MDR-TB Treatment & Prevention
TB Update from the CDC NPIN: Feb. 7-13, 2010
TB-Related News and Journal Items Weekly Update Week of February 7, 2010
to February 13, 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
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
*1. CDC’s Popular Pamphlet “Questions and Answers about TB” Is Now Available in spanish
*Preguntas y Respuestas Sobre la Tuberculosis*
*[Questions and Answers about Tuberculosis]*
To access this pamphlet online:
http://www.cdc.gov/tb/publications/faqses/default.htm
To order copies of the pamphlet in Spanish or English:
http://wwwn.cdc.gov/pubs/tb.aspx
To access English-version online:
http://www.cdc.gov/tb/publications/faqs/default.htm
*2. Stop TB Partnership Launches New Initiative to Help Countries Increase TB Case Detection
January 25, 2010 - Geneva - The Stop TB Partnership launched the TB REACH
initiative and announced the first call for proposals.
The main objective of TB REACH is to promote early and increased detection
of infectious tuberculosis (TB) patients and ensure their timely treatment,
while maintaining high cure rates within DOTS programs. TB REACH will
encourage the development and application of innovative, ground-breaking and
efficient techniques, interventions, and activities that result in increased
TB case detection, reduced transmission, and prevention of the emergence of
drug-resistant forms of TB. As suggested by its name, TB REACH will focus on
reaching people who have limited or no access to TB services.
"For the first time we are launching an initiative devoted specifically to
increasing case detection, while targeting people who have limited access to
health services. We hope TB REACH will galvanize governments, organizations,
and affected communities to embrace innovative thinking and ambitious action
to reach all people who need TB care," said Dr. Marcos Espinal, Executive
Secretary of the Stop TB Partnership.
Key information about TB REACH, eligibility criteria for applicants, and
information on how to apply for a grant are now available on its web pages
http://www.stoptb.org/tbreach/ . The deadline for submitting proposals for
this first round is *March 5, 2010*. Eligible applications will be reviewed
by an independent group of experts - the Proposal Review Committee - during
March 2010. Results of the review will be made available to all applicants
in April 2010.
"We wish to acknowledge the support of the Canadian International
Development Agency (CIDA) to this important initiative, which is critical
for TB control," Dr. Espinal said.
For more information, write to .
News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News Update
*1. Vaccine 'Could Cut HIV TB Deaths' *
BBC, January 30, 2010
An inactivated, whole cell mycobacterial vaccine could cut TB cases among
HIV-infected Africans by almost two-fifths, suggests a new study. TB is the
most common cause of death for Africans with HIV. The placebo-controlled,
double-blinded trial involved 2,013 Tanzanian patients with Bacille
Calmette-Guerin scars and at least 200 CD4 cells/mm3. Participants were
randomized to receive either five intradermal doses of *M. vaccae* (N=1,006)
or placebo (N=1,007), and to be followed up every three months for a median
of 3.3 years. The primary endpoint was disseminated TB, with definite or
probable TB as secondary endpoints. The trial was terminated early because
of the slow accrual of disseminated TB, and significant protection against
definite TB. Hazards ratios were: disseminated TB, 0.52 (95 percent
confidence interval [CI] 0.21-1.34; seven cases in *M. vaccae* group, 13
cases in placebo group; log-rank P=0.16), definite TB, 0.61 (95 percent CI
0.39-0.96; 33 cases in *M. vaccae *group, 52 cases in placebo group; P=0.03)
and probable TB, 1.17 (95 percent CI 0.76-1.80; 48 cases in *M.
vaccae*group, 40 cases in placebo group; P=0.46). The
*M. vaccae* was well-tolerated, with no adverse effect on CD4 cell count or
viral load and no increase in serious adverse events. The number of
confirmed TB cases was 39 percent lower in the vaccinated group compared
with those who received a placebo, representing a “significant milestone,”
said lead author Professor Ford von Reyn. The booster might be given to
patients in poor countries as soon as they are diagnosed with HIV,
especially where officials are struggling to place those infected on
antiretroviral drugs, according to experts. A vaccine program could be
cost-effective, compared with earlier antiretroviral treatment - the
alternative means to fight TB in HIV patients, said Alvaro Bermejo,
Executive Director of the International HIV/AIDS Alliance. “This is a very
important finding - it is the first time we are going to have a vaccine
which is influential in preventing opportunistic infections in HIV
patients,” Bermejo said. “TB is a massive problem. The reduction of 39
percent seen in Tanzania, although not fabulous, is a good result.” The full
study, “Prevention of Tuberculosis in Bacille Calmette-Guerin-Primed,
HIV-Infected Adults Boosted with an Inactivated Whole-Cell Mycobacterial
Vaccine,” was published ahead of print by
*AIDS*(2010;doi:10.1097/QAD.obo13e328335of1b).
*2. Recurrent TB: Relapse or Re-infection? The Effect of HIV in a General
Population Cohort in Malawi *
AIDS Vol. 24; No. 3: January 28, 2010, P. 417-426, by Amelia C. Crampin; J.
Nimrod Mwaungulu; Frank D. Mwaungulu; D. Totah Mwafulirwa; et al.
The authors designed a long-term cohort study in Karonga district, rural
Malawi, to estimate rates of recurrent TB due to re-infection and relapse,
by HIV status, in a general population. All TB patients with culture-proven
disease in the district were followed up after treatment, with HIV testing
offered and all *M. tuberculosis* isolates fingerprinted using IS6110 RFLP.
The researchers compared fingerprints from initial and recurrent disease
episodes to distinguish relapse and re-infection: a second episode was
considered a relapse if the fingerprint was identical, or differed by only
one to four bands and was the first occurrence of that pattern in the
population. Survival analysis and Poisson regression were used to estimate
rates of and risk factors for recurrence, re-infection, and relapse. During
1995 to 2003, 584 culture-positive TB episodes were diagnosed and treatment
was completed in patients with known HIV status; 53 culture-positive
recurrences occurred by May 2005. Paired fingerprints were available for 39
of these. Re-infections accounted for 1/16 recurrences in HIV-noninfected
and 12/23 in HIV-infected patients. Relapse rates were similar in
HIV-infected and HIV-noninfected individuals. Using multiple imputation to
allow for missing fingerprint information, the rate of re-infection disease
in HIV-infected patients was 2.2/100 person-years and 0.4/100 person-years
in HIV-noninfected individuals. “HIV increases the rate of recurrent TB in
this setting by increasing the rate of re-infection disease, not relapse,”
concluded the authors.
Headlines
*1. US Interior Gives Marshall Islands 1.4M to Fight TB (Marshall Islands)*
Yokwe Online, http://yokwe.net, February 6, 2010
Tony Babauta, Marshall Islands Assistant Secretary for the Interior for
Insular Areas, announced a $1,456,932 grant from the United States that will
be used to fight an outbreak of multidrug-resistant TB (MDR TB) in the
Marshall Islands. Babauta noted that this was not the first outbreak of
drug-resistant TB. In 2008, an outbreak occurred in the Freely Associated
States (FAS), for which the US government also provided financial
assistance. Babauta commented that containment and cure should be the
priority for ensuring that FAS and US citizens are protected.
*2. TB Program Saved – For Now (United States)*
Ukiah Daily Journal, www.ukiahdailyjournal.com, February 10, 2010, by
Tiffany Revelle
Public treatment of patients with latent TB infection (LBTI) in Ukiah and
Fort Bragg, California, will continue at least until July of 2010.
Cancellation of the program was an agenda item at a recent meeting of the
Mendocino County Board of Supervisors, as the board is required to have a
public hearing before the county can cut public health care. The cut was
expected to save the county $65,667 toward replacing falling revenue and to
help the lack of funding for nursing jobs. According to Stacy Cryer,
Director of the Community Health Services Branch of the Mendocino County
Health and Human Services Agency, the program is able to continue, due to
some one-time funding that public health had received this year. As a
result, the board removed the hearing from the agenda; however, Cryer warned
that the problem could arise again in budget hearings in the summer of 2010.
Dr. Charlie Evans, CEO of Pacific Redwood Medical Group, commented that the
proposed closure was very short-sighted. He explained that closing the LTBI
treatment clinic would increase instances of latent and active TB disease,
as well as cases of drug-resistant TB.
*3. State Cuts May Fuel Local TB Spike (United States)*
Arizona Daily Star, www.azstarnet.com, February 10, 2010, by Stephanie
Innes,
Health officials in Pima County, Arizona, are worried that budget cuts could
cause local TB rates to increase. The county’s TB program is funded by a
combination of county, state, and federal funds. In 2008, state funding for
the TB program was $167,000, but it was dropped to $76,000 in 2009.
According to Dr. Michelle McDonald, Pima County Health Department’s Chief
Medical Officer, and Anne Davis, Pima County Clinic Manager, the cuts have
forced the county to limit shelter to homeless TB patients. Formerly, the
county provided apartments for homeless people with TB throughout the course
of treatment, which could last as long as 18 months. At present, housing is
provided only during the period when the patient is contagious. The problem
is that DOT requires the health worker to give the patient each dose of
medication, but it is difficult to find homeless persons if they are not
housed in one location. Also, Dr. McDonald notes that it is a hardship for
homeless patients to get to the clinic, particularly at its new location.
Pima County has averaged 25 to 50 confirmed cases of TB a year for the last
decade. The disease is prevalent among homeless people, incarcerated
persons, substance abusers, and those with compromised immune systems. Dr.
McDonald commented that Pima County’s TB rates have not been declining as
quickly as rates throughout the United States, partly because it is located
in a border state and has a large population of foreign-born people.
*4. Road Mapping Could Be Key to Curing TB (United Kingdom)*
Science Daily, www.sciencedaily.com, February 8, 2010
Researchers at the University of Surrey (United Kingdom) are using a systems
biology approach to investigate the metabolic changes that cause the TB
bacterium to survive dormant for decades in host cells. An understanding of
these changes could open the way for development of new drugs. Professor
Johnjoe McFadden of the University of Surrey compared metabolic pathways in
cells to Britain’s road network, in that when one road is blocked, others
can be used to arrive at one’s destination. One starting point in studying
functional pathways is using a mathematical model of the cell, which takes
into account the system properties of the whole network, rather than
focusing on key control points. The professor explains how microbes are
suited to the systems-level approach, as they have few genes to interact
with each other, making computational modeling simpler. Also, microbes are
able to precisely control their growth, and this “steady-state growth” is an
important assumption on which mathematical models are based. The study is
published in *Microbiology Today*, February 2010, 16-18.
*5. Treatment for TB to Be Extended to All Inmates (Cambodia)*
Phnom Penh Post, www.phnompenhpost.com, February 5, 2010, by Mom Kunthear,
and Khuon Leakhana
Government officials in Cambodia announced plans to provide TB treatment to
all 25 prisons in the country by 2015, to prevent the spread of the disease
among incarcerated persons. Dr. Mao Tan Eang, Director of the National
Center for TB and Leprosy Control (CENAT), said that a 2005 survey found the
TB infection rate among prisoners to be five to six times higher than among
the general population. In 2005, 45 of 1,275 prisoners surveyed had TB. Heng
Hak, Director of the Prisons Department at the Interior Ministry, commented
that 206 of 13,374 prisoners had TB. He noted that treatment was difficult
because of the lack of funds and overcrowding. At present, TB treatment
provided by CENAT is only available in four prisons, two in Phnom Penh, one
in Siem Reap province, and one in Kampong Cham province. Dr. Mao Tan Eang
said that similar programs will soon be instituted in prisons in Battambang
and Banteay Meanchey provinces.
*6. Tuberculosis Survey in Nigeria Records Progress (Nigeria)*
234next.com, http://234next.com, Februry 6, 2010, by Abiose Adelaja
According to Dr. Oni Idigbe, Chairperson of the National TB and Leprosy
Committee in Nigeria, the national survey on multidrug-resistant TB (MDR TB)
in Nigeria indicates that the disease is being treated. At the half-way
point of the six-month survey, researchers say barriers such as lack of
specialized wards to treat patients and lack of second-line drugs are being
addressed. A 30-bed ward was recently completed at the University College
Hospital, Ibadan, Oyo State. All the medical personnel there have been
trained to manage MDR TB cases, and the first batch of second-line drugs
approved by the World Health Organization (WHO) has arrived in the country.
The survey aimed to properly identify MDR TB and determine its prevalence to
ensure treatment accuracy. Dr. Idigbe stated that the drugs received from
the WHO Green Light Committee were enough for 80 patients, but the country
is applying for additional drugs to treat 300 to 400 patients, based on
conclusions from the study. More specialized wards are to be created in
other regions, in order to cover as many zones as possible.
*7. Vietnam 12th in Top 22 for TB Patients (Viet Nam)*
Viet Nam net, http://english.vietnament.vn, February 9, 2010
Viet Nam was number 12 on the WHO list of tuberculosis high-burden nations
last year. Nguyen Thi Xuyen, Viet Nam’s Deputy Health Minister, has asked
the Central Lung Hospital to build an antituberculosis network on a national
scale. He has asked the Central Lung Hospital for more equipment and
personnel for hospitals at grass roots levels so that Viet Nam can meet the
national TB program targets in 2010. The Deputy Health Minister also asked
foreign organizations to assist the country with its TB program.
Journal Articles
*1.* Future Microbiology. 2009 Dec; Volume 4: 1317-35. *Adjusting to a New
Home: Mycobacterium tuberculosis Gene Expression in Response to an
Intracellular Lifestyle; *Stokes, R.W., Waddell, S.J.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/19995191?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
*Mycobacterium tuberculosis* remains the most significant single species of
bacteria causing disease in mankind. The ability of *M. tuberculosis* to
survive and replicate within host macrophages is a pivotal step in its
pathogenesis. Understanding the microenvironments that *M.
tuberculosis*encounters within the macrophage and the adaptations that
the bacterium
undergoes to facilitate its survival will lead to insights into possible
therapeutic targets for improved treatment of TB. This is urgently needed
with the emergence of multi- and extensively drug resistant strains of *M.
tuberculosis*. Significant advances have been made in understanding the
macrophage response on encountering *M. tuberculosis*. Complementary
information is also accumulating regarding the counter responses of *M.
tuberculosis* during the various stages of its interactions with the host.
As such, a picture is emerging delineating the gene expression of
intracellular *M. tuberculosis* at different stages of the interaction with
macrophages.
*2.* Infection Control and Hospital Epidemiology. 2010 Jan; Volume 31,
Number 1: 78-84. *How Soon Should Patients with Smear-Positive Tuberculosis
Be Released from Inpatient Isolation? *Horne, D.J., Johnson, C.O., Oren, E.,
Spitters, C., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/19968490?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
In patients with smear-positive pulmonary TB who are hospitalized or reside
in congregate settings, guidelines recommend airborne infection isolation
until sputum smear results are negative. Studies have identified factors
associated with delayed sputum smear and culture conversion in patients with
TB. Because these studies did not use methods of survival analysis,
estimates of time to sputum smear conversion that are based on initial
patient characteristics are not available. The ability to predict time to
sputum smear conversion could be useful for programmatic planning and
patient counseling. The researchers performed a cohort study using survival
analysis to identify factors associated with time to sputum smear and
culture conversion. The time to sputum smear conversion was defined as the
time elapsed from the start of treatment to the first date of sustained
conversion. Ninety-eight patients had sputum smear samples positive for
acid-fast bacilli. Lower initial smear grade (on 1+ to 4+ scale) and absence
of cavitation on chest radiograph were associated with earlier sputum smear
conversion in bivariate analysis. In multiple regression analysis, initial
smear grade (hazard ratio, 0.45; 95% confidence interval, 0.35-0.57) and
drug resistance (hazard ratio, 2.30; 95% confidence interval, 1.08-4.89)
remained statistically significant; a model comprising only initial smear
grade performed almost as well. Predictors of sputum culture conversion were
similar. Initial smear grade was the strongest predictor of time to sputum
smear and culture conversion in patients with pulmonary TB and may be a
useful predictor for programmatic planning and patient counseling.
*3.* International Journal of Infectious Diseases. 2009 Sep; Volume 13,
Number 5: 600-5. Epub 2008 Dec 25. *Gender Differences in the Clinical
Diagnosis of Tuberculous Lymphadenitis--a Hospital-Based Study from Central
India; *Purohit, M.R., Mustafa, T., Mørkve, O., Sviland, L.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/19111495?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
Tuberculous lymphadenitis can be difficult to diagnose clinically, and as it
is thought to be more common in females, the researchers describe here the
clinical characteristics of cervical tuberculous lymphadenitis in men and
women and compare this with cytology to assess their diagnostic value. Two
hundred and nineteen patients with tuberculous lymphadenitis, aged 14 years
or more, who presented with a neck mass to the Department of Pathology,
Ujjain Hospital, Ujjain, India were included in the study. The presenting
clinical symptoms and signs were compared between men and women and with the
cytology of fine needle aspirates from the lymph nodes. Seventy-five percent
of the patients were aged between 14 and 35 years, with a male to female
ratio of 1:2.1. One or more constitutional symptoms were present in 56.6% of
patients on presentation. There were more men with clinical symptoms than
women. Fever was the most common manifestation in both gender groups. Fever
for more than 30 days, cough, weight loss, and night sweats were
significantly more common in men. On cytology, necrotic granulomas were
found to be associated with constitutional symptoms. Constitutional symptoms
were more frequently reported by men than by women and showed a correlation
with necrotic granulomas on cytology.
*4.* International Journal of Microbiology. 2009; 2009: 879621. Epub 2009
Jul 22. *The Differential Gene Expression Pattern of Mycobacterium
tuberculosis in Response to Capreomycin and PA-824 versus First-Line TB
Drugs Reveals Stress- and PE/PPE-Related Drug Targets; *Fu, L.M., Tai, S.C.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20016672?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
TB is a leading infectious disease causing millions of deaths each year. How
to eradicate mycobacterial persistence has become a central research focus
for developing next-generation TB drugs. Yet, the knowledge in this area is
fundamentally limited and only a few drugs, notably capreomycin and PA-824,
have been shown to be active against non-replicating persistent TB bacilli.
In this study, the researchers performed a new bioinformatics analysis on
microarray-based gene expression data obtained from the public domain to
explore genes that were differentially induced by drugs between the group of
capreomycin and PA-824 and the group of mainly the first-line TB drugs. The
study identified 42 genes specifically induced by capreomycin and PA-824.
Many of these genes are related to stress responses. In terms of the
distribution of identified genes in a specific category relative to the
whole genome, only the categories of PE/PPE and conserved hypotheticals have
statistical significance. Six among the 42 genes identified in this study
are on the list of the top 100 persistence targets selected by the TB
Structural Genomics Consortium. Further biological elucidation of their
roles in mycobacterial persistence is warranted.
*5.* The International Journal of Tuberculosis and Lung Disease. 2010 Jan;
Volume 14, Number 1: 122-5. *Tuberculosis Attributed to Household Contacts
in the Philippines; *Sia, I.G., Orillaza, R.B., St Sauver, J.L., Quelapio,
I.D., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20003706?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
Data on the burden of disease from TB in Filipino households are limited.
This study determined the magnitude of undiagnosed TB in TB households, and
the demographic and socio-economic factors associated with TB in the
Philippines. Household contacts of adult smear-positive TB patients seen
from July 2001 to June 2003 were assessed based on interview, chest X-ray,
tuberculin skin test, and sputum examination. History of TB and older age
were independently associated with TB disease, and age and duration of
cohabitation with TB infection. TB and TB infection are highly prevalent in
TB households in the Philippines.
*6.* The International Journal of Tuberculosis and Lung Disease. 2010 Jan;
Volume 14, Number 1: 119-21. *Drug-Resistant Tuberculosis Epidemic in the
Western Cape Driven by a Virulent Beijing Genotype Strain; *Johnson, R.,
Warren, R.M., van der Spuy, G.D., Gey van Pittius, N.C., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20003705?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
Temporal analysis of drug-resistant TB cases in the Western Cape, South
Africa, showed a 1.5-fold increase over a 2-year period, suggesting a
doubling time of 8.2 years. This increase was strongly associated with
multidrug resistance and the Beijing genotype. Forty-two per cent of the
overall increase was due to the Beijing genotype strain R220, suggesting
that this strain had evolved unique properties that allowed for both
acquisition and transmission of drug resistance. To curb the drug-resistant
TB epidemic in this setting, it will be essential to implement rapid
diagnostics and efficient infection control measures, improve contact
screening and ensure treatment adherence.
*7.* The International Journal of Tuberculosis and Lung Disease. 2010 Jan;
Volume 14, Number 1: 93-8. *The Diagnostic Efficacy of Fine-Needle
Aspiration Using Cytology and Culture in Tuberculous Lymphadenitis;
*Asimacopoulos,
E.P., Berry, M., Garfield, B., Roesner, M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20003701?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
This study retrospectively assessed the diagnostic efficacy of fine-needle
aspiration (FNA) using cytological and microbiological examinations in
tuberculous lymphadenitis. Patients with tuberculous lymphadenitis treated
at St Mary's Hospital, London, between January 2001 and June 2007 were
identified. The cytological and microbiological reports of 97 patients were
found. The criteria for a definite diagnosis of tuberculous lymphadenitis
were based on a compatible clinical history, tuberculin positivity, and
either an indicative cytological result or positive culture. In 77 of the 97
(79%) cases, FNA cytology showed evidence of a tuberculous process. In 65
cases, *Mycobacterium tuberculosis* was cultured from the aspirates, and 54
of these 65 cases showed corresponding cytological evidence of a tuberculous
process; 23 cases were diagnosed by cytology but not microbiology, while 11
cases were diagnosed by microbiology but not cytology. Cytological and
microbiological results appeared to correlate well, but each also gives an
exclusive diagnosis. When combining both modalities, the diagnostic efficacy
of FNA rises to 91%. A definitive microbiological diagnosis was achieved in
67% of cases and provided information on drug susceptibility. It is
concluded that samples should be provided for both cytological and
microbiological examination when using FNA to diagnose possible tuberculous
lymphadenitis.
*8.* The International Journal of Tuberculosis and Lung Disease. 2010 Jan;
Volume 14, Number 1: 79-85. *The Impact of Nutritional Deficit on Mortality
of In-Patients with Pulmonary Tuberculosis; *Kim, H.J., Lee, C.H., Shin, S.,
Lee, J.H., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20003699?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
This study investigated the impact of the nutritional deficit assessed by
the Nutritional Risk Score (NRS) on the outcomes of inpatients with
pulmonary TB (PTB). All hospitalized patients with microbiologically
confirmed PTB at a metropolitan governmental medical center, Seoul, Republic
of Korea, were enrolled. A four-point NRS included low body mass index
(<18.5 kg/m(2)), hypoalbuminemia (<30.0 g/l), hypocholesterolemia (<2.33
mmol/l) and severe lymphocytopenia (<7 x 10(5) cells/l). The primary outcome
was overall in-hospital mortality. The degree of radiographical resolution
after antituberculosis treatment was also evaluated. In a total of 156
patients, the male to female ratio was 1.6:1. The overall mortality was
13.5% and TB-specific fatality was 3.9%. Predisposing factors and high NRS
(>/=3 points) were independent risk factors for in-hospital death after
adjusting for the severity of PTB. High NRS (OR = 16.8, P < 0.001) and
predisposing factors (OR = 5.4, P = 0.032) were independent risk factors for
30-day survival. The NRS was not associated with radiographic improvement.
Regardless of disease severity, the high NRS was a significant negative
predictor among inpatients with PTB; this finding should therefore be
considered in the management of PTB despite the current era of effective
antituberculosis chemotherapy.
*9.* The International Journal of Tuberculosis and Lung Disease. 2010 Jan;
Volume 14, Number 1: 72-8. *Reduced Health Provider Delay and Tuberculosis
Mortality Due to an Improved Hospital Programme; *Liu, Y.C., Lin, H.H.,
Chen, Y.S., Su, I.J., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20003698?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
This study evaluated the impact of an in-hospital TB quality care program
initiated in May 2005 on health provider delay and outcome of newly
diagnosed TB cases from a referral hospital in Kaohsiung, Taiwan.
Retrospective chart review was conducted of newly diagnosed TB cases
presenting in 2002 and 2006. Health provider delay, clinical manifestations,
management, and outcome were recorded. Overall, 327 patients before (2002)
and 262 patients after (2006) the program began were enrolled. Patients were
older men (mean age 65.9 years) and 23.4% (138/589) had diabetes; 84.4% had
received antituberculosis treatment. The program shortened the time for
doctors to order a chest X-ray (P < 0.01), and the reporting time for smear
(P < 0.0001) and culture (P < 0.0001). On multivariable analysis, risk
factors for attributable mortality included age >/=65 years (OR 4.4, 95%CI
1.8-10.9, P = 0.001) and liver cirrhosis (OR 4.3, 95%CI 1.1-16.6, P = 0.04).
Treatment reduced mortality by 81% (OR 0.2, 95%CI 0.1-0.4, P < 0.001) and
the program halved overall mortality (OR 0.5, 95%CI 0.3-0.8, P = 0.01), and
reduced attributable mortality by 62% (OR 0.4, 95%CI 0.2-0.8, P < 0.01).
Intervention at the hospital level for quality control of TB care was
instrumental in reducing health provider delay and led to a significant
reduction in mortality.
*10.* The International Journal of Tuberculosis and Lung Disease. 2010 Jan;
Volume 14, Number 1: 65-71. *Adding Moxifloxacin Is Associated with a
Shorter Time to Culture Conversion in Pulmonary Tuberculosis; *Wang, J.Y.,
Wang, J.T., Tsai, T.H., Hsu, C.L., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20003697?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
This study investigated whether adding moxifloxacin (MXF) to the standard
antituberculosis regimen can shorten the time to sputum culture conversion
in pulmonary TB (PTB). Adults with culture-positive PTB were divided into
two treatment groups by their choice: standard regimen alone (HERZ group)
and standard regimen plus daily 400 mg MXF in the first 2 months (MXF
group). Sputum samples were collected thrice weekly in the first 8 weeks.
The propensity score was calculated to estimate the conditional probability
of entering the MXF group. Factors influencing time to culture conversion
were investigated using Cox proportional hazards regression analysis
stratified by propensity score. Sixty-two patients were enrolled in the MXF
group and 88 in the HERZ group; respectively 51 and 72 completed the study.
The regimen was modified before culture conversion in respectively 6 (12%)
and 12 (16%; P = 0.47) patients, due to adverse effects. The time to culture
conversion was shorter in the MXF group (HR 2.1, 95%CI 1.4-3.2). The culture
conversion rate after 6 weeks of treatment was respectively 82% and 61% (P =
0.011, <0.05/4, calculated using the modified Bonferroni method). Adding MXF
to the standard antituberculosis regimen in the first 2 months was
associated with a shorter time to culture conversion, a higher 6-week
culture conversion rate, and reduced transmission of TB.
*11.* The International Journal of Tuberculosis and Lung Disease. 2010 Jan;
Volume 14, Number 1: 59-64. *Experience Establishing Tuberculosis Laboratory
Capacity in a Developing Country Setting; *Paramasivan, C.N., Lee, E., Kao,
K., Mareka, M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20003696?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
This study describes the experience of strengthening laboratory diagnosis of
TB in a resource-limited country with high TB-HIV and multidrug-resistant TB
(MDR TB) prevalence. In the Kingdom of Lesotho, which is confronted with
high levels of TB, MDR TB and HIV prevalence, between 2006 and 2008 a
coalition of the Foundation for Innovative New Diagnostics, Partners In
Health, and the World Health Organization renovated the National TB
Reference Laboratory and reinforced microscopy services, streamlined
conventional culture and drug susceptibility testing (DST), and introduced
modern TB diagnostic methods. It was feasible to establish a biosafety level
three facility for solid culture and DST and an external quality assessment
program for smear microscopy within 4 months, all in 2007. Liquid culture
and DST were introduced a month later. Preliminary results were comparable
to those found in laboratories in industrialized countries. A year later,
line-probe assay for the rapid detection of MDR TB was introduced. Through
strong political commitment and collaboration, it is possible to rapidly
establish quality assured TB diagnostic capacity, including current methods,
in a resource-limited setting. Case detection and management for TB and MDR
TB have been greatly enhanced. From a low baseline, TB culture throughput in
the laboratory increased ten-fold and has been sustained. This experience
has served as a catalyst to translate policy into practice with new
diagnostic technologies. It supports global policy setting to enhance and
modernize laboratory work in developing countries.
*12.* Intern Med. 2009;48(24):2061-7. *Active Tuberculosis in Patients
Undergoing Hemodialysis for End-stage Renal Disease: A 9-year Retrospective
Analysis in a Single Center; *Nakamura, H., Tateyama, M., Tasato, D.,
Teruya, H., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20009393?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
TB in patients undergoing hemodialysis (HD) for end-stage renal disease
(ESRD) is commonly thought to be associated with a very poor prognosis.
Moreover, it is difficult to diagnose. This report describes this condition
and determined the mortality rate and risk factors associated with
mortality. In addition, the study evaluated the usefulness of QuantiFERON
TB-2G((R)) (QFT-2G). In this retrospective study, patients with confirmed TB
admitted between January 2001 and May 2009 were retrospectively identified
and enrolled. The clinical, radiological, and bacteriological data at the
time of admission were recorded. A multivariate analysis was performed to
identify the predictive factors for mortality. A total 19 TB patients (6
females; median age, 73 years) were included. TB occurred in most cases
within 1.3 years from the initiation of dialysis. Most patients presented
with fever (84.2%) and extrapulmonary TB (57.9%). The mortality rate within
24 weeks of the initiation of TB treatment was 36.8%. The factors associated
with mortality were: a short duration of dialysis (HR 8.86, 95% CI
1.03-75.7, p=0.04), and underweight (HR 10.88, 95% CI 1.28-92.6, p=0.02).
The sensitivity of QFT-2G, acid-fast smear, and polymerase chain reaction
was 50, 80, and 88.2% respectively. Data indicate a high incidence of TB in
the early stages of HD and a high mortality rate among these patients. The
clinical utility of QFT-2G was found to be limited. Hypoalbuminemia might
therefore be related to either indeterminate or negative results of QFT-2G.
*13.* The Journal of Bone and Joint Surgery. British Volume. 2009 Oct;
Volume 91, Number 10: 1301-4. *Total Hip Replacement in Active Advanced
Tuberculous Arthritis; *Sidhu, A.S., Singh, A.P., Singh, A.P.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/19794163?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
The researchers describe the results of cemented total hip replacement in 23
patients (23 hips) with active tuberculous arthritis of the hip with a mean
follow-up of 4.7 years (4 to 7). In two patients the diagnosis was proved by
pre-operative biopsy, whereas all others were diagnosed on a
clinicoradiological basis with confirmation obtained by histopathological
examination and polymerase chain reaction of tissue samples taken at the
time of surgery. All patients received chemotherapy for at least three
months before surgery and treatment was continued for a total of 18 months.
Post-operative dislocation occurred in one patient and was managed
successfully by closed reduction. No reactivation of the infection or
loosening of the implant was recorded and function of the hip improved in
all patients. It is concluded that total hip replacement in the presence of
active tuberculous arthritis of the hip is a safe procedure when
pre-operative chemotherapy is commenced and continued for an extended period
after operation.
* *
*14.* Jornal Brasileiro de Pneumologia. 2009 Nov; Volume 35, Number 11:
1092-9. *Bacteriological Analysis of Induced Sputum for the Diagnosis of
Pulmonary Tuberculosis in the Clinical Practice of a General Tertiary
Hospital; *Garcia, S.B., Perin, C., Silveira, M.M., Vergani, G., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20011844?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
This study determined the diagnostic sensitivity of bacteriological analyses
in induced sputum (IS) for the diagnosis of pulmonary TB and identified the
clinical characteristics associated with the confirmed diagnosis, as well as
determined the diagnostic yield of bronchoscopy carried out when IS tests
negative for AFB in smear microscopy. A retrospective, cross-sectional study
was conducted of patients suspected of having active pulmonary TB and
referred to the clinic for sputum induction. The researchers consecutively
reviewed the laboratory data of all patients submitted to sputum induction
between June of 2003 and January of 2006, as well as their electronic
medical records. In addition, the results of the bacteriological analysis of
bronchoscopic specimens collected from the patients whose AFB tests were
negative in IS were reviewed. Of the 417 patients included in the study, 83
(19.9%) presented IS samples that tested positive for TB (smear microscopy
or culture). In the logistic regression analysis, radiological findings of
cavitation (OR = 3.8; 95% CI: 1.9-7.6) and of miliary infiltrate (OR = 3.7;
95% CI: 1.6-8.6) showed the strongest association with the diagnosis of
pulmonary TB. In 134 patients, bronchoscopy was carried out after negative
AFB results in IS and added 25 (64.1%) confirmed diagnoses of pulmonary TB.
In the researchers’ clinical practice, the frequency of confirmed diagnosis
of pulmonary TB using IS (19.9%) was lower than that previously reported in
controlled trials. Cavitation and miliary infiltrate increase the diagnostic
probability of pulmonary TB using IS. The use of bronchoscopy when IS tests
negative for AFB significantly increases sensitivity in the diagnosis of
pulmonary TB.
*15. *Journal of Infection in Developing Countries.; Volume 3, Number 10:
783-8. *Knowledge and Attitudes of Tuberculosis Management in San Juan de
Lurigancho District of Lima, Peru; *Kiefer, E.M., Shao, T., Carrasquillo,
O., Nabeta, P., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/20009280?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1>
Expansion of the health care workforce in Peru to combat TB includes both
professional health care providers (HCPs) such as doctors and nurses, and
non-professional HCPs such as community health workers (CHWs). The
researchers describe the knowledge and attitudes of these HCPs, and identify
modifiable barriers to appropriate antituberculosis treatment. The
researchers surveyed HCPs practicing in 30 clinical settings (hospitals,
community health centers, and health posts) in the San Juan de Lurigancho
district of Eastern Lima, Peru. Multiple-choice questions were used to
assess knowledge of TB. A five-item Likert scale was created to assess
attitudes toward the community, patients, and clinics. Linear regression was
used to identify predictors of mean knowledge score, and analysis of
variance was used to test differences in HCP score. Of the 73 HCPs surveyed,
15% were professionals (doctors or nurses). The remaining 85% were health
technicians, community health workers (CHWs) or students. The mean knowledge
score was 10.0 +/- 1.9 (maximum 14) with professional HCPs scoring higher
than other HCPs (11.7 +/- 1.1 vs. 9.7 +/- 1.9), p < .01). Knowledge gaps
included identification of patients at high risk for TB, assessment of
treatment outcomes, and consequences of treatment failure. The most commonly
cited modifiable barriers were structural, including laboratory facilities
and staffing of TB clinics, with 52.1% and 62.5% of HCPs, respectively,
citing these as problematic. Efforts to improve knowledge of TB HCPs in Peru
should focus on the specific gaps the researchers identified. Further
research is needed to evaluate whether these knowledge gaps correlate with
TB control.
Job Announcements 1. Supervisory Research Health Scientist,
(Mycobacteriology) *NEW* Sponsor: Department Of Health And Human
Services, Centers for Disease Control & Prevention
Location: Atlanta, Georgia
Application deadline: February 19, 2010
This announcement for the branch chief position (Supervisory Research Health
Scientist, GS-601-15) for the Mycobacteriology Laboratory Branch is now open
on the USAJOBS website http://www.usajobs.com/.
JOB SUMMARY:
The position serves as Chief, Mycobacteriology Laboratory Branch, and is
responsible for providing leadership during the planning, directing, and
execution of the activities and services of the Branch.
CDC supports the use of teleworking as a way to help attract and retain
talented individuals in public service, increase worker productivity, and
better prepare the agency to operate during emergencies. Teleworking also
supports the agency's sustainability efforts by reducing energy use,
greenhouse gas emissions, and traffic congestion. This position may be
authorized for teleworking.
Teleworking eligibility will be discussed during the interview process.
While routine participation in the teleworking program is voluntary,
situational teleworking may be required in the event of an emergency.
Interested current federal employees serving under a career or career
conditional appointment should apply to the Job Announcement
HHS-CDC-T3-2010-0077<http://jobview.usajobs.gov/GetJob.aspx?JobID=86121459&JobTitle=Supervisory+Research+Health+Scientist%2c+%28Mycobacteriology%29&q=Health+Scientist&where=Atlanta&brd=3876&vw=b&FedEmp=Y&FedPub=Y&x=81&y=11&pg=1&rad=0&rad_units=miles&re=0&AVSDM=2010-02-05+13%3a29%3a00>between
now and
*February 19,* when it closes.
U.S. citizens should apply to the Job Announcement
HHS-CDC-D3-2010-0119<http://jobview.usajobs.gov/GetJob.aspx?JobID=86127321&JobTitle=Supervisory+Research+Health+Scientist%2c+%28Mycobacteriology%29&q=Health+Scientist&where=Atlanta&brd=3876&vw=b&FedEmp=Y&FedPub=Y&x=81&y=11&pg=1&rad=0&rad_units=miles&re=0&AVSDM=2010-02-05+13%3a35%3a00>between
now and
*February 19*, when it closes.
*2. Senior Director, Behavioral & Biomedical Research Department *
*Sponsor: Family Health International*
Location: Durham, North Carolina
Family Health International (FHI) is dedicated to improving me lives
worldwide through a highly diversified portfolio of research and public
health programs. Since its inception in 1971, FHI has formed partnerships
with national governments and local communities in dozens of countries
throughout the developing world to support lasting improvements in the
health of individuals and the effectiveness of health care systems. FHI
seeks qualified candidates for the position of Senior Director, Behavioral
and Biomedical Research Department to join their team in Durham, NC.
This Senior Director will lead a large research department (70+ staff)
comprising PhD and MD level senior scientists, and master’s level public
health research associates, to develop and maintain an integrated and
coordinated research portfolio in support of FHI’s strategic plan, goals,
and objectives. The incumbent should possess a high level of scientific and
management expertise and substantial experience relevant to research in
HIV-related, reproductive health and/or other relevant research fields and
the ability to manage a diverse portfolio of projects within a complex
organizational framework keeping department staff aligned with
organizational goals.
For more information visit the job website:
http://tbe.taleo.net/NA12/ats/careers/requisition.jsp?org=FHI&cws=1&rid=1217
* *
* *
*3. Infectious Disease Director *
*Sponsor: Chemonics International*
Location: Washington, DC
Application deadline: February 26, 2010
Chemonics International seeks an infectious disease specialist to lead
infectious disease activities and provide strategic and technical approaches
for projects.
Responsibilities include serving as project director for the USAID-funded TB
indefinite quantity contract, and providing home-office management and
technical guidance on all of its task orders. Responsibilities also include
leading infectious disease projects by providing technical, administrative,
and management oversight to project teams; and assisting in new business
development efforts in infectious disease and other health areas, including
providing technical input, performing research, writing proposal sections,
accomplishing strategic positioning, and tracking global infectious disease
trends.
Qualifications:
Master's degree in public health or advanced degree in medicine,
epidemiology, or other related field; minimum 10 years of experience with
donor-funded infectious disease programs in the developing world; experience
in TB, HIV/AIDS, or malaria required; experience in all three diseases
preferred; proven ability to conceptualize, perform, and direct technical
assignments and write technical documents; extensive experience in program
design and implementation; experience with USAID-funded activities strongly
preferred; and fluency in one or more foreign languages preferred.
Application Instructions: Send electronic submissions to
by February 26, 2010. No telephone inquiries, please.
Finalists will be contacted.
For more information in Chemonics International, please visit the website at
http://www.chemonics.com or contact Danielle Kuczynski at
.
* *
*4. Medical Consultant *
*Sponsor: The Heartland National TB Center (HNTC) *
Location: San Antonio, Texas
Responsibilities:
Perform duties as directed by the HNTC Medical Director, and as required by
CDC guidelines; assist Center in coordinating and establishing a clear
definition of needs, plans, and goals; handle administrative duties and
committee functions as assigned; provide appropriate and timely consultative
care via telephone and e-mail requests for consultation on TB patients
throughout the HNTC 13-state region; provide education and training to
fellows, students, and staff; participate and/or assist in research
projects; provide oversight of the development of and input into HNTC
educational opportunities and enduring educational product development;
write and/or assist in writing and reviewing grants, proposals, etc.;
participate as a speaker at Center events and represent the Center when
conducting presentations at local, regional, and national events.
Qualifications: Doctor of Medicine degree required; license to practice in
the United States required. Experience diagnosing and treating TB
preferred.
To apply, submit resume/CV via e-mail to Stephanie Ott at
.
For more information on the HNTC project, call 1-800-TEX-LUNG, or visit our
website at http://www.heartlandntbc.org/ .
*5. 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. 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/ .
* *
*2. 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/
*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. TB/HIV Update: Pre-Conference at the 14th Annual Meeting of the IUATLD
North America Region *
Sponsors: New Jersey Medical School, Global Tuberculosis Institute.
Heartland National TB Center. Francis J. Curry National Tuberculosis Center.
Southeastern National Tuberculosis Center.
Date: March 10, 2010
Location: Orlando, Florida
Registration deadline: February 26, 2010
This four and one-half hour clinical update will familiarize participants
with pertinent topics related to the care and management of patients
coinfected with TB and HIV. Join TB experts from the Regional Training and
Medical Consultation Centers to discuss the challenging epidemic of TB/HIV
with a look at clinical management, preventive therapy, IRIS, case
management, and special topics to include drug interactions and side
effects, infection control, and the use of IGRAs.
Pre-registration is required by February 26 and available online at
http://sntc.medicine.ufl.edu/Training.aspx .
For additional information on the North America Region conference including
registration: http://www.bc.lung.ca/lungdiseases/tuberculosis_iuatld.html .
*5. 14th Annual Conference of the Union-North America Region*
Sponsor: International Union Against Tuberculosis and Lung Disease (IUATLD)
Dates: March 11 – 13, 2010
Location: Orlando, Florida
The conference objectives are to present the current state of the science,
research on diagnosis, treatment, and management of TB and HIV coinfection;
to provide a forum for participants from Latin America, the Caribbean and
Haiti to network with TB experts from North America; and to provide an
opportunity for exchange of knowledge and expertise among professionals
working in the HIV/TB field. General session topics will include (1) TB-HIV
Co-infection: A Sum Greater than Its Parts; (2) Basic Science: From the
Bench to the Bedside; (3) Social Determinants of TB Transmission; (3)
Diagnosis and Treatment; and (4) Assessing the Roles, Results and
Confounders of Newer Laboratory Methods. Related sessions will include a
Stop TB North American Meeting (U.S. and Canada); the annual Stop TB USA
Advocacy Session; the annual Nursing Assembly; a Latin American Liaison
Meeting; plus plenty of networking opportunities and a "Clinical
Conversations" session where there will be opportunities for clinicians and
others to discuss challenging cases with colleagues.
For more information, contact Kitty McAndrews, American Lung Association of
the Upper Midwest. E-Mail ; phone (312) 781-1100; or
access the BC lung Association website at
http://www.bc.lung.ca/lungdiseases/tuberculosis_iuatld.html .
* *
* *
*6. TB Case Management and Contact Investigation for Nurses *
Sponsors: University of Medicine & Dentistry of New Jersey (UMDNJ). New
Jersey Medical School Global Tuberculosis Institute
Dates: March 16 – 17, 2010
Location: Newark, New Jersey
This is an interactive workshop designed to enhance TB case management and
contact interviewing skills of the nurses who attend. Topics include
effective communication, treatment adherence, management of TB in the
pediatric population, and cultural competency. The format includes lectures,
role playing and interview of simulated patients, and small group exercises.
Enrollment is limited to registered nurses who have TB case management as
part of their job responsibilities.
Registration fee: $50. Continuing education credits are available.
For more information, contact DJ McCabe, E-mail: ; Phone:
(973) 972-0978; or access the Web site:
http://www.umdnj.edu/globaltb/courses/brochures/tbcasemgmt2010.html .
*7. TB Infection Control: Training Course for Managers at National and
Sub-National Levels *
Sponsors: WHO Collaborating Center for TB and Lung Diseases. Fondazione S.
Maugeri, Care & Research Institute Tradate. (Italy)
Dates: April 12 – 17, 2010
Location: Sondalo, Italy
Registration deadline: February 15, 2010
The course is addressed to TB and HIV/AIDS managers needing to ensure
implementation of adequate infection control measures at national and
subnational level. It has been designed to review the principles of
infection control and the package to implement infection control measures as
developed by WHO. The course consists of theoretical and practical sessions,
including exercises, problem-solving sessions, and discussion of real
situations in different settings. Participants will be required to develop
an infection control plan as part of the training. A vaneometer will be
provided for each participant.
For more information Contact WHO Collaborating Center for TB, Italy, S.
Maugeri Foundation, Via Roncaccio, 16 21049 Tradate (VA), Italy by E-mail:
or ; by Phone +39 0331
829 404; by Fax: +39 0331 829 402; or access the Web site:
http://www.stoptbitalia.it/who/page8/page9/page9.html .
*8. The South African TB Conference 2010 *
Sponsor: The Southern African NGO Network (SANGONeT)
Dates: June 1 – 4, 2010
Location: Durban, South Africa
Organized by the Foundation for Professional Development (FPD), this TB
conference will be a forum for people of diverse backgrounds, experiences,
and skills. Attendees will come together to review the evidence and to
debate and develop innovative approaches to fight the TB epidemic in the era
of HIV. The theme of the conference will be "Forging Strategic Partnerships
to Fight TB and HIV". This will highlight two central strategies. The first
is the involvement of communities in prevention, case finding, and case
holding activities. The second is the provision of integrated TB and HIV
services.
Early registration fee prior to January 21, 2010: R3 306.00 including VAT;
Regular registration fee prior to May 14, 2010: R3 876.00 including VAT;
On-site registration fee from June 1, 2010: R4 446.00 including VAT.
For more information, contact Tamlynne Wilton, Head, Conference Division,
E-mail: ; Tel: +27 (0) 12 816 9000, 0861 115 182; Fax:
+27 (0) 12 807 7191/ 7153, 0861 115 181 / 180 / 185; or access the Web site
at http://www.ngopulse.org/event/south-african-tb-conference-2010 .
*9. Using Geographic Information Systems (GIS) in Disease Control
Programmes *
Sponsors: International Institute for Geo-Information Science and Earth
Observation (ITC). Royal Tropical Institute (KIT)
Dates: June 21 – July 2, 2010
Locations: Enschede and Amsterdam, Netherlands
This course focuses on the epidemiological assessment of disease burden and
the improvement of programmatic planning and management. Special attention
is given to the requirements for using GIS tools and how routine program
data can be incorporated into the GIS system. Special attention is given to
using GIS tools for TB control programs, but case studies related to malaria
and other infectious diseases are also used. The course will use
ArcViews/ArcGIS. Participants will obtain a one-year student license of
ArcGIS (ArcView).
Application deadline: 2 months before start of course. Fee: €1450 (2010).
For more information contact by emailing ,
; or accessing the Web site:
http://www.kit.nl/smartsite.shtml?id=16884 .
* *
*10. High Global Infectious Diseases Program: US-Japan Tuberculosis and
Leprosy Research Conference & Workshop *
Sponsor: US-Japan Cooperative Medical Science Program (USJCMSP)
Dates: July 13 – 15, 2010
Location: Cambridge, Massachusetts
The US and Japan TB and Leprosy Panels are one of ten scientific panels that
comprise the US-Japan Cooperative Medical Science Program (USJCMSP), a
program sponsored by the National Institute of Allergy and Infectious
Diseases (NIAID), US National Institutes of Health (NIH), and the US
Department of Health and Human Services. The TB/Leprosy Panels sponsor
annual scientific meetings, which alternate between the two regions, and
serve to facilitate scientific exchanges in public health and diseases of
high significance to the Asian region. In addition to the information
exchange, common outcomes of these meetings are US-Japan collaborative
projects that may result in exchanges of personnel between laboratories,
publications, and at times joint funding. In 2010, Harvard University will
host the USJCMSP 45th Tuberculosis and Leprosy Research Conference.
For more information, access the Web site at
http://gid.globalhealth.harvard.edu/icb/icb.do?keyword=k54064&tabgroupid=icb.....
* *
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