevention
Fwd: [tb-update] Week of October 2 to October 8, 2011
TB-Related News and Journal Items Weekly Update Week of October 2 to
October 8, 2011
To subscribe to the list, or to change your subscription options, please
visit:
https://www.cdcnpin.org/framework/ui/login.aspx?re=/lyris/ui/subscriptions.aspx,
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
releases, and announcements. Reproduction of this text is encouraged;
however, copies may not be sold. For those items reproduced from the first
section of the TB weekly update, the CDC HIV/Hepatitis/STD/TB Prevention
News Update should be cited. For any other items in the TB weekly update,
you may cite the CDC TB-Related News and Journal Items Weekly Update.
This Week's Contents
TB-Related Announcements <#132defe24cb3422f_H1>
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News
Update<#132defe24cb3422f_H2>
Headlines <#132defe24cb3422f_H3>
Journal Articles <#132defe24cb3422f_H4>
Job Announcements <#132defe24cb3422f_H5>
Upcoming Conferences, Trainings, and Other Events <#132defe24cb3422f_H6>
TB-Related Announcements
*1. WHO and PATH Publish Toolkit on Strategies to Address MDR-TB* *NEW*
Stop TB Partnership, October 4, 2011
WHO and PATH have published a
toolkit<http://www.path.org/publications/detail.php?i=1678>designed to
help countries develop or strengthen the multidrug-resistant TB
(MDR TB) components within national TB strategies or plans.
The toolkit contains guidance on the key steps of the planning process,
including developing objectives, identifying current gaps in service
coverage, securing funding sources, and determining how to monitor progress.
The toolkit is aimed at countries, technical partners, international
organizations, and donors who want to improve the detection and treatment of
drug-resistant TB.
A MDR-TB assessment and monitoring
tool<http://www.path.org/publications/detail.php?i=1678>,
on which the new toolkit is based, is also available in English, Russian,
and Spanish.
For the announcement, visit:
http://stoptb.org/news/announcements/2011/a11_018.asp
* *
* *
*2. 5**th edition of the “Core Curriculum on Tuberculosis: What the
Clinician Should Know”** *
CDC, Division of Tuberculosis Elimination (DTBE)
The CDC, Division of Tuberculosis Elimination (DTBE) announces the release
of the 5th edition of the *Core Curriculum on Tuberculosis: What the
Clinician Should Know. *The *Core Curriculum* is* *intended for use as a
self-study guide or reference manual for clinicians and other public health
professionals caring for people with or at high risk for TB disease or
infection. In addition, the *Core Curriculum* includes a slide set designed
to be useful in developing educational programs.
Originally developed in 1989 and last updated in 2000, the *Core
Curriculum*required further revisions to reflect new guidelines for TB
prevention,
treatment, testing, diagnosis, and patient management and public health
practice. The *Core Curriculum *includes the following chapters:
Chapter 1 – Overview of TB Epidemiology in the United States
Chapter 2 – Transmission and Pathogenesis of TB
Chapter 3 – Testing for TB Infection and Disease
Chapter 4 – Diagnosis of TB Disease
Chapter 5 – Treatment of LTBI
Chapter 6 – Treatment of TB Disease
Chapter 7 – TB Infection Control
Chapter 8 – Community TB Control
To view the *Core Curriculum*, please visit:
http://www.cdc.gov/tb/education/corecurr/default.htm* *
To view or download the *Core Curriculum *slide set, please visit:
<https://mail.danya.com/owa/redir.aspx?C=cfdccaddd4a5462781471e38d0f1a4d3&URL=...>
http://www.cdc.gov/tb/publications/slidesets/corecurr/default.htm
Continuing education (CE) credits are offered free of charge for various
professions. More information about CE credits is available at
http://www.cdc.gov/tb/education/CE/default.htm.
Print copies of the *Core Curriculum *will be available for ordering by the
end of October.
* *
* *
*3. Round 11 Global Fund Launch: Let's Make It a TB Round! *
Stop TB Partnership, August 15, 2011
Proposal submission deadline: December 15, 2011
August 15, 2011, was a very important day for all people committed to making
TB care available to all who need it. It marked the launch of Round 11 of
the Global Fund to Fight AIDS, Tuberculosis and Malaria. The year in which
the Stop TB Partnership has committed to meet the MDGs and the targets of
the Global Plan to Stop TB is 2015. Round 11 provides a unique and timely
opportunity to move forward. The Stop TB Partnership wants to make it as
easy as possible for eligible countries to write high-quality proposals that
are specifically tailored to each country's context and are inclusive,
sharp, and linked to clear gap analysis and budgets.
To this end, a user-friendly web
page<http://www.stoptb.org/global/tbfriends/>has been established that
includes guidance and tools to help you prepare
the best possible proposal and links you to other partners' resources. The
Stop TB Partnership encourages you to visit the page often, as new and
helpful materials will continually be added to the page.
On August 15, the Stop TB Partnership launched an e-mail-based Round 11
hotline – . The staff in the Stop TB Partnership
Secretariat and colleagues from the WHO Stop TB Department will be on a
continuous duty roster, ready to answer questions that come up as you write
your proposal. The hotline will remain live until December 15, the deadline
for proposal submission.
The Stop TB Partnership urges you to include in your TB proposals strong
components on civil society strengthening and to make sure that community
representatives are included in all stages of planning and preparation of
your Global Fund proposals.
You are welcome to write directly to Dr. Lucica Ditiu, Executive Secretary,
Stop TB Partnership, for advice or to share your thoughts or challenges,
using the hotline address .
For more information, visit
http://www.stoptb.org/news/stories/2011/ns11_056.asp.
* *
*4. Call for Papers *
Tuberculosis Research and Treatment Journal
Manuscript Due: November 18, 2011
Tuberculosis Research and Treatment invites investigators to contribute
original research articles and review articles that describe public health
theory or efforts that demonstrate the critical importance of adopting and
implementing innovative techniques and methods for detection, prevention,
control, and treatment of TB. Furthermore, space will be allocated for those
that highlight the process of translation, policy implementation, and
impact. Legal and regulatory reforms are important parts of the policy
process. Potential topics include, but are not limited to:
- Surveillance, including establishing new systems components,
innovation, and enhancements, and their relationship to public health policy
and practice
- Testing and implementation of new diagnostics into existing practice
and algorithms
- Innovative methods for detection and control of transmission
- Development of new drugs and drug regimens for treatment of disease
and latent TB infection
- Translating innovation into public health practice
- Importance and impact of policy, including legal and reform, for
implementation of innovative methods and techniques for control of
tuberculosis
Before submission, authors should carefully read the journal's Author
Guidelines, which are located at
http://www.hindawi.com/journals/trt/guidelines/. Prospective authors should
submit an electronic copy of their complete manuscript through the journal
Manuscript Tracking System at http://mts.hindawi.com/ according to the
following timetable:
Manuscript Due: November 18, 2011
First Round of Reviews: February 17, 2012
Publication Date: May 18, 2012
For more information, visit http://www.hindawi.com/journals/trt/si/pait/.
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News Update
*1. County: TB Not an Issue at Game (Texas)*
Dallas Morning News, September 30, 2011, by Sherry Jacobson
On September 29, Dallas County health authorities acted to alleviate fears
about the spread of TB in Ennis, where a TB investigation is underway at a
local high school. Blanca Cantu, a spokesperson for Dallas County Health and
Human Services, said some parents mistakenly believed that football players
might be exposed to the infection during the September 30 game between teams
from Ennis high school and Waxahachie. News reports indicated that the
Waxahachie team brought its own equipment and water to avoid possible
contamination. “There is no risk being an athlete on a team and drinking
someone else’s water,” said Dr. Garry Woo, the county’s medical director of
TB control. “TB is an airborne disease that normally is transmitted by an
infectious person who has been coughing on other people. It takes prolonged
exposure to spread this disease,” Woo said, adding that such exposure is
unlikely at a sporting event. Since early September, when a person
associated with the high school was diagnosed with active TB disease,
testing of 481 potentially exposed individuals has identified 128 who are
positive for latent TB infection. Free screenings for the local high school
students and staff are continuing.
*2. State Officials Say Westminster Student Has TB (Missouri)*
Associated Press, October 1, 2011
A student at a college in Fulton, Missouri, has been diagnosed with active
TB disease, according to the Missouri State Health Department. The diagnosis
resulted from a routine screening at the college, and officials are working
with the patient to identify persons who may have had prolonged regular
contact with her or him. The student has been isolated and is undergoing
treatment, Westminster said, adding there is no need for anyone in the
college community to take special precautions at this time.
Headlines
*1. European Union Invests 30 Million Euros in New Vaccine Research
Programme *
Stop TB Partnership, www.stoptb.org, October 1, 2011
The European Union has invested €30 million (approximately US $40,000,000)
in the Advanced Immunization Technologies (ADITEC) program to accelerate the
development of vaccines. The program was instituted by scientists from 42
research partners in 13 countries for the purpose of encouraging
collaborative development of new immunization technologies. Jelle Thole,
Director of the TB Vaccine Initiative and one of the architects of ADITEC,
commented on the urgent need for new TB vaccines, since the only available
vaccine is 90 years old and does not protect against pulmonary TB. He noted
that the development of new TB vaccines has been back on track in the past
10 years, and the new techniques emerging from this research program will
definitely accelerate the process. Partners in ADITEC include leading
universities and research institutions, pharmaceutical and biotechnology
companies, and the World Health Organization.
*2. San Diegans May Have Been Exposed to TB (United States)*
NBC San Diego, www.nbcsandiego.com, October 3, 2011, by Lindsay Hood
County health officials in San Diego are notifying the public that they may
have been exposed to TB from a fellow bus passenger. Anyone who rode the
Metropolitan Transit System (MTS) route 860 express bus in the mornings from
the Carmel Mountain Ranch area to Pacific Highway and Grape Street and back
in the evenings, from June 1 to September 14, could have been exposed to the
disease. The county encourages all who think they may have been exposed to
call their physician, or contact the county TB control program at (619)
692-8621.
*3. Award Winner Calls for Dedicated Inpatient Unit for Treatment of TB
(United Kingdom)*
Irish Medical Times, www.imt.ie, September 29, 2011, by Lloyd Mudiwa,
Professor Joseph Keane, Director of Clinical TB Services, St. James’s
Supra-regional Center, Dublin, Ireland, and winner of the inaugural William
Stokes Award, has commented on the need for a dedicated inpatient TB
treatment unit in Dublin. The Supra-regional Center has been treating TB
patients since the TB service at Peamount, Dublin, closed six years ago. He
stated that plans were underway with the Health and Safety Executive (HSE)
to construct a new TB facility at St. James’s. The facility will have a
16-bed isolation unit, five-days-a week open access TB screening outpatient
service, and the co-located Irish mycobacteria reference laboratories.
Prof. Keane explained that although most cases are treated in the community,
it was important to have the inpatient option to treat the more resistant
and complex TB cases, particularly in this era of multidrug- and extensively
drug-resistant TB. The facility will cost approximately €11 million, but
Prof. Keane argued that the cost should not delay construction, as caring
for the more difficult cases in the facility would be more cost-effective
than the present situation. Also, the facility would be a resource for
regional general hospitals to send their difficult-to-treat cases. Prof.
Keane anticipated clinical and research productivity resulting from such a
facility and noted that the financial investment would generate a center of
excellence for TB care and research to benefit the entire country.
*4. DST Lab to Benefit TB Patients (India)*
Deccan Chronicle, www.deccanchronicle.com, October 1, 2011
The government of Andhra Pradesh state has modernized the local chest
disease hospital in the north Andhra region. The hospital will provide
state-of-the-art equipment in a drug susceptibility testing laboratory, the
first of its kind in the region. The lab will be used to diagnose patients
who cannot afford a private hospital. It was provided by the World Health
Organization and the central TB Division. According to Dr. P. Subba Rao, 56
MDR TB patients were diagnosed using the new equipment and treated since May
this year. A 30-bed inpatient accommodation has been provided for patients
referred through the District TB Control Program.
*5. Current Smoking Rates Could Lead to Millions of TB Deaths (Global)*
WebMD, www.webmd.com, October 4, 2011, by Kathleen Doheny
According to a study by Sanjay Basu, MD, PhD, and colleagues, if smoking is
not controlled worldwide, it could cause an increase in TB disease and
deaths between 2010 and 2050. The researchers created a mathematical model
of TB epidemics to compute the impact of smoking trends on TB. They
projected incidence of TB, TB mortality, prevalence, and mortality from 2010
to 2050, taking into account changing trends in smoking, TB treatment, and
other factors. The model predicted that if smoking continues along the
present trends, it could result in 18 million new TB cases and 40 million
deaths from TB. The number of TB cases would increase by seven percent, from
256 million to 274 million, and the number of TB deaths would increase by 66
percent from 61 million to 101 million. The areas most likely to be affected
by new TB cases linked to smoking would be Africa, the Eastern
Mediterranean, and Southeast Asia. The researchers also estimated that if
smoking rates were aggressively lowered, TB deaths linked to smoking could
decrease by 27 million by 2050. They defined aggressive lowering as a
decrease of one percent per year until smoking is eliminated. The study was
published online in the *British Medical Journal* 2011; 343:d5506 doi:
10.1136/bmj.d5506
*6. Doctor Bares Half His Face to the Razor for TB Cause (United Kingdom)*
The Courier, www.warwickcourier.co.uk, mailto:October 5, 2011, by Sundari
Sandar,
Dr. Dipanker Bose, a consultant anesthetist and intensive care consultant at
Warwick Hospital, Warwickshire, England, recently sponsored a beard shaving
event to raise money for TB Alert, a charity that supports TB awareness and
treatment. The doctor had his beard shaved off in systematic chunks, and
worked the rest of the day with a patchwork beard. Dr. Bose and his son Abi,
who also had his beard shaved, had a personal reason for holding the
fundraiser. Dr. Dipanker’s wife, Anjali, is seriously ill with TB disease
and in the hospital. Anjali, who is also a doctor, was being treated for
rheumatoid arthritis with strong immunosuppressants. According to Dr.
Dipanker, one of the risks of taking immunosuppressants is that these drugs
can trigger TB in someone with latent TB infection (LTBI); therefore, a
great effort should be made to detect whether the patient has LTBI before
being placed on immunosuppressants. Anjali will have to undergo TB treatment
for at least another year. Dr. Dipankar advocates absolutely strict
protocols, ensuring that strong immunosuppressant drugs should not be
prescribed without prior testing for LTBI. He also emphasized that TB does
not happen only to the poor, homeless, and malnourished, but that everybody
is at risk. He called for more research into better vaccines.
*7. Spanish-Language Series Offers New Educational Tool for TB Awareness
(United States**)*
University of Florida News, http://news.ufl.edu, September 28, 2011, by
Claudia Adrien,
“Live Life to the Fullest!” or in Spanish, “¡Vivir a Todo Pulmón!” is a
40-page recently released Spanish-language series that addresses
misconceptions about TB to better educate communities that are vulnerable to
the disease. According to Dr. Paula Hamsho-Diaz, a physician with the
Southeastern National TB Center of the University of Florida College of
Medicine and UF Emerging Pathogens Institute, the idea was to create a story
understandable to a Latino audience, but identifiable to the Mexican
community. The story was modeled after the storyline of a stereotypical
Latin-American soap opera. In the fotonovela, a woman accompanies her
husband to the doctor’s office, social events, and Sunday mass, where the
concerns and stigmas are addressed that family, friends, or co-workers
living with TB might encounter. The team that created the fotonovela was led
by Dr. Hamsho-Diaz, and it took three years to develop and evaluate the
cultural appropriateness of the themes incorporated into the story. The
fotonovela is similar to a graphic novel, but uses photographs instead of
drawings. To access the fotonovela, visit
http://sntc.medicine.ufl.edu/Products.aspx.
Journal Articles
*1.* Acta Medica Okayama. 2011 Aug; Volume 65, Number 4: 259-63. *Is
Adenosine Deaminase in Pleural Fluid a Useful Marker for Differentiating
Tuberculosis from Lung Cancer or Mesothelioma in Japan, a Country with
Intermediate Incidence of Tuberculosis? *Ogata, Y., Aoe, K., Hiraki, A.,
Murakami, K., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21860532>
This study evaluated the utility of the determination of adenosine deaminase
(ADA) level in pleural fluid for the differential diagnosis between
tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) in
Japan, a country with intermediate incidence of TB. The researchers
retrospectively reviewed the clinical records of 435 patients with pleural
effusion and investigated their pleural ADA levels as determined by an auto
analyzer. ROC analysis was also performed. The study included patients with
MPE (n＝188), TPE (n＝124), benign nontuberculous pleural effusion (n＝94), and
pleural effusion of unknown etiology (n＝29). The median ADA level in the TPE
group was 70.8U/L, which was significantly higher than that in any other
groups (p＜0.05). The area under the curve (AUC) in ROC analysis was 0.895.
With a cut-off level for ADA of 36U/L, the sensitivity, specificity,
positive predictive value, and negative predictive value were 85.5%, 86.5%,
69.7%, and 93.6%, respectively. As many as 9% of patients with lung cancer
and 15% of those with mesothelioma were false-positive with this ADA cutoff
setting. Although the ADA activity in pleural fluid can help in the
diagnosis of TPE, it should be noted that some cases of lung cancer or
mesothelioma show high ADA activity in geographical regions with
intermediate incidence of TB, in contrast to high prevalence areas.
*2.* APMIS. 2011 Sep; Volume 119, Number 9: 581-587. doi:
10.1111/j.1600-0463.2011.02790.x. Epub 2011 Jul 5. *Epidemiological Studies
of Beijing Strains of Mycobacterium tuberculosis from Taipei and Other Asian
Cities Based on MIRU Profiles;* Sun, J.R., Dou, H.Y., Lee, S.Y., Chiueh,
T.S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21851415>
This study investigated the distribution of the Beijing strains of
*Mycobacterium
tuberculosis* (MTB) in Taipei and other Asian cities. A total of 323 MTB
isolates were analyzed by spacer oligonucleotide typing (spoligotyping) and
mycobacterial interspersed repetitive unit (MIRU) typing. The largest
cluster of the TB isolates from Taipei was type MT11 (MIRU type
2233-2517-3533). A comparison of the MIRU type data for the Beijing strains
from Taipei and previously published MIRU type data for the Beijing strains
from Asian cities with major population of Chinese was analyzed. The six
major Beijing MIRU types (MT01, MT02, MT08, MT11, MT21, and MT44) were found
to be common in four Asian cities including Taipei, Singapore, Hong Kong,
and Wuhan. Results of this study indicate that there is geographical
difference in the distribution of different Beijing strains of MTB.
*3.* BMC Infectious Diseases. 2011 Aug 16; Volume 11: 219. *Tuberculosis in
Sudan: A Study of Mycobacterium tuberculosis Strain Genotype and
Susceptibility to Anti-Tuberculosis Drugs;* Sharaf Eldin, G.S., Fadl-Elmula,
I., Ali, M.S., Ali, A.B., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21846389>
Sudan is a large country with a diverse population and history of civil
conflict. Poverty levels are high with a gross national income per capita of
less than two thousand dollars. The country has a high burden of TB with an
estimated 50,000 incident cases during 2009, when the estimated prevalence
was 209 cases per 100,000 of the population. Few studies have been
undertaken on TB in Sudan and the prevalence of drug resistant disease is
not known. In this study *Mycobacterium tuberculosis* isolates from 235
patients attending three treatment centers in Sudan were screened for
susceptibility to isoniazid, rifampicin, ethambutol, and streptomycin by the
proportion method on Lowenstein Jensen media. Two hundred and thirty-two
isolates were also genotyped by spoligotyping. Demographic details of
patients were recorded using a structured questionnaire. Statistical
analyses were conducted to examine the associations between drug resistance
with risk ratios computed for a set of risk factors (gender, age, case
status - new or relapse, geographic origin of the patient, spoligotype,
number of people per room, marital status and type of housing.
Multidrug-resistant TB (MDR TB), being the resistance to at least rifampicin
and isoniazid, was found in 5% (95% CI: 2,8) of new cases and 24% (95% CI:
14,34) of previously treated patients. Drug resistance was associated with
previous treatment with risk ratios of 3.51 (95% CI: 2.69-4.60; p < 0.001)
for resistance to any drug and 5.23 (95% CI: 2.30-11.90; p < 0.001) for MDR
TB. Resistance was also associated with the geographic region of origin of
the patient, being most frequently observed in patients from the Northern
region and least in the Eastern region with risk ratios of 7.43
(95%CI:3.42,16.18; p: < 0.001) and 14.09 (95%CI:1.80,110.53; p:0.026) for
resistance to any drug and MDR TB. The major genotype observed was of the
Central Asia spoligotype family (CAS1_Delhi), representing 49% of the 232
isolates examined. It is concluded that emergence of drug resistant TB has
the potential to be a serious public health problem in Sudan and that
strengthened TB control and improved monitoring of therapy is needed.
Further surveillance is required to fully ascertain the extent of the
problem.
*4.* British Journal of Nursing. 2011 Jul 15-28; Volume 20, Number 13:
824-7. *Latent Tuberculosis: Concordance and Duration of Treatment Regimens;
*Clerk, N., Sisson, K., Antunes, G.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21841691>
Over the past century, the United Kingdom has made significant progress in
combating TB through improved health care and better preventative measures.
However, it has now been identified as a new threat that needs concerted
action. An important component in dealing with this threat is identifying
and treating people with latent TB infection (LTBI). This will prevent
active disease and thwart the spread of TB infection. This study determined
whether treatment concordance was affected by length of treatment regimen in
the United Kingdom, and identified factors that may impact upon treatment
completion. The audit was spread over a two-year period and looked at all
patients on treatment for LTBI, using the UK recommended regimens of either
three months of dual therapy or six months using monotherapy. The results
indicated that the 3-month regimen had not improved concordance, as
expected, with a slightly better completion rate in the 6-month group.
However, the study did highlight a “lost-to-follow-up” group of patients,
who failed to present themselves following presumed completion.
*5.* Clinical & Developmental Immunology. 2011; Volume 2011: 549023. Epub
2011 Aug 25. *HLA-B57 and Gender Influence the Occurrence of Tuberculosis in
HIV Infected People of South India;* Jagannathan, L., Chaturvedi, M.,
Satish, B., Satish, K.S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21876708>
Substantial evidence exists for HLA and other host genetic factors being
determinants of susceptibility or resistance to infectious diseases.
However, very little information is available on the role of host genetic
factors in HIV-TB coinfection. Hence, a longitudinal study was undertaken to
investigate HLA associations in a cohort of HIV seropositive individuals
with and without TB in Bangalore, South India. A cohort of 238 HIV
seropositive subjects were typed for HLA-A, B, and DR by PCR-SSP and
followed up for 5 years or till manifestation of TB. HLA data of 682 HIV
negative healthy renal donors was used as control. The ratio of males and
females in HIV cohort was comparable (50.4% and 49.6%). But the incidence of
TB was markedly lower in females (12.6 %), than males (25.6%). Further,
HLA-B*57 frequency in HIV cohort was significantly higher among females
without TB (21.6%, 19/88) than males (1.7%, 1/59); P = 0.0046; OR = 38. CD4
counts also were higher among females in this cohort. This study suggests
that HIV positive women with HLA-B*57 have less occurrence of TB as compared
to males.
*6.* Clinical Infectious Diseases. 2011 Sep; Volume 53, Number 6:
555-62. *Current
Diagnosis and Management of Peripheral Tuberculous Lymphadenitis; *Fontanilla,
J.M., Barnes, A., von Reyn, C.F.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21865192>
Peripheral tuberculous lymphadenitis accounts for about 10% of TB cases in
the United States. Epidemiologic characteristics include a 1.4:1
female-to-male ratio, a peak age range of 30-40 years, and dominant foreign
birth, especially East Asian. Patients present with a 1-2 month history of
painless swelling of a single group of cervical lymph nodes. Definitive
diagnosis is by culture or nucleic amplification of *Mycobacterium
tuberculosis*; demonstration of acid-fast bacilli and granulomatous
inflammation may be helpful. Excisional biopsy has the highest sensitivity
at 80%, but fine-needle aspiration is less invasive and may be useful,
especially in immunocompromised hosts and in resource-limited settings.
Antimycobacterial therapy remains the cornerstone of treatment, but response
is slower than with pulmonary TB; persistent pain and swelling are common,
and paradoxical upgrading reactions may occur in 20% of patients. The role
of steroids is controversial. Initial excisional biopsy deserves
consideration for both optimal diagnosis and management of the otherwise
slow response to therapy.
*7.* Clinical Infectious Diseases. 2011 Oct; Volume 53, Number 7:
716-24. *Efficacy
and Safety of Once-Daily Nevirapine- or Efavirenz-Based Antiretroviral
Therapy in HIV-Associated Tuberculosis: A Randomized Clinical Trial;
*Swaminathan,
S., Padmapriyadarsini, C., Venkatesan, P., Narendran, G., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21890776>
Nevirapine (NVP) can be safely and effectively administered once-daily but
has not been assessed in HIV-infected patients with TB. The researchers
studied the safety and efficacy of once-daily NVP, compared with efavirenz
(EFV; standard therapy); both drugs were administered in combination with 2
nucleoside reverse-transcriptase inhibitors. An open-label, noninferiority,
randomized controlled clinical trial was conducted at 3 sites in southern
India. HIV-infected patients with TB were treated with a standard
short-course anti-TB regimen (2EHRZ(3)/4RH(3); [2 months of Ethambutol,
Isoniazid, Rifampicin, Pyrazinamide / 4 months of Isoniazid and Rifampicin]
thrice weekly) and randomized to receive once-daily EFV at a dose of 600 mg
or NVP at a dose of 400 mg (after 14 days of 200 mg administered once daily)
with didanosine 250/400 mg and lamivudine 300 mg after 2 months. Sputum
smears and mycobacterial cultures were performed every month. CD4+ cell
count, viral load, and liver function test results were monitored
periodically. Primary outcome was a composite of death, virological failure,
default, or serious adverse event (SAE) at 24 weeks. Both intent-to-treat
and per protocol analyses were done, and planned interim analyses were
performed. A total of 116 patients (75% [87 patients] of whom had pulmonary
TB), with a mean age of 36 years, a median CD4+ cell count of 84
cells/mm(3), and a median viral load of 310, 000 copies/mL, were randomized.
At 24 weeks, 50 of 59 patients in the EFV group and 37 of 57 patients in the
NVP group had virological suppression (P = .024). There were no deaths, 1
SAE, and 5 treatment failures in the EFV arm, compared with 5 deaths, 2
SAEs, and 10 treatment failures in the NVP arm. The trial was halted by the
data and safety monitoring board at the second interim analysis. Favorable
TB treatment outcomes were observed in 93% of the patients in the EFV arm
and 84% of the patients in the NVP arm (P = .058). Compared with a regimen
of didanosine, lamivudine, and EFV, a regimen of once-daily didanosine,
lamivudine, and NVP was inferior and was associated with more frequent
virologic failure and death.
*8.* Clinical Infectious Diseases. 2011 Jun; Volume 52, Number 11: 1374-83.
*Timing of Initiation of Antiretroviral Therapy in Human Immunodeficiency
virus (HIV)-Associated Tuberculous Meningitis;* Török, M.E., Yen, N.T.,
Chau, T.T., Mai, N.T., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21596680>
The optimal time to initiate antiretroviral therapy (ART) in HIV-associated
tuberculous meningitis is unknown. The researchers conducted a randomized,
double-blind, placebo-controlled trial of immediate versus deferred ART in
patients with HIV-associated tuberculous meningitis to determine whether
immediate ART reduced the risk of death. Antiretroviral drugs (zidovudine,
lamivudine, and efavirenz) were started either at study entry or 2 months
after randomization. All patients were treated with standard
antituberculosis treatment, adjunctive dexamethasone, and prophylactic
cotrimoxazole and were followed up for 12 months. The researchers conducted
intention-to-treat, per-protocol, and prespecified subgroup analyses. A
total of 253 patients were randomized, 127 in the immediate ART group and
126 in the deferred ART group; 76 and 70 patients died within 9 months in
the immediate and deferred ART groups, respectively. Immediate ART was not
significantly associated with 9-month mortality (hazard ratio [HR], 1.12;
95% confidence interval [CI], .81-1.55; P = .50) or the time to new AIDS
events or death (HR, 1.16; 95% CI, .87-1.55; P = .31). The percentage of
patients with severe (grade 3 or 4) adverse events was high in both arms
(90% in the immediate ART group and 89% in the deferred ART group; P = .84),
but there were significantly more grade 4 adverse events in the immediate
ART arm (102 in the immediate ART group vs. 87 in the deferred ART group; P
= .04). Immediate ART initiation does not improve outcome in patients
presenting with HIV-associated tuberculous meningitis. There were
significantly more grade 4 adverse events in the immediate ART arm,
supporting delayed initiation of ART in HIV-associated tuberculous
meningitis.
*9.* Diagnostic Microbiology and Infectious Disease. 2011 Sep; Volume 71,
Number 1: 57-65. *Diagnosis of Tuberculosis Infection by Tuberculin Skin
Test and a Whole-Blood Interferon-γ Release Assay in Patients Considered for
Anti-Tumor Necrosis Factor-α Therapy; *Casas, S., Andreu, A., Juanola, X.,
Bordas, X., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21851871>
This study assessed the performance of QuantiFERON®-TB Gold in-Tube
(QFT-GIT; Cellestis, Carnegie, Australia) and tuberculin skin test (TST) in
patients with immune-mediated inflammatory diseases (IMID), before
anti-tumor necrosis factor-α (TNF-α) therapy, and compared the results with
those from the healthy population. Three hundred fourteen subjects (214 with
IMID and 100 controls) underwent simultaneous QFT-GIT and TST. QFT-GIT was
positive in 21% of IMID patients and in 16% of controls (P = 0.29). Among
IMID patients, 21% tested positive by QFT-GIT and 24%, by TST (P = 0.30).
Positive QFT-GIT results were not affected by immunosuppressive therapy
(odds ratio, 0.78; 95% confidence interval [CI], 0.36-1.68; P = 0.52).
Agreement between both tests in those patients who tested positive by one of
the tests was 50% (95% CI, 37.2-62.8). QFT-GIT is useful for identifying
IMID patients requiring treatment of latent TB before anti-TNF therapy.
However, given the poor agreement between TST and QFT-GIT, the researchers
advocate a strategy of simultaneous testing to optimize diagnostic
sensitivity.
*10.* Disease Markers. 2011 Jan 1; Volume 31, Number 2: 101-10. *Prognostic
Values of Serum IP-10 and IL-17 in Patients with Pulmonary Tuberculosis; *Chen,
Y.C., Chin, C.H., Liu, S.F., Wu, C.C., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21897004>
This study identified patients at high risk of relapse after
antituberculosis (TB) therapy or with poor long-term outcomes. Subjects were
51 patients with pulmonary TB: 7 were classified as high association with
both cavitations on initial chest radiography and positive sputum
smear/cultures after two months of anti-TB treatment (HA group); 19 medium
association (MA, one risk alone); and 25 low association (LA, neither risk).
Serum interferon (IFN)-γ-inducible protein 10 (IP-10), interleukin-17
(IL-17), and C-reactive protein levels were investigated. There was a trend
toward higher serum IP-10 levels (p=0.042) for HA patients throughout the
6-month treatment period. Month-2 IP-10 levels were higher in the HA than in
the MA/LA group (656.2 ± 234.4 vs. 307.6 ± 258.5 pg/ml, adjusted p =0.005).
Receiver operating characteristic curves showed that the risk of relapse was
well-captured by month-2 IP-10 levels at a cut-off value of 431 pg/ml
(AUC=0.857, 95% CI 0.75-0.97, p =0.003). Month-2 serum IL-17 levels were
lower in non-survivors than survivors (15.7 ± 2.9 pg/ml vs. 24.6 ± 8.2
pg/ml, p=0.001). Multivariate analysis demonstrated that a month-2 serum
IL-17 level of ⩽ 17 pg/ml (p =0.026) was independently associated with
all-cause mortality. Serum IP-10 and IL-17 levels after 2 months of anti-TB
treatment may be biomarkers for estimating risk of both cavitation and
delayed sputum conversion, and for predicting long-term mortality,
respectively.
*11.* PLoS One. 2011; Volume 6, Number 7: e22927. Epub 2011 Jul 29.
*Quantifying
the Burden and Trends of Isoniazid Resistant Tuberculosis, 1994-2009; *Jenkins,
H.E., Zignol, M., Cohen, T.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21829557>
Quantifying isoniazid resistant (INH-R) TB is important because isoniazid
resistance reduces the probability of treatment success, may facilitate the
spread of multidrug resistance, and may reduce the effectiveness of
isoniazid preventive therapy (IPT). The researchers used data reported to
the World Health Organization between 1994 and 2009 to estimate the INH-R
burden among new and retreatment TB cases. They assessed geographical and
temporal variation in INH-R and reported levels in high HIV prevalence
countries (≥2%) to understand implications for IPT. 131 settings reported
INH-R data since 1994. A single global estimate of the percentage of
incident TB cases with INH-R was deemed inappropriate due to particularly
high levels in the Eastern European region where 44.9% (95% CI: 34.0%,
55.8%) of incident TB cases had INH-R. In all other regions combined, 13.9%
(95% CI: 12.6%, 15.2%) of incident cases had INH-R with the lowest regional
levels seen in West/Central Europe and Africa. Where trend data existed, the
researchers found examples of rising and falling burdens of INH-R. Forty
percent of high HIV prevalence countries reported national data on INH-R and
7.3% (95% CI: 5.5%, 9.1%) of cases in these settings had INH-R. Outside the
Eastern European region, one in seven incident TB cases has INH-R, while
this rises to nearly half within Eastern Europe. Many countries cannot
assess trends in INH-R and the scarcity of data from high HIV prevalence
areas limits insight into the implications for IPT. Further research is
required to understand reasons for the observed time trends and to determine
the effects of INH-R for control of TB.
*12.* PLoS One. 2011; Volume 6, Number 7: e22637. Epub 2011 Jul 28. *Immune
Response to Mycobacterium tuberculosis Infection in the Parietal Pleura of
Patients with Tuberculous Pleurisy;* Caramori, G., Lasagna, L., Casalini,
A.G., Adcock, I.M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21829471>
The T lymphocyte-mediated immune response to *Mycobacterium
tuberculosis*infection in the parietal pleura of patients with
tuberculous pleurisy is
unknown. This study investigated the immune response in the parietal pleura
of tuberculous pleurisy compared with nonspecific pleuritis. The researchers
have measured the numbers of inflammatory cells particularly T-cell subsets
(Th1/Th2/Th17/Treg cells) in biopsies of parietal pleura obtained from 14
subjects with proven tuberculous pleurisy compared with a control group of
12 subjects with nonspecific pleuritis. The number of CD3+, CD4+, and CCR4+
cells and the expression of RORC2 mRNA were significantly increased in the
tuberculous pleurisy patients compared with the nonspecific pleuritis
subjects. The number of toluidine blue+ cells, tryptase+ cells and GATA-3+
cells was significantly decreased in the parietal pleura of patients with
tuberculous pleurisy compared with the control group of nonspecific
pleuritis subjects. Logistic regression with receiver operator
characteristic (ROC) analysis for the three single markers was performed and
showed a better performance for GATA-3 with a sensitivity of 75%, a
specificity of 100% and an AUC of 0.88. There was no significant difference
between the two groups of subjects in the number of CD8, CD68, neutrophil
elastase, interferon (IFN)-γ, STAT4, T-bet, CCR5, CXCR3, CRTH2, STAT6, and
FOXP3 positive cells. Elevated CD3, CD4, CCR4, and Th17 cells and decreased
mast cells and GATA-3+ cells in the parietal pleura distinguish patients
with untreated tuberculous pleurisy from those with nonspecific pleuritis.
*13.* PLoS One. 2011; Volume 6, Number 7: e21008. Epub 2011 Jul 26. *Treatment
Outcome and Mortality at One and Half Year Follow-Up of HIV Infected TB
Patients under TB Control Programme in a District of South India;* Vijay,
S., Kumar, P., Chauhan, L.S., Narayan Rao, S.V., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21814542>
There is paucity of data from India on the impact of HIV related
immunosuppression in response to TB treatment and mortality among HIV
infected TB patients. The researchers assessed the TB treatment outcome and
mortality in a cohort of HIV-infected TB patients treated with intermittent
short course chemotherapy under the TB control program in a high HIV
prevalent district of south India. Among 3,798 TB patients registered for
treatment in Mysore district from July 2007 to June 2008, 281 HIV-infected
patients formed the study group. The socio-demographic and treatment related
data of these patients was obtained from TB and HIV program records and
patient interviews 19 months after TB treatment initiation by field
investigators. Treatment success rate of 281 patients was 75% while in smear
positive pulmonary TB cases it was 62%, attributable to defaults (16%) and
deaths (19%). Only 2 patients had treatment failure. Overall, 83 (30%)
patients were reported dead; 26 while on treatment and 57 after TB
treatment. Association of treatment related factors with treatment outcome
and survival status was studied through logistic regression analysis.
Factors significantly associated with “unfavorable outcome” were disease
classification as pulmonary [aOR-1.96, CI (1.02-3.77)], type of patient as
retreatment [aOR-4.78, CI (2.12-10.76)], and non-initiation of ART
[aOR-4.90, CI (1.85-12.96)]. Factors associated with “Death” were non
initiation of ART [aOR-2.80, CI (1.15-6.81)] and CPT [aOR-3.46, CI
(1.47-8.14)]. Despite the treatment success of 75% the high mortality (30%)
in the study group is a matter of concern and needs immediate intervention.
Non-initiation of ART has emerged as a high risk factor for unfavorable
treatment outcome and mortality. These findings underscore the importance of
expanding and improving delivery of ART services as a priority and
reconsideration of the program guidelines for ART initiation in HIV infected
TB patients.
*14.* PLoS One. 2011; Volume 6, Number 7: e22718. Epub 2011 Jul 25. *Cellular
Immune Responses to Nine Mycobacterium tuberculosis Vaccine Candidates
following Intranasal Vaccination;* Sable, S.B., Cheruvu, M., Nandakumar, S.,
Sharma, S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21799939>
The identification of *Mycobacterium tuberculosis* vaccines that elicit a
protective immune response in the lungs is important for the development of
an effective vaccine against TB. In this study, a comparison of intranasal
(i.n.) and subcutaneous (s.c.) vaccination with the BCG vaccine demonstrated
that a single moderate dose delivered intranasally induced a stronger and
sustained *M. tuberculosis*-specific T-cell response in lung parenchyma and
cervical lymph nodes of BALB/c mice than vaccine delivered subcutaneously.
Both BCG and a multicomponent subunit vaccine composed of nine *M.
tuberculosis* recombinant proteins induced strong antigen-specific T-cell
responses in various local and peripheral immune compartments. Among the
nine recombinant proteins evaluated, the alanine proline rich antigen (Apa,
Rv1860) was highly antigenic following i.n. BCG and immunogenic after
vaccination with a combination of the nine recombinant antigens. The
Apa-induced responses included induction of both type 1 and type 2 cytokines
in the lungs as evaluated by ELISPOT and a multiplexed microsphere-based
cytokine immunoassay. Of importance, i.n. subunit vaccination with Apa
imparted significant protection in the lungs and spleen of mice against *M.
tuberculosis* challenge. Despite observed differences in the frequencies and
location of specific cytokine secreting T cells both BCG vaccination routes
afforded comparable levels of protection in the study. Overall, findings
support consideration and further evaluation of an intranasally targeted
Apa-based vaccine to prevent TB.
*15.* Prilozi. 2011 Jul; Volume 32, Number 1: 257-68. *Cut-off Value of
Mantoux Induration in Tuberculous Children in R. Macedonia and Their
Nutritional Status;* Taushanova, B., Pavlovska, I., Arsevska, E.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21822193>
The interpretation of the Mantoux test, as well as knowledge of factors that
affect the test's induration size, are significant for the early diagnosis
of TB in children. This study determined the Mantoux test induration cut-off
size, which distinguishes between positive and negative results in
Macedonian children suffering from TB disease, and whether there is any
correlation between the nutritional status (malnutrition) and the Mantoux
induration size. A retrospective and descriptive study was carried out in
270 patients up to 14 years old with diagnosed TB, treated during the period
of 2003-2007 in the pediatric TB Department at the Kozle Institute for
Respiratory Diseases in Children, Skopje, Macedonia. The cut-off value of
the Mantoux test induration size was determined by analysis of the test
results distribution. The nutritional status was calculated as the weight
for age standard (z-score). Correlation between the TST results and the
nutritional status was calculated with Pearson's coefficient of correlation.
Two hundred and seventy (270) children with TB were included in the study.
The pulmonary form of TB was present in 87.8% of the children. 53.7% of the
patients were male, and 46.3% were female. The age group of 1-2 years was
the most numerous (15.2%), followed by the group aged 7-8 years (10.4%).
Thirty-three children (12.2%) were undernourished (z-score < -2). The
Mantoux test induration size was in the range of 0 to 32 mm, with an average
of 13.4 mm. The distribution of the frequencies of the indurations had a
bimodal form, with the primary mode at 0 mm, the secondary mode at 15-19 mm,
and antimode at 5-9 mm. The Mantoux test had a sensitivity of 82.5%,
specificity of 62%, positive predictive value of 68.46%, and negative
predictive value of 78.61%. Pearson's coefficient of correlation (r) of
0.175 showed a weak positive correlation between the results of TST
(induration size) and nutritional status. The cut-off value of the
induration which distinguished negative from positive Mantoux reaction was 5
mm. The interpretation of the test is recommended to be carried out
depending on the risk factors for TB development, which surround the
children. The Mantoux test in malnourished children should be interpreted
with caution.
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. Medical Officer (GS-602-15)*
*Sponsor: Field Services and Evaluation Branch (FSEB), Division of
Tuberculosis Elimination (DTBE), CDC*
Location: New York City, New York
The Field Services and Evaluation Branch (FSEB), Division of Tuberculosis
Elimination (DTBE), CDC, announces the availability of a position for a
Medical Officer based in New York City.
Duties:
Incumbent serves as Director, Bureau of Tuberculosis Control, for the City
of New York (the largest TB control program and the most complex in the
world based upon the number of cases reported annually, disease incidence
rate, structure, budget, staffing, population, and public health
infrastructure). Relied upon for authoritative advice on all aspects of the
TB control and elimination program plans, goals, objectives, initiatives and
requirements. Manages the activities of the Bureau of Tuberculosis Control
and its multifaceted TB programs, operations and issues as they pertain to
TB elimination. Actively participates and influences outcomes with the
Commissioner of Health and Associate Commissioner for Disease Intervention
Services in the formulation of policies and programs concerning TB for the
Department of Health and Mental Hygiene. As the primary advisor to the
Commissioner of Health and all deputy and associate commissioners regarding
TB matters, provides substantive advice on a myriad of topics that include
but are not limited to TB treatment and case management, contact
investigation, targeted testing for latent TB infection, legislation,
research efforts, implementing new diagnostic tests, staffing, and
application of the New York City Health Code to TB situations, conditions,
etc. Assists them in resolution of conflicts that arise between city and CDC
priorities, avoiding interferences with program operations.
INTERNAL Applicants may apply under announcement # HHS-CDC-MP-11-535453:
Apply here<http://jobview.usajobs.gov/GetJob.aspx?JobID=102433557&JobTitle=Medical+Officer&FedEmp=Y&FedPub=Y&sort=rv%2c-dtex&vw=d&re=3&caller=basic.aspx&jbf574=HE39&pg=2&AVSDM=2011-09-15+00%3a03%3a00#duties>
EXTERNAL Applicants may apply under announcement # HHS-CDC-DE-11-532622:
Apply here<http://jobview.usajobs.gov/GetJob.aspx?JobID=102383441&JobTitle=Medical+Officer&brd=3876&vw=b&FedEmp=N&pg=1&where=New+York+City&rad=20&rad_units=miles&re=0&q=Medical+Officer&AVSDM=2011-09-15+00%3a03%3a00>
* *
Upcoming Conferences, Trainings, and Other Events Find up-to-date
information on TB-related conferences, US training opportunities, and other
events at the DTBE Monthly Calendar<http://www.cdc.gov/tb/events/default.htm>
.
* *
1. Targeted Testing and Treatment of Latent TB Infection: An Online
Presentation (60 minutes)
Sponsor: The Francis J. Curry National Tuberculosis Center
This slide presentation is presented by L. Masae Kawamura, M.D., TB
Controller of the San Francisco Department of Public Health and co-principal
investigator of the Francis J. Curry National TB Center/UCSF. Dr. Kawamura
explores the diagnosis and treatment of LTBI, including the rationale for TB
screening and what is meant by "targeted testing," risk factors for TB, the
tuberculin skin test and new interferon gamma release assays (IGRAs),
current LTBI treatment guidelines, and how to counsel and motivate patients.
This slide presentation with streaming audio provides information on how to
effectively target test for TB as well as how to treat latent TB infection
(LTBI). A question and answer guide, a printable PowerPoint slide file, and
other useful resources are also included as supplemental materials.
For more information, visit
http://www.nationaltbcenter.ucsf.edu/testing_ltbi/ .
*2. Practical Solutions for TB Infection Control: Infectiousness and
Isolation *
Sponsor: Francis J. Curry National Tuberculosis Center
Location: Online Course
Length: 60 minutes
This 60-minute Flash presentation with streaming audio provides information
on how to determine whether a TB patient is infectious and demonstrates
practical ways to prevent TB transmission in the clinic, in transit, and in
the patient's home. Throughout the training, interactive questions allow
participants to test and apply what has been learned. At the end of the
presentation, there is a list of additional resources that includes links to
further written information as well as links to the Regional Training and
Medical Consultation Centers (RTMCCs).
For further assistance, contact Francis J. Curry National Tuberculosis
Center. E-mail ; telephone (415) 502-4600;
or fax (415) 502-4620.
For a course description, visit
http://www.nationaltbcenter.ucsf.edu/tbicweb/ .
*3. 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 .
*4. Northeast TB Controllers Conference *
Sponsors: Ohio Department of Health. American Lung Association of Ohio.
MetroHealth Hospital.
Dates: October 12 – 13, 2011
Location: Cleveland, Ohio
The Northeast TB Controllers Conference is the region’s most comprehensive
meeting dedicated to advancing TB control and elimination activities. This
conference offers TB program staff, public health workers and health care
providers from across the region an opportunity to learn and network with
colleagues. Conference activities will include plenary sessions on
Wednesday, October 12th and educational sessions on Thursday, October 13th.
Registration fee: $50 per day includes continuing education credit. In
conjunction with the Northeast TB Controllers Conference, the NJMS Global TB
Institute will sponsor 2 separate educational sessions.
For more information, contact Maureen Murphy. Email
; phone (614) 387-0652; or access the Web site at
http://www.mrsnv.com/evt/home.jsp?id=3223.
*5. The Denver TB Course *
Sponsor: National Jewish Health
Dates: October 12 – 15, 2011
Location: Denver, Colorado
The purpose of this course is to present knowledge about the management of
TB to general internists, public health workers, infectious diseases and
chest specialists, registered nurses, and other health care providers who
will be responsible for the management and care of patients with TB. This
event includes the following course highlights: Transmission and
pathogenesis of adult and pediatric TB; MDR TB and XDR TB; Screening for and
treatment of latent TB infection; Factors influencing TB infections;
Planning TB control programs with particular emphasis on organization of
outpatient chemotherapy; TB and HIV coinfection; and Mycobacteriology
Laboratory Tour.
Continuing education credits are available.
For more information, contact Nicole Austin Ross, National Jewish Health.
E-mail ; phone (303) 398-1110; fax (303) 270-2239; or
access the website at http://www.njhealth.org/TBCourse.
*6. Managing Tuberculosis: Emerging and Complex Topics for Physicians*
Sponsor: New Jersey Medical School Global Tuberculosis Institute
Date: October 13, 2011
Location: Cleveland, Ohio
This training is intended for physicians and is being held as part of the
Northeast TB Controllers Conference. Topics for discussion include new
findings on short-course treatment for latent TB infection, managing complex
TB cases, management of side effects, management of LTBI, and new findings
on TST and IGRAs.
Registration fee: $50 per day.
For questions about the course, contact Nickolette Patrick, E-mail:
; Phone: (617) 279-2240, ext. 262; for conference related
questions, contact Maureen Murphy, E-mail: ;
Phone: (614) 387-0652; or access the Website:
http://www.umdnj.edu/globaltb/courses/brochures/2011/managingtb.html.
*7. Working Better by Working Together: Challenges and Opportunities for
Nurses in TB*
Sponsor: New Jersey Medical School Global Tuberculosis Institute
Date: October 13, 2011
Location: Cleveland, Ohio
This training is intended for nurses and is being held as part of the
Northeast TB Controllers Conference. Topics include: TB nurse case
management competencies, contact investigations, forging partnerships, a
case study of a multi-state outbreak among the homeless, and region-based
educational opportunities for nurses.
The registration process is combined for the Conference and this training.
To register, click https://www.mrsnv.com/evt/e09/reg/form.jsp?id=3223 .
For more information about the course, contact Nickolette Patrick. E-mail
, or phone (617) 279-2240 ext. 262. For information about
conference-related questions, contact Maureen Murphy by e-mailing
; phoning (614) 387-0652; or accessing the
Website at
http://www.umdnj.edu/globaltb/courses/brochures/2011/workingbetter.html .
*8. New TB Vaccines for the Future *
Sponsor: TuBerculosis Vaccine Initiative (TBVI)
Dates: October 17 – 18, 2011
Location: Madrid, Spain
TBVI, together with the University of Zaragoza and Fundacion Ramon Areces,
will organize an international symposium on 17-18 October in Madrid. This
symposium will provide a stage to world leaders in the field of
investigation of host-pathogen interactions and new vaccines against TB, to
present their efforts and the results of the latest research in vaccines
against TB to the scientific community.
Registration is free of charge. If you have any trouble with registration
because the registration form is in Spanish, please go to the home page of
Rundacion Ramon Areces: http://www.fundacionareces.es/fundacionareces/ ,
click on English, click on upcoming events, select this symposium.
For more information, contact Erna Balk, Director Communications & Advocacy
Relations. Email ; phone +31 320 277 552; or access the Web
site at
http://www.tbvi.eu/news-agenda/events/event/symposium-new-tb-vaccines-for-the....
*9. TB Challenges: When Your Patient Has Other Complicated Medical
Conditions *
Sponsor: New Jersey Medical School Global Tuberculosis Institute
Date: October 18, 2011
Location: Shrewsbury, Massachusetts
The purpose of this training is to increase provider knowledge and awareness
of TB, including TB & TNF-alpha antagonists, TB & viral hepatitis, TB &
pregnancy, TB & diabetes, TB & mental health, and medications for TB. This
training utilizes lectures, discussions, and small interactive breakout
sessions.
Register online by October 4th at: http://ma2011.eventbrite.com/ . Free of
charge. Continuing education credits are available.
For more information contact Nickolette Gaglia, E-mail: ;
Phone: (617) 279-2240 x262; or access the Web site:
http://www.umdnj.edu/globaltb/courses/brochures/2011/tbchallenges.html .
*10. TB Case Management and Contact Investigation Intensive *
Sponsor: Curry International Tuberculosis Center
Dates: October 18 – 21, 2011
Location: San Francisco, California
This course is intended for physicians, nurses, and other licensed medical
care providers who manage patients with TB or who are at risk for TB. Topics
covered include: Epidemiology of TB; Fundamentals of TB case management;
Completion of care; TB contact investigation; The role of the laboratory;
Medical management of TB; Quality assurance in TB control programs; Targeted
testing for TB; Treatment of latent TB infection (LTBI); Culture, community,
and TB care; Working with special populations; and Interviewing skills.
There is no fee for this course. Enrollment is limited, and pre-registration
is required.
For more information, contact Jennifer Kanouse, Program Manager. E-mail
; phone (415) 502-2712; or access the
website at http://www.nationaltbcenter.edu/training/tbcmcioct11.cfm .
*11. TB Management in the HIV Patient: Current Strategies and Exciting New
Possibilities Webinar *
Sponsor: The Johns Hopkins University School of Medicine, Clinical
Pharmacology
Date: October 19, 2011
Location: Nationwide, USA
This webinar is one of the Special Webinar Series on HIV Management. Dr.
Kelly E. Dooley, Assistant Professor of the Johns Hopkins University School
of Medicine, Clinical Pharmacology, will be the webinar speaker. Funding for
this series is provided by the Gilead Foundation and private donations to
CCGHE.
No registration is required; however, access is limited to the first 200
live viewers. All sessions will be recorded and available for on-demand
viewing from the JHU CCGHE website at http://ccghe.jhmi.edu/ccg/index.asp .
For questions related to the course procedures or website, e-mail
.
*12. 42nd Union World Conference on Lung Health *
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: October 26 - 30, 2011
Location: Lille, France
The Union announces that the 42nd Union World Conference on Lung Health,
organized by the International Union Against TB and Lung Disease, will be
hosted in Lille, France, from October 26 to 30, 2011.
The conference theme this year is "Partnerships for Scaling-up and Care,"
which will highlight the vital importance of collaboration in the common
efforts to address the conditions affecting lung health.
Together participants will not only learn about the latest developments in
the fields of TB, tobacco control, HIV, and lung health, but also connect
with all levels of caregivers from physicians and academicians, to civil
society and the private sector.
For five days, participants will be able to discuss, debate, and network
with colleagues from more than 120 countries, strengthening anew the
commitment to global efforts to find and implement health solutions for the
poor and underserved.
The official languages for this conference are English and French.
Online registration available at
http://registration.theunion.org/useraccount/index.php?currserv=WConf.
For more information, contact the Conference Secretariat, The Union, 68,
boulevard Saint-Michel, 75006 Paris, France. E-mail ;
telephone (+33) 1 44 32 03 60; fax (+33) 1 53 10 85 54 / (+33) 1 43 29 90 87;
or visit http://www.worldlunghealth.org.
*13. Late-Breaker Session on Tuberculosis at the 42nd World Conference on
Lung Health *
Sponsors: International Union Against Tuberculosis and Lung Disease (The
Union). Centers for Disease Control and Prevention (CDC)
Location: Lille, France
The 42nd Union World Conference on Lung Health and the Centers for Disease
Control and Prevention are pleased to 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, 2011, 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.
For more information, contact Chinnambedu N Paramasivan (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 <>; telephone (404)
639-8123; fax (404) 639-8961; or visit the website at
http://www.worldlunghealth.org/confLille/index.php/Abstracts/the-unioncdc-lat....
*14. TB Nurse Case Management *
Sponsor: Heartland National TB Center
Dates: November 2 – 4, 2011
Location: San Antonio, Texas
This course is intended for nurses and public health staff who are actively
engaged in the identification, case management, and treatment of patients
with tuberculosis infection or disease.
For more information, contact Lead Educator Jessica Quintero. E-mail
; phone 210-531-4568; or access the web site at
http://www.heartlandntbc.org/training/brochure_sat_tx_02_nov_2011.pdf. To
register, visit http://www.heartlandntbc.org/training.asp. Pre-registration
is required, and priority enrollment will be given to participants from the
Heartland region (AZ, IL, IA, KS, MN, MO, NE, NM, ND, OK, SD, TX, WI). There
is no fee for this course. Nursing continuing education hours will be
available for those who successfully complete the requirements.
*15. UNIDOS Binational TB Conference *
Sponsor: Heartland National Tuberculosis Center
Dates: November 15 – 16, 2011
Location: Las Cruces, New Mexico
Registration deadline: October 14, 20111
The goal of this conference is to provide information to assist clinicians
in addressing complex diagnostic and treatment issues in order to
effectively and efficiently handle TB along the US-Mexico border. Clinicians
will acquire increased knowledge and skills that will result in higher
levels of treatment completion by the patient, reduce the development of
drug resistance through appropriate treatment, address legal and immigration
issues, and manage the patient with co-morbid conditions.
The conference is free of charge, but pre-registration is mandatory.
For more information, contact Jessica Waguespack. E-mail
; phone (210) 531-4509; or access the Website at
http://www.heartlandntbc.org/training.asp .
*16. Human Resources Management *
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: November 28 – December 3, 2011
Location: Kuala Lumpur, Malaysia
Application deadline: October 25, 2011
Focusing on improving human resources capabilities among health
organizations, this course trains participants to align staff output with
health program strategy. Participants will also learn about how to recruit
and retain the best qualified candidates for health projects. Key topics the
course addresses: (1) Determine an organization’s human resources needs; (2)
Align management of human resources with HR and organizational strategy; (3)
Practice and incorporate HR performance management systems tools and
techniques including appraisals, training, retention, and other staffing
mechanisms; and (4) Discover how to carry out a comprehensive organizational
HR audit.
To register or receive more information, e-mail , or visit
http://www.union-imdp.org.
For more information, e-mail , or visit the website at
http://www.union-imdp.org/courses/human-resources-management.
* *
*17. 1st International Conference on Drug Therapy in TB Infection *
Sponsor: Africa Health Research Organization
Dates: January 6 – 7, 2012
Location: Edinburgh, United Kingdom
This conference will provide a stimulating scientific environment for
exchange of ideas and updates in TB medicine. The conference includes the
following tracks: (1) Biology & Epidemiology of TB; (2) TB Immunology &
Pathogenesis; (3) Current TB Chemotherapy; (4) Drug Resistance; (5) HIV/TB:
A Deadly Syndemic; (6) Current Strategies in TB Drug Development: From Bench
to Bedside; and (7) TB Vaccine: Concept & Progress.
Abstract submission deadline: November 30, 2011. Abstracts dealing with
track areas can be submitted to with the words: TB
Abstract, in the subject of the email.
For more information, visit http://www.eventsbot.com/events/eb662245306 .
*18. 3rd Global Symposium on IGRAs 2012 *
Sponsor: UC San Diego School of Medicine
Dates: January 12 - 15, 2012
Locations: Waikoloa, Hawaii
Students of TB have been interested in the immune response to *M.
tuberculosis* since the modern understanding of the clinical disease. For
decades, the skin test response to tuberculin (TST) was the primary tool
clinicians have had for study. With the development of Interferon Gamma
Release Assays (IGRA) the recurrent question has been -- which is better,
the TST or an IGRA? Many papers have been written on this topic, and
numerous guidelines have been issued. The conference will provide a solid
framework for assessing this rapidly moving field, and will provide a basis
for making clinical decisions.
The meeting will present basic and developing information that will be of
interest to academic physicians and practicing physicians, such as those who
practice infectious disease, pulmonary medicine, and pediatrics. It will
also be of interest to public health physicians, dermatologists,
rheumatologists, gastroenterologists, and epidemiologists.
For registration and more information, visit http://cme.ucsd.edu/igras/.
*19. The Union North America Region Meeting: 16th Annual Conference *
Sponsor: The Union Against Tuberculosis and Lung Disease (The Union)
Dates: February 23 – 25, 2012
Location: San Antonio, Texas
The 16th Annual Conference of the International Union Against Tuberculosis
and Lung Disease will be held February 23-25, 2012, in San Antonio, Texas,
USA. The secretariat welcomes the submission of abstracts for poster and
oral presentations of research
on all aspects of TB control, including epidemiologic, clinical, basic
science, nursing, social, behavioral, psychosocial, and educational studies,
or outcomes of
program initiatives.
For more information, visit
http://www.bc.lung.ca/association_and_services/union.html .
* *
*
*
Edit Comment Text