MDR-TB Treatment & Prevention
[tb-update] Week of July 3 to July 9, 2011
TB-Related News and Journal Items Weekly Update Week of July 3 to July 9,
2011
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CDC provides the TB-Related News and Journal Items Weekly Update as a
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do not confirm the accuracy of the data in the articles that are abstracted.
Providing synopses of key scientific articles and lay media reports on TB
does not constitute CDC endorsement. This update may also include
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Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press
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however, copies may not be sold. For those items reproduced from the first
section of the TB weekly update, the CDC HIV/Hepatitis/STD/TB Prevention
News Update should be cited. For any other items in the TB weekly update,
you may cite the CDC TB-Related News and Journal Items Weekly Update.
This Week's Contents
TB-Related Announcements <#1310ac4b9c353fe1_H1>
Headlines <#1310ac4b9c353fe1_H3>
Journal Articles <#1310ac4b9c353fe1_H4>
Job Announcements <#1310ac4b9c353fe1_H5>
Upcoming Conferences, Trainings, and Other Events <#1310ac4b9c353fe1_H6>
TB-Related Announcements
*1. 2011 Images to Stop Tuberculosis photo award invites entries*
*NEW*
Stop TB Partnership, June 24, 2011
Application deadline: July 20, 2011
The 2011 Images to Stop Tuberculosis award is open for entries until 20
July. The award, which has the goal of promoting creation of outstanding
photos depicting prevention and treatment of tuberculosis (TB), is sponsored
by the Lilly MDR-TB Partnership.
Photographers are invited to submit their work for consideration. An
international jury of photography experts and representatives from UN and
other partner organizations and chaired by internationally renowned
photojournalist Gary Knight will select the winning photographer. The winner
will receive US$ 5000 in prize money and a US$ 5000 grant to produce a photo
reportage about TB, a disease that takes the lives of 1.7 million people
each year.
The 2010 award went to Misha Friedman, who was born in 1977 in the Moldovan
Soviet Socialist Republic (now the Republic of Moldova) and relocated to the
United States in 1991. For the award assignment Mr. Friedman travelled to
Donetsk, Ukraine. The reportage was featured in the Ukrainian magazine Focus
and in Time Magazine online, among other publications. Photos from the
reportage are available for viewing on the Stop TB Partnership | Award
Winners <http://www.stoptb.org/global/awards/images/awardees/default.asp>.
Applicants for the 2011 award must submit a portfolio of 10 to 15
photographs depicting health-related issues. All entries must be received at
the Stop TB Partnership by 20 July 2011. The name of the winner will be
announced in October 2011.
Find out more about the award <http://stoptb.org/global/awards/images/>
*2. TB Radiology Resource Page*
Curry International Tuberculosis Center (CITC) announces the launch of their
TB Radiology Resource Page. The page contains links to CITC’s 2009 edition
of Radiographic Manifestations of Tuberculosis: A Primer for Clinicians
(hard copy and online versions) as well as their newest product, Basic Chest
Radiology for the TB Clinician. This online self-study presentation provides
learners with an introduction to TB radiology through CITCs’ Medical
Director, Lisa Chen MD, presenting the basics of how to read chest
radiographs. This presentation covers basic anatomy, disease patterns, and
TB-specific radiographic presentations. Learners can follow the presentation
by listening or reading along at their own pace. A companion document, Basic
Chest Radiology for the TB Clinician Presentation Materials, consists of an
animated teaching slide-set which covers the same material in a downloadable
format that you can use to present your own radiology seminar. The teaching
notes are more detailed than in the self-study version and help prepare the
presenter with background information for training as well as offering
interactive teaching suggestions and slide-show animation cues.
These three products can be found at
http://www.currytbcenter.ucsf.edu/tbradiology/.
* *
* *
*3. TB Education and Training Network Project Excellence and TB Educator of
the Year Awards - Request for Nominations *
Nomination deadline: July 15, 2011
The TB Education and Training Network (TB ETN) is currently accepting
nominations for two awards:
- Project Excellence Award
- TB Educator of the Year Award
These two awards have been established to recognize excellence in TB health
education and training by TB ETN members around the world. The awards will
be presented during the annual TB ETN conference (September 20-22, 2011) in
Atlanta, GA.
To be considered for recognition, a completed nomination form, along with
supporting documentation, must be received by TB ETN no later than July 15,
2011. A person may self-nominate or be nominated by someone else.
Submissions will be reviewed by the TB ETN Membership Development Workgroup
and the TB ETN Steering Committee.
For more information regarding award criteria and nomination requirements,
please contact Sarah Segerlind by e-mail at ; by
telephone at (404) 639-8338; or access the TB ETN website:
http://www.cdc.gov/tb/education/tbetn/conference.htm .
* *
*4. Stop TB Partnership – Kochon Prize*
2011 Call for Nominations
The Stop TB Partnership Kochon Prize supports the global fight against TB.
The prize, consisting of a medal and US $65,000, is awarded once a year to
persons, institutions, or organizations that have made a highly significant
contribution to combating TB.
The Stop TB Partnership Secretariat is currently receiving nominations for
the 2011 Kochon Prize, to be awarded at the 42nd Union World Conference on
Lung Health.
Deadline for submitting nominations: July 31, 2011
For information on nomination criteria and on submitting a nomination, visit
the Kochon Prize website at
http://www.stoptb.org/global/awards/kochon/default.asp.
For further information, contact .
*5. Stop TB Partnership and WHO Issue Call for Applications for Membership
in the Green Light Committee, Western Pacific Region *
Stop TB Partnership, May 20, 2011
In response to the need to scale up programmatic management of
drug-resistant TB in the WHO Western Pacific Region, and following the
decision of the Stop TB Partnership Coordinating Board at its most recent
meeting, the Green Light Committee (GLC) is establishing a GLC Western
Pacific. This regional GLC will function as an advisory committee to the WHO
Regional Office for the Western Pacific, WHO’s Member States in the Pacific
region, donors, and partners. The Secretariat of the GLC Western Pacific
will be hosted by the WHO Regional Office for the Western Pacific.
Members of the GLC Western Pacific are expected to serve a term of two
years, from July 2011 to June 2013. Members will be selected by a committee
convened by the Stop TB Partnership and WHO based on consensus and an
equitable distribution of experts across technical areas and constituencies.
Experts from the Western Pacific region or with extensive experience in the
region are strongly encouraged to apply.
Click here [.pdf]<http://www.stoptb.org/assets/documents/news/GLC%20Pacific%20Call.pdf>for
more information and application instructions.
*6. Call to Action on Childhood TB *
Stop TB Partnership/World Health Organization
The Stop TB Partnership encourages you to sign the Call to Action on
Childhood TB. The call was an outcome of an international meeting organized
jointly by the European Center for Disease Prevention and Control (ECDC) and
the Stop TB Partnership's Childhood TB Subgroup in March.
The meeting was attended by a wide range of participants, including
researchers, pediatricians, community representatives, civil society
organizations, and ECDC and WHO staff. The objectives of the meeting were
to:
- identify and highlight the gaps, challenges, and needs in childhood TB
control.
- prepare the scientific rationale for the need for advocacy and to identify
the key areas where more advocacy and targeted engagement with stakeholders
are needed.
- reach a consensus on how to advocate for childhood TB control.
There was strong consensus among participants on the urgent need to make the
voice of children heard through concerted advocacy efforts. A detailed
program of the meeting, with all presentations, can be found at the ECDC
website<http://ecdc.europa.eu/en/press/events/Lists/Events/ECDC_DispForm.aspx?List=43564830%2D6b8a%2D442f%2D84e7%2D2495fa49489b&ID=125&RootFolder=%2Fen%2Fpress%2Fevents%2FLists%2FEvents>
The Call to Action <http://www.stoptb.org/getinvolved/ctb_cta.asp> is now
available on the Stop TB Partnership website. Click here to
sign<http://www.stoptb.org/getinvolved/cta_signup.asp>
.
Headlines
*1.* *MSF Launches New Series of Blogs by MDR-TB Patients (Switzerland)*
Stop TB Partnership, www.stoptb.org, June 24, 2011
Médecins Sans Frontièrs (Doctors Without Borders) has created a new website
with blogs written by patients being treated for multidrug-resistant TB (MDR
TB). The website, TB and Me, features bloggers from all over the world
writing about their experience living with MDR TB. The site can be accessed
at http://msf.ca/blogs/tb/.
*2.* *New TB Vaccine Most Effective When Not Co-Administered with Other
Childhood Vaccines (The Gambia)*
Pediatric Supersite, www.pediatricsupersite.com, June 22, 2011
Clinical trials of the new TB vaccine (MVA85A, Oxford-Emergent TB
Consortium) proved to be more effective when administered alone compared to
being administered with other childhood immunizations. The new vaccine was
designed to boost BCG. Dr. Martin Ota and colleagues tested MVA85A by
administering it to three groups of four-month-old infants. One group
received the normal childhood vaccines; the second group received the usual
childhood vaccines plus BCG as well as MVA85A; and the third group received
MVA85A alone. The infants in the second and third groups had a significant
immune response, but there was a significantly lower immune response in
those who received both routine childhood immunizations and MVA85A. Findings
indicate that MVA85A and BCG may work best when given together, but separate
from other childhood immunizations. The article was published online in
Science Translational Medicine 2011 Jun 22; Volume 3, Number 88: 88ra56 DOI:
10.1126/scitranslmed.3002461.
*3. MetroAccess Riders Exposed to Tuberculosis Sue Transit Agency (United
States)*
Washington Examiner, http://washingtonexaminer.com, June 27, 2011, by Kytja
Weir,
A group of individuals with disabilities who used MetroAccess has filed a
class-action lawsuit against the transit service for exposing them to TB. A
driver with MetroAccess had TB and continued to transport the complainants
for several months in 2008. At least three of the individuals who used
MetroAccess have tested positive for latent TB infection.
*4. Sanofi and Weill Cornell to Conduct TB Research (France)*
Zenopa, www.zenopa.com, July 1, 2011
The French pharmaceutical company Sanofi has signed an agreement with Weil
Cornell Medical College to conduct research on TB drugs. Under the
agreement, Sanofi will provide the college with access to 80,000 of its
chemical compounds to be screened for potential efficacy against TB. Any
new compounds that result will be developed by Sanofi as new treatments for
TB. It is hoped that the new drugs will shorten treatment time as well as
cure drug-resistant TB. The drug rifampicin, which is still used in TB
treatment, was discovered by Sanofi in the early 1960s.
*5. Epistem to Evaluate Xcelris’ Genedrive PoC System for TB Diagnosis in
India (United Kingdom)*
GEN, www.genengnews.com, June 30, 2011
Epistem of the United Kingdom and Xcelris Laboratories of India will jointly
evaluate the use of Epistem’s Genedrive™ point-of-care molecular diagnostic
device used by India’s Revised National TB Control Program (RNTCP). The
system was developed to provide rapid, low-cost analysis of molecular
biomarkers in a simple integrated unit, with results available in less than
30 minutes. The handheld device will be evaluated for early identification
of TB disease. After the evaluation, the partners anticipate rolling out the
device to select remote locations prior to a full evaluation of market
positioning. The RNTCP began using the system in 1997 to improve rapid TB
diagnosis and treatment.
*6. Home Sick Home? Architect Goes after Tuberculosis in Haiti (United
Kingdom)*
VPR News, www.vpr.net, June 28, 2011, by Eliza Barclay
Peter Williams, an architect and visiting scholar in the Healthy
Infrastructure College, London, has founded a nonprofit group, Architecture
for Health in Vulnerable Environments (ARCHIVE). The group is based in New
York. Williams has worked in many countries and has seen overcrowding in
slums where TB bacteria can be transmitted in badly ventilated places. Since
good ventilation can prevent TB transmission, the group plans to build
better homes for people at risk of acquiring infections. The first project
is in Saint-Marc, Haiti. Haiti had a TB rate of 306 cases per 100,000
persons in 2007. The ARCHIVE competition for designs of the homes resulted
in submissions from 1,600 people from around the world, who were then
reduced to 20 finalists. Construction of the five winning prototypes began
in June of 2011 and should be finished by September and then tested by local
people. ARCHIVE will then choose one design to be built for 20 inhabitants.
The homes use stacked ventilation with perforated walls to maintain
continuous airflow. They have less indoor humidity and better access to
sunlight. One winning prototype called Breathe House was designed by
architects and their students from the United States and the United Kingdom,
and includes a user’s guide for easy construction with mostly local
materials. ARCHIVE will pay the cost of building the homes, as the $50,000
price is too expensive for most Haitians.
*7. Va Prison Locked Down by Possible TB Case (Richmond, VA , United States)
*
WJTV.com, http://www2.wjtv.com, June 29, 2011, by Associated Press
The housing unit of Virginia’s Haynesville Correctional Center has been
under lock down because of a possible case of TB. Protective face masks were
issued to staff and inmates of the unit. According to Larry Traylor, State
Department of Corrections Spokesperson, an inmate was recently isolated at
the prison’s medical unit after showing TB symptoms. The Virginia Department
of Health will conduct mass testing, and if no cases are found, the unit
will return to normal operations. Haynesville is a medium- and low-security
prison with about 1,150 inmates.
*8. PAHO/WHO Move to Step Up Coordination between HIV, TB Programmes in
Region (Latin America and Caribbean nations)*
Jamaica Observer, www.jamaicaobserver.com, July 6, 2011
Most patients in Latin America and the Caribbean who are coinfected with HIV
and TB are unaware of their coinfection because HIV-infected patients are
not being tested for TB, and TB patients are not being tested for HIV.
Public health experts believe that this situation results from a lack of
coordination between HIV and TB programs. The Pan American Health
Organization (PAHO) and the World Health Organization (WHO) have organized
two meetings in Panama City to promote increased coordination among HIV and
TB programs with other public health partners. The meetings will include
heads of HIV and TB programs from 18 Latin American and Caribbean countries
and experts from the US Agency for International Development (USAID), the US
Centers for Disease Control and Prevention, the Pan American Association of
Infectology, the UN Office on Drug and Crime, and the International Labor
Organization. UNAIDS will host a workshop on accelerating advocacy on TB/HIV
for representatives of patient advocacy groups and civil society
organizations from 15 countries in the region. In the PAHO/WHO meetings,
experts will provide recommendations on scaling up collaborative activities
between HIV and TB programs, and will urge active involvement of public and
private health care providers, partner organizations, patients and patient
advocates, and other members of the community and civil society to support
the efforts to intensify the HIV-TB collaboration.
Journal Articles
*1.* African Health Sciences. 2011 Mar; Volume 11, Number 1: 116-27. *Central
Nervous System Tuberculosis;* Cherian, A., Thomas, S.V.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21572867>
Central nervous system (CNS) involvement, one of the most devastating
clinical manifestations of TB is noted in 5 to 10% of extrapulmonary TB
cases, and accounts for approximately 1% of all TB cases. Definitive
diagnosis of tuberculous meningitis (TBM) depends upon the detection of the
tubercle bacilli in the CSF. Every patient with TBM should preferably be
evaluated by imaging with contrast enhanced CT either before or within the
first 48 hours of treatment. An extra-neural focus of TB should be sought
clinically and radiologically in all patients with CNS TB as it may indicate
safer and more accessible sites for diagnostic samplings. A minimum of 10
months treatment is warranted, prompted by the uncertain influences of
disease severity, CNS drug penetration, undetected drug resistance and
patient compliance. All patients with TB meningitis may receive adjunctive
corticosteroids at presentation regardless of disease severity even for
those with HIV infection. Drug resistance is strongly associated with
previous treatment. The key principle of managing drug-resistant TB is never
to add a single drug to a failing regimen. Early ventriculo-peritoneal
shunting should be considered in those with hydrocephalus failing medical
management. The single most important determinant of outcome is the stage of
tuberculous meningitis at which treatment has been started.
*2.* Annals of Thoracic and Cardiovascular Surgery. 2011 Apr; Volume 17,
Number 2: 143-7. *Surgery Offers High Cure Rates in Multidrug-Resistant
Tuberculosis;* Yaldiz, S., Gursoy, S., Ucvet, A., Kaya, S.O.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21597410>
Drug resistance has become a major problem in the treatment of TB, and
pulmonary resection in combination with chemotherapy appears to be an
effective measure for the treatment. The study investigated the results of
resection for multidrug-resistant pulmonary TB (MDR TB). The researchers
retrospectively reviewed case files from January 2003 to December 2006 of 13
patients with MDR TB who underwent pulmonary resection. Of 13 patients, 7
(53.9%) were sputum positive for *Mycobacterium
tuberculosis*preoperatively, though after surgery, they were sputum
negative. Lobectomy
was performed in 8 (61.5%) and pneumonectomy, in 5 (38.5%). In the lobectomy
group, 2 patients had an additional superior segmentectomy and 1 had a
middle lobectomy for other segmental or lobar lesions. Operative mortality
was 7.6% (1/13). There were no late surgical deaths. In the early
postoperative period, 3 patients had serious complications (postoperative
bleeding, prolonged air leak, expansion deficit, bronchopleural fistula and
empyema) that were resolved with surgery (morbidity 23.0%). The 12 patients
who survived the operation received appropriate chemotherapy and were
followed up for 24-37 months. None of the patients relapsed, and the overall
cure rate was 92.3% (12/13). Even with high morbidity in the early
post-operative period, surgery, in addition to medical therapy, offers
higher cure rates than only medical therapy; however, meticulous
preoperative evaluation of patients is needed.
*3.* APMIS. 2011 Jun; Volume 119, Number 6: 377-84. doi:
10.1111/j.1600-0463.2011.02743.x. Epub 2011 Mar 24. *Latent Tuberculosis
Infection among New Recruits to the Army in Beijing, China in 2009;* Wu, X.,
Liang, Y., Wang, L., Wang, Z., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21569096>
China is a country with high latent TB infection (LTBI) and has a policy of
routine BCG vaccination. To monitor (TB) infection, a total of 907 new
recruits to the army were interviewed and routinely examined by chest
radiographs. They were intradermally injected with purified protein
derivative (PPD) and detected with enzyme-linked immunospot (ELISPOT) assay
with recombinant CFP-10/ESAT-6 (rCFP-10/ESAT-6) fusion protein, as a
stimulus, from December 2009 to February 2010. The prevalence of LTBI among
new recruits was estimated as 50.2% and 30.7% by PPD skin test and ELISPOT
assay, respectively. Of 452 PPD-negative and 455 PPD-positive volunteers,
132 (29.2%) and 146 (32.1%) were ELISPOT positive, respectively. The overall
consistency between these two tests was 51.4% (466/907). Although 65.6% of
PPD-positive volunteers and 27.8% of ELISPOT-positive volunteers
(spot-forming cells; SFC 12.2 ± 21.2) could find the vaccination scars on
their arms, 21.3% of PPD-positive volunteers and 35.9% of ELISPOT-positive
volunteers (SFC 18.3 ± 34.6) could not. Thus, the TB infection rate in army
recruits in China was not as high as previously reported. The results
suggest that the ELISPOT technique, the researchers presented, is an
accurate method for screening TB infection in China.
*4.* Archives of Medical Research. 2011 Feb; Volume 42, Number 2:
138-43. *Indeterminate
Results of QuantiFERON-TB Gold In-Tube Assay in Nonimmunosuppressed
Children;* Zrinski Topić, R., Zoričić-Letoja, I., Pavić, I., Dodig, S.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21565627>
QuantiFERON-TB Gold In-Tube (QFT-IT) assay is a highly sensitive and
specific test for the diagnosis of latent TB infection. Data on the use of
QFT-IT assay in children are scarce and contradictory. The study assessed
the rate of indeterminate test results and identified factors contributing
to indeterminate results on routine use of QFT-IT assay in
nonimmunosuppressed children. This retrospective study included 2,173
children with ages ranging from 1 month to 18 years. Determination of
interferon-gamma (IFN-γ) in peripheral blood was performed by commercial
QFT-IT assay. Indeterminate test results were recorded in ten (0.46%)
subjects with ages ranging from 15 months to 15 years. The value of negative
control was >8.0 kIU/L in one subject, whereas in the remaining nine
subjects indeterminate results were consequential to positive control (<0.50
kIU/L). None of these subjects had any history data on congenital or
acquired immunodeficiency disorders. Bacterial infection (with elevated body
temperature and therapy with β-lactam antibiotics) was present in eight
subjects with indeterminate results, one subject had exacerbation of asthma
(therapy with inhalation corticosteroids), and one subject was clinically
healthy. Repeat IFN-γ determination performed in seven subjects did not
yield indeterminate results. Study results showed the rate of indeterminate
QFT-IT results in nonimmunosuppressed children of all age groups to be very
low. QFT-IT should preferably be performed upon resolution of acute
inflammation in order to avoid repeat testing of indeterminate results in a
new blood sample and to reduce the cost of testing.
*5.* Drugs. 2011 May 7; Volume 71, Number 7: 815-25. doi:
10.2165/11585440-000000000-00000. *Drug-Resistant Tuberculosis: What are the
Treatment Options? *Albanna, A.S., Menzies, D.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21568360>
Drug-resistant TB (DR-TB) is an emerging global health threat as treatment
involves complex multiple drug regimens, which are longer and more toxic
than standard therapy and yet have worse outcomes. In the presence of
resistance to one or more first-line drugs, an alternative regimen should be
designed. A major problem is the almost complete lack of published evidence
regarding the optimal drug combinations and duration of treatment for the
different types of DR-TB. Current principles, some of which are based on
expert opinion, are that at least three new anti-TB agents should be added
to a failing regimen and four agents when multidrug resistance is suspected.
All first-line oral anti-TB agents to which the *Mycobacterium
tuberculosis*strains are susceptible should be used, plus one
fluoroquinolone. In
addition, one injectable anti-TB agent and one or more second-line oral
anti-TB agents should be added to the regimen until the target number of
drugs is reached. The duration of treatment depends on the type of drug
resistance, the type and number of drugs used in the regimen, and the extent
of the disease. All forms of DR-TB should receive daily, not intermittent,
therapy and all doses should be directly observed. Because of the high rate
of adverse drug effects, careful monitoring and appropriate management of
these adverse reactions are important to achieve successful treatment.
Supportive measures, such as adequate nutrition along with emotional and
social supports, are an important part of the treatment. Careful
consideration is required when dealing with pregnant or lactating women and
HIV co-infected patients, as well as in treatment of extrapulmonary DR-TB.
*6.* Evidence-Based Complementary and Alternative Medicine. 2011; Volume
2011: 782503. Epub 2011 Mar 31. *Flourensia cernua: Hexane Extracts a Very
Active Mycobactericidal Fraction from an Inactive Leaf Decoction against
Pansensitive and Panresistant Mycobacterium tuberculosis;* Molina-Salinas,
G.M., Peña-Rodríguez, L.M., Mata-Cárdenas, B.D., Escalante-Erosa, F., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21584254>
The efficacy of decoction in extracting mycobactericidal compounds
from *Flourensia
cernua* (Hojasé) leaves and fractionation with solvents having ascending
polarity was compared with that of (i) ethanol extraction by still
maceration, extraction with a Soxhlet device, shake-assisted maceration, or
ultrasound-assisted maceration, followed by fractionation with n-hexane,
ethyl acetate, and n-butanol; (ii) sequential extraction with n-hexane,
ethyl acetate, and n-butanol, by still maceration, using a Soxhlet device,
shake-assisted maceration, or ultrasound-assisted maceration. The in vitro
mycobactericidal activity of each preparation was measured against
drug-sensitive (SMtb) and drug-resistant (RMtb) *Mycobacterium
tuberculosis*strains. The results of which were expressed as absolute
mycobactericidal
activity (AMA). These data were normalized to the ΣAMA of the decoction
fraction set. Although decoction was inactive, the anti-RMtb normalized ΣAMA
(NAMA) of its fractions was comparable with the anti-RMtb NAMA of the still
maceration extracts and significantly higher than the anti-SMtb and
anti-RMtb NAMAs of every other ethanol extract and serial extract and
fraction. Hexane extracted, from decoction, material having 55.17% and
92.62% of antituberculosis activity against SMtb and RMtb, respectively.
Although the mycobactericidal activity of decoction is undetectable; its
efficacy in extracting *F. cernua* active metabolites against *M.
tuberculosis* is substantially greater than almost all pharmacognostic
methods.
*7.* International Journal of Preventive Medicine. 2011 Apr; Volume 2,
Number 2:v79-81. *A Six Months Follow-up on Children Less Than 6 Years Old
in Contact with Smear Positive Tuberculosis Patients, Varamin City, Tehran,
Iran;* Aminzadeh, Z., Asl, R.T.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21603012>
Current international guidelines recommend 6-9 months of isoniazid (INH)
preventive chemotherapy to prevent the development of active TB in children
exposed to smear positive TB patients. This study evaluated the adherence to
a six-month of supervised INH prophylaxis program and outcome in children
with household exposure to an adult pulmonary TB index case in Varamin city,
Tehran, Iran. This cross sectional study was conducted among household
contacts in Varamin city, between 1997- 1998. All children <6 years old with
a household contact with an adult pulmonary TB index case were screened for
TB and given supervised INH preventive chemotherapy once active TB was
excluded as planned. Adherence and outcome were monitored. In total, 31
index cases and 128 household contact cases were identified; 23 (18%)
children <6 years old experienced household exposure, who were fully
evaluated. Two children were treated for active TB and 15 (12%) children
received preventive chemotherapy. All children completed 6 months of
supervised INH prophylaxis with normal clinical examination in 3 and 6
months after beginning INH prophylaxis. No side effects (peripheral
neuropathy or liver damage) were reported or observed within this study.
Strategy of six months of supervised INH chemoprophylaxis is successful,
particularly in children who are at a high risk to progress to disease
following exposure.
*8.* The International Journal of Tuberculosis and Lung Disease. 2011 Jun;
Volume 15, Number 6: 848-50. *Decline in Tuberculosis with 19 Years of
Universal Directly Observed Therapy in a Comprehensive Statewide
Program;*Webb, R.M., Penman, A., Holcombe, M., Dobbs, T., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21575310>
The Mississippi State Department of Health TB program serves a rural
southeastern US state of 2.9 million people in an area of 121 489 km(2)
(46 907 square miles). Statewide, DOT began in 1986. To evaluate the
program's effectiveness, trends in Centers for Disease Prevention and
Control program indicators for 1981-2005 were compared and found to be
significant (P < 0.0001). Inclusion of rifampin and pyrazinamide in the
regimens was reviewed. An annual decline in cases and case rates began in
1990, falling by 65% by 2005. It is concluded that successful DOT is
feasible over a large geographic area.
*9.* The International Journal of Tuberculosis and Lung Disease. 2011 Jun;
Volume 15, Number 6: 838-43. *Association between Smoking Status, Other
Factors and Tuberculosis Treatment Failure in Morocco;* Tachfouti, N.,
Nejjari, C., Benjelloun, M.C., Berraho, M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21575308>
The association between smoking and TB treatment failure has not yet been
assessed in Morocco. This study evaluated the impact of smoking on the
failure rate of patients with TB. A cohort of 727 new TB cases was followed
between 2004 and 2009. Socio-demographic measurements and smoking status
were collected by questionnaire. Treatment failure was defined according to
international guidelines. Univariate analyses were used to assess
associations of treatment failure with smoking status and demographic
characteristics. Multivariate logistic regression was used to adjust for
potential confounding. The patients' mean age was 35.0 ± 13.2 years. The
monthly household income was <€180 for 71.4% of the patients. The rate of
treatment failure was 6.9%. Failure was significantly higher among smokers
(9.1% vs. 4.5%; P < 0.01), alcohol drinkers (18.5% vs. 4.9%; P < 0.01), and
those with a monthly income of <€180 (8.4% vs. 3.3%; P < 0.01). After
adjusting for confounding variables, smoking and low income remained
significantly associated with treatment failure (adjusted OR 2.25, 95%CI
1.06-4.76, and 3.23, 95%CI 1.12-9.32). Smoking is associated with TB
treatment failure in Morocco. Anti-smoking interventions should be
incorporated into current TB case management.
*10.* The International Journal of Tuberculosis and Lung Disease. 2011 Jun;
Volume 15, Number 6: 795-8. *Detection of Tuberculosis Using artus® M.
tuberculosis PCR Kit and COBAS® AMPLICOR™ Mycobacterium tuberculosis
Test;*Hur, M., Moon, H.W., Yun, Y.M., Kang, T.Y., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21575301>
Nucleic acid amplification tests can detect *Mycobacterium
tuberculosis*complex rapidly and reliably. This study compared the
diagnostic performance
of the artus® *M. tuberculosis* PCR Kit and COBAS® AMPLICOR™ *Mycobacterium
tuberculosis* Test. In the artus assay, an appropriate cycle threshold (Ct)
value was determined for positivity. A total of 238 clinical respiratory
specimens were analyzed using both the artus and COBAS AMPLICOR assays. In
221 specimens, these results were further compared with culture results. The
overall agreement between artus and COBAS AMPLICOR was 96.2% (229/238).
Among the nine (3.8%) discrepant specimens, three (1.3%) were artus-positive
and COBAS AMPLICOR-negative, while the other six (2.5%) were artus-negative
and COBAS AMPLICOR-positive. Using culture as a standard, the sensitivity
and specificity of the artus assay were 97.8% and 85.1%, and those of COBAS
AMPLICOR assay were 100% and 86.2%, respectively. The difference was not
statistically significant. In the artus assay, the minimum Ct value for the
positivity determination was 38. The artus and COBAS AMPLICOR assays showed
comparable diagnostic performance and can be confidently used for detection
of *M. tuberculosis* complex. In the artus assay, a Ct value of 38 could be
suggested as an appropriate cut-off value.
*11.* The International Journal of Tuberculosis and Lung Disease. 2011 Jun;
Volume 15, Number 6: 789-94. *Genotyping and Drug Resistance Patterns
of Mycobacterium
tuberculosis Strains in Five Provinces of China;* Guo, Y.L., Liu, Y., Wang,
S.M., Li, C.Y., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21575300>
* *
This study evaluated the distribution of the *Mycobacterium
tuberculosis*Beijing genotype and the association of the genotype with
drug-resistant
*M. tuberculosis* strains in five provinces in China. *M.
tuberculosis*strains (n = 158) isolated from five provinces of China
were subjected to
insertion sequence 6110 restriction fragment length polymorphism (RFLP),
spoligotyping and mycobacterial interspersed repetitive units (MIRU)
analyses. The prevalence of the Beijing genotype strains in each province
was determined and compared. The proportion method was used to test the drug
susceptibility of all strains. Of the 158 strains, 123 (77.8%) were
identified as the Beijing genotype by RFLP and spoligotyping. Nearly all the
strains (n = 152, 96.2%) were grouped into 14 shared spoligotypes. Six other
spoligotypes were unique to China. The prevalence of the Beijing genotype
was significantly higher in the interior than in coastal areas (P < 0.001,
OR 5.4, 95%CI 2.3-12.7). Resistance to rifampicin (RMP) was associated with
the Beijing strain (P = 0.05, OR 3.7, 95%CI 1.2-11.1). The *M.
tuberculosis*Beijing genotype varies in prevalence in different
regions of China and is
solely associated with RMP resistance.
* *
* *
*12.* Neurology India. 2010 Sep-Oct; Volume 58, Number 5: 732-5. *Tuberculous
Optochiasmatic Arachnoiditis;* Anupriya, A., Sunithi, M., Maya, T., Goel,
M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21045497>
Arachnoiditis involving optic nerve and the optic chiasm can occur as a
complication of tuberculous meningitis (TBM). This study evaluated the
clinical features, cerebrospinal fluid (CSF), and laboratory parameters and
imaging findings of optochiasmatic arachnoiditis (OCA) and also tried to
identify any factors which could predict this complication in patients with
TBM. Patients admitted with TBM in the neurology wards of a tertiary care
teaching hospital over a period of 6 years formed the material for this
study. Student's "t" test and univariate analysis were done to identify any
predictors for this complication and the variables found to be significant
were further analyzed by multivariate logistic regression analysis. One
hundred sixty-three patients with TBM, admitted over a 6-year period, were
studied. Twenty-three (14%) patients developed OCA. Eighteen out of 23 (78%)
developed this complication while on antituberculous treatment (ATT) and
5/23 (22%) were newly diagnosed cases of TBM. Of those already on treatment,
12/23 (52%) were receiving only ATT, the remaining 6/23 (26%) had received
steroids along with ATT in varying doses and duration. The average period
from diagnosis of TBM to visual symptoms was 6.4 months. On the multivariate
logistic regression analysis, female sex (P < 0.037), age less than 27 (P <
0.008) years and protein content in the CSF > 260 mg% (P < 0.021) were the
factors predisposing toward this complication. At 6 months follow-up, on
treatment with steroids and ATT, 17% had improvement and no further
deterioration was noted in visual acuity in 52%. OCA can develop even while
on treatment with ATT. Young women with a high CSF protein content seem to
be more prone for this complication.
*13.* PLoS Med. 2011 May; Volume 8, Number 5: e1001029. Epub 2011 May
3. *Effectiveness
of Early Antiretroviral Therapy Initiation to Improve Survival among
HIV-Infected Adults with Tuberculosis: A Retrospective Cohort
Study;*Franke, M.F., Robins, J.M., Mugabo, J., Kaigamba, F., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21559327>
Randomized clinical trials examining the optimal time to initiate
combination antiretroviral therapy (cART) in HIV-infected adults with sputum
smear-positive tuberculosis (TB) disease have demonstrated improved survival
among those who initiate cART earlier during TB treatment. Since these
trials incorporated rigorous diagnostic criteria, it is unclear whether
these results are generalizable to the vast majority of HIV-infected
patients with TB, for whom standard diagnostic tools are unavailable. The
researchers examined whether early cART initiation improved survival among
HIV-infected adults who were diagnosed with TB in a clinical setting. The
researchers retrospectively reviewed charts for 308 HIV-infected adults in
Rwanda with a CD4 count≤350 cells/µl and a TB diagnosis. They estimated the
effect of cART on survival using marginal structural models and simulated
2-y survival curves for the cohort under different cART strategies:start
cART 15, 30, 60, or 180 d after TB treatment or never start cART. The
researchers conducted secondary analyses with composite endpoints of (1)
death, default, or lost to follow-up and (2) death, hospitalization, or
serious opportunistic infection. Early cART initiation led to a survival
benefit that was most marked for individuals with low CD4 counts. For
individuals with CD4 counts of 50 or 100 cells/µl, cART initiation at day 15
yielded 2-y survival probabilities of 0.82 (95% confidence interval: [0.76,
0.89]) and 0.86 (95% confidence interval: [0.80, 0.92]), respectively. These
were significantly higher than the probabilities computed under later start
times. Results were similar for the endpoint of death, hospitalization, or
serious opportunistic infection. cART initiation at day 15 versus later
times was protective against death, default, or loss to follow-up,
regardless of CD4 count. As with any observational study, the validity of
these findings assumes that biases from residual confounding by unmeasured
factors and from model misspecification are small. Early cART reduced
mortality among individuals with low CD4 counts and improved retention in
care, regardless of CD4 count.
*14.* PLoS One. 2011 Apr 29; Volume 6, Number 4: e19399. *Characteristics
and Treatment Outcomes of Patients with MDR and XDR Tuberculosis in a TB
Referral Hospital in Beijing: A 13-Year Experience;* Liu, C.H., Li, L.,
Chen, Z., Wang, Q., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21559362>
Information on treatment outcomes among hospitalized patients with
multidrug-resistant TB (MDR TB) and extensively drug-resistant TB (XDR TB)
are scarce in China. The researchers conducted this retrospective study to
analyze the characteristics and treatment outcomes in MDR- and XDR TB
patients in the 309 Hospital in Beijing, China, during 1996-2009.
Socio-demographic and clinical data were retrieved from medical records and
analyzed. Logistic regression analysis was performed to identify risk
factors associated with poor treatment outcomes and Cox proportional hazards
regression model was further used to determine risk factors associated with
death in TB patients. Among the 3,551 non-repetitive hospitalized TB
patients who had drug susceptibility testing (DST) results, 716 (20.2%) had
MDR TB and 51 (1.4%) had XDR TB. A total of 3,270 patients who had medical
records available were used for further analyses. Treatment success rates
(cured and treatment completed) were 90.9%, 53.4%, and 29.2% for patients
with non-MDR TB, patients with MDR TB excluding XDR TB, and patients with
XDR TB, respectively. Independent risk factors associated with poor
treatment outcomes in MDR TB patients included being a migrant (adjusted OR
= 1.77), smear-positivity at treatment onset (adjusted OR = 1.94) and not
receiving 3 or more potentially effective drugs (adjusted OR = 3.87).
Independent risk factors associated with poor treatment outcomes in XDR TB
patients were smear-positivity at treatment onset (adjusted OR = 10.42) and
not receiving 3 or more potentially effective drugs (adjusted OR = 14.90).
The independent risk factors associated with death in TB patients were
having chronic obstructive pulmonary disease (adjusted HR = 5.25) and having
hypertension (adjusted HR = 4.31). While overall satisfactory treatment
success for non-MDR TB patients was achieved, more intensive efforts should
be made to better manage MDR- and XDR-TB cases in order to improve their
treatment outcomes and to minimize further emergence of so-called totally
drug-resistant TB cases.
*15.* Saudi Medical Journal. 2011 May; Volume 32, Number 5: 484-8. *Drug
Susceptibility Pattern of Mycobacterium tuberculosis Isolates against
Conventional Anti-Tuberculosis Drugs in Dhaka, Bangladesh;* Mottalib, A.,
Hossain, M., Khalil, I., Islam, S., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21556469>
This study investigated the drug susceptibility pattern of isolated
*Mycobacterium
tuberculosis* (*M. tuberculosis*) against conventional anti-tuberculosis
drugs in Dhaka, Bangladesh. Sputum samples from 101 suspected new and
previously treated patients were collected and *M. tuberculosis* was
identified by microscopic observation and Ziehl-Neelsen staining. Drug
susceptibility was performed against 4 anti-tuberculosis drugs, and the
obtained data was analyzed. This study was performed in the Bangladesh
Institute of Research and Rehabilitation in Diabetes, Endocrine and
Metabolic Disorders Hospital, Dhaka, Bangladesh between October 2008 and
November 2009. Among 101 suspected, 59 (58.4%) cases were identified as *M.
tuberculosis* and the drug susceptibility pattern of 50 positives isolates
was studied against 4 anti-tuberculosis drugs. Out of these 50 isolates of *M.
tuberculosis*, 25 (50%) were sensitive to all drugs, and 25 (50%) were
resistant to one or more drugs. Among 50 positive patients, 37 (74%) were
new cases, and 13 (26%) were previously treated cases. Among 37 new cases,
14 (37.8%) cases were resistant to one or more drugs, whereas 11 out of 13
(84.6%) treated cases were resistant to one or more drugs. Among the 50
positive isolates, 26% demonstrated resistance to isoniazid, 12% to
rifampicin, 22% to streptomycin, 20% to ethambutol, and 8% to multidrug
resistance. The emergence of drug resistant *M. tuberculosis* isolates in
Dhaka is alarming, which is currently 5-fold higher than last decade. Strict
measures should be taken to control and prevent drug-resistant TB.
*16.* Tuberkuloz ve Toraks. 2011 Mar; Volume 59, Number 1: 43-7. *Comparison
of Tuberculin Skin Testing and QuantiFERON-TB Gold-In Tube Test in Health
Care Workers;* Cağlayan, V., Ak, O., Dabak, G., Damadoğlu, E., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21554229>
This prospective, cross-sectional observational study compared the
tuberculin skin testing (TST) with QuantiFERON-TB Gold-In Tube (QTF-GIT) for
the detection of latent TB infection (LTBI) in healthcare workers (HCWs).
The study included 78 volunteers who are HCWs at the same tertiary care
teaching hospital for chest diseases and TB. Participants with active TB,
immunodefficiency or malnutrition were not included. The TST was
administered by the Mantoux method. Peptides representing ESAT-6, CFP-10 and
TB7-7 were used as TB-specific antigens in the whole-blood Interferon-gamma
(IFN-g) assay (QTF-GIT). There was a statistically significant relation
between the number of Bacille Calmette-Guerin (BCG) scars and the diameter
of TST (p< 0.01). QTF results according to previous BCG vaccinations did not
significantly differ (p> 0.05). There was an intermediate concordance
between two tests (k: 0.346). QTF-GIT has a sensitivity of 56.14% (both TST
and QTF-GIT are positive), specificity of 90.48% (both TST and QTF-GIT are
negative); positive predictive value of 94.12% and negative predictive value
of 43.18% and accuracy is 65.38%. There was a statistically significant
relation between TST diameter and QTF result (p< 0.01). LTBI prevalence of
the study population was 43% according to QTF-GIT test, 73% according to TST
and BCG vaccination rate was 87%. In conclusion, TST is affected by previous
BCG vaccinations, QTF-GIT is not. The researchers can recommend QTF-GIT test
for the detection of LTBI as an alternative to TST in populations with
routine BCG vaccination program.
*17.* Tuberkuloz ve Toraks. 2011 Mar; Volume 59, Number 1: 36-42. *Pulmonary
Tuberculosis in Infants Less Than One Year Old: Implications for Early
Diagnosis;* Bayhan, G.I., Ekşioğlu, A.S., Kitiş Çelik, B., Tanır, G.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21554228>
TB in older children has been well described; however, its description in
infants is very limited. There are a few studies of infants with TB in the
literature. In this study from February 2007 to May 2009, cases of infantile
TB were investigated retrospectively. Thirteen patients with pulmonary TB
were detected. Mean age of the patients was 168.8 days. The most frequent
symptoms were cough in 10 (72.4%) patients, night sweating in five (35.7%),
and fever in three (21.4%). Four patients didn't have any symptoms. Physical
examinations were normal in 12 patients. Thorax computerized tomography
studies of all of the patients were abnormal included the cases with normal
chest radiographies. Antituberculosis treatment was well tolerated by all of
the patients and all of them improved. Prevention of TB in infants rests
upon the early detection and treatment of TB in the infant's household
members. This study demonstrates that with high index of suspicion and the
correct use of chest radiographs and thorax computerized tomography, the
disease can be diagnosed early in infants. Early diagnosis and treatment may
prevent dissemination and may reduce mortality, so pediatricians should be
on the alert for TB in infants.
*18.* Tuberkuloz ve Toraks. 2011 Mar; Volume 59, Number 1: 27-35. *High
Level Isoniazid Resistance Correlates with Multiple Mutation in the katG
Encoding Catalase Proxidase of Pulmonary Tuberculosis Isolates from the
Frontier Localities of Iran; *Bostanabad, S.Z., Nojoumi, S.A., Jabbarzadeh,
E., Shekarabei, M., et al.
Click here for PubMed abstract:
PubMed<http://www.ncbi.nlm.nih.gov/pubmed/21554227>
This study investigated the significance of multiple-mutations in the katG
gene, predominant nucleotide changes and its correlation with high level of
resistance to isoniazid in *Mycobacterium tuberculosis* isolates that were
randomly collected from sputa of 42 patients with primary and secondary
active pulmonary TB from different geographic regions of Iran. Drug
susceptibility testing was determined using the CDC standard conventional
proportional method. DNA extraction, katG gene amplification, and DNA
sequencing analysis were performed. Thirty four (80%) isolates were found to
have multiple-mutations (composed of 2-5 mutations) in the katG gene.
Increased number of predominant mutations and nucleotide changes were
demonstrated in codons 315 (AGC-->ACC), 316 (GGC-->AGC), 309 (GGT-->GTT)
with a higher frequency among patients bearing secondary TB infection with
elevated levels of resistance to isoniazid (MIC ≥ 5-10 µg/mL). Furthermore,
it was demonstrated that the combination of mutations with their predominant
nucleotide changes were also observed in codons 315, 316, and 309 indicating
higher frequencies of mutations among patients with secondary infection
respectively. In this study, 62% (n= 21) of multi-mutated isolates found to
have combination of mutations with predominant nucleotide changes in codons
315 (AGC-->ACC), 316 (GGC-->GTT), 309 (GGT-->GGT), and also demonstrated to
be more frequent in isolates of patients with secondary infections, bearing
higher level of resistance to isoniazid (≥ 5-10 µg/mL).
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. Physician Medical Epidemiologist & Director for Tuberculosis and
Communicable Diseases *
*Sponsor: Westchester County Department of Health, New York State*
Location: New Rochelle, New York
Position Description:
The Westchester County Department of Health offers an opportunity for
combining medical epidemiology, clinical medicine, education, and public
policy. NYS license/specialty certification/medical epidemiology/clinical
administrative experience required and public health experience desirable
for the position/TB expertise required. Infectious Diseases certification
desirable for this position.
Salary range $99,645-$127,125
Qualifications:
M.D./New York State physician/medical licensure, specialty board
certification, medical epidemiology and clinical administrative
training/experience. Strong computer skills; experience with relevant
database, data analysis, and clinical IT applications. Managerial
experience.
Please send resumes to: .
* *
* *
*2. Training and Consultation Specialist (Job Number: 11NS963476) *
*Sponsor: NJMS Global Tuberculosis Institute*
Location: Newark, New Jersey, USA
The New Jersey Medical School Global TB Institute is currently accepting
applications for a Training and Consultation Specialist. Responsibilities
for this position will include both Regional Training and Medical
Consultation Consortium (RTMCC) activities as well as international TB
training and education activities.
Responsibilities will include developing and implementing training courses
for TB Program staff and developing patient and provider educational
materials for use in domestic and international settings. Previous
experience in international TB training and education is desired.
More information and an online application are available at
http://umdnj.hodesiq.com/job_detail.asp?JobID=2289868&user_id=
Upcoming Conferences, Trainings, and Other Events Find up-to-date
information on TB-related conferences, US training opportunities, and other
events at the DTBE Monthly Calendar<http://www.cdc.gov/tb/events/default.htm>
.
*1. TB Intensive* *
NEW*
Dates: August 2 – 5, 2011
Sponsor: Heartland National Tuberculosis Center
Location: San Antonio, Texas
Application deadline: July 15, 2011
This course is intended for physicians and nurse experts with direct
experience in the management of patients with, or at risk of, tuberculosis.
This is not an introductory course. It is recommended that nursing
participants attend a TB Nurse Case Management course prior to attending TB
Intensive. The goal of the conference is to enhance the expertise of
providers to improve the prevention, treatment, and management of patients
with TB.
There is no fee, but enrollment is limited to 25 participants.
Pre-registration is required. Continuing education credits are available.
For more information, contact Robert Petrossian, Heartland National TB
Center. Email ; phone (210) 531-4538; or access
the website at http://www.heartlandntbc.org/training.asp.
2. 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/ .
*3. 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/ .
*4. Medical Management of Tuberculosis: An Online Presentation*
Sponsor: Francis J. Curry National Tuberculosis Center
Length: 30 minutes
Credit: 0.5 contact hour CME/CNE
This slide presentation with streaming audio will provide information on how
to manage treatment of TB. A question and answer guide, a printable
PowerPoint slide file, and other useful resources are also included as
supplemental reading materials. This 30-minute lecture, conducted by Dr.
Karen Smith, covers the general principles of TB treatment, the drugs used
to cure TB, alternative regimens, monitoring, and potential adverse
reactions to therapy. It targets audiences of clinicians and health care
professionals.
For a course description or to receive continuing medical education (CME) or
continuing nursing education (CNE) contact hours, please visit
http://www.nationaltbcenter.edu/med_mgmt/ .
*5. 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 .
*6. The TB Cohort Review Process*
Sponsors: Charles P. Felton National Tuberculosis Center/ICAP. New York City
Department of Health & Mental Hygiene Bureau of Tuberculosis Control.
University of Medicine & Dentistry of New Jersey (UMDNJ). New Jersey Medical
School Global Tuberculosis Institute.
Dates: July 14 - 15, 2011
Location: New York City, New York
The purpose of this one and one-half-day course is to provide TB program
leaders, managers, and clinicians with the necessary knowledge and skills to
lead TB cohort reviews in their program areas. The course covers principles
of the TB cohort review process, guidance from the Centers for Disease
Control and Prevention (CDC) regarding this requirement in the cooperative
agreement, impact of cohort reviews, and planning for implementation in
local program areas. The format includes lectures; observation of an actual
cohort review; group discussions; individual and group exercises using tools
for case presentation and data analysis; use of computers to enter, analyze,
and report cohort data; and a planning guide for adaptation and
implementation.
Registration fee: $45.
For more information, call (973) 972-0979, or access the website at
http://www.umdnj.edu/globaltb/courses/brochures/2011/tbcohortworkshop.html.
*7. Africa TB Conference 2011 *
Sponsors: Management Sciences for Health, Strengthening Pharmaceutical
Systems (SPS) Program. World Health Organization. Stop TB Partnership.
Dates: July 19 – 21, 2011
Location: Johannesburg, South Africa
The conference's objective is the identification of specific actions the
region can take to ensure universal access to quality TB medicines and
commodities and contain drug resistance through their appropriate use. In
addition, participants will learn how to use modern technologies,
frameworks, best practices, and new TB tools to strengthen TB pharmaceutical
management systems.
Download the registration form from
http://africatb2011.wordpress.com/conference-registration/ . Space is
limited to 100 participants.
For more information, contact SPS TB Conference Management Sciences for
Health. E-mail ; phone (703) 524-6575; fax (703)
524-7898; or access the website at http://africatb2011.wordpress.com./.
*8. TB? Maybe Not: the Differential Diagnosis of Tuberculosis *
Sponsor: Curry International Tuberculosis Center
Date: July 20, 2011
Location: Nationwide, US
This course is targeting the clinicians and others who are involved in the
diagnosis of active TB disease. With a panel of experts, this web-based
seminar will review case scenarios of the most common diagnostic dilemmas in
the diagnosis of TB, which will include basic issues in the recognition of
NTM, infectious pneumonia, and cancers.
There is no fee for this course. Enrollment is limited, and pre-registration
is required. Continuing education credits are available.
For more information, visit
http://www.currytbcenter.ucsf.edu/training/nationalwebseminar.cfm.
*9. 2011 Infectious Disease Training and Exercise *
Sponsor: Arizona Department of Health Services, Tuberculosis Control Program
Dates: July 27 – 29, 2011
Location: Tempe, Arizona
This three-day infectious disease training will introduce participants to a
variety of topics in infectious disease, including vaccine preventable
diseases, nosocomial infections, TB and sexually transmitted diseases,
vector-borne and zoonotic diseases, food-borne diseases, and information on
outbreaks and investigations. Sessions will be led by experts in the field
of infectious disease, with emphasis on current trends. Participants are
encouraged to forge connections with partners and exchange information and
knowledge of current infectious disease topics.
There will be a one-hour break for lunch each day. There is no fee
associated with this event.
For more information, contact Carla Chee, Program Manager, Tuberculosis
Control Program, Arizona Department of Health Services. E-mail
; phone (602) 364-3846; fax (602) 364-3267; or access the
website at http://www.azdhs.gov/phs/oids/training/2011training.htm.
*10. Strategic Planning and Innovation *
Dates: August 15 – 20, 2011
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Location: Singapore
Leading teams that work within critical areas of health care is a
considerable challenge for any national TB program manager who is expected
to develop and adhere to strategies for a country’s health projects.
Participants in this course will learn to foresee potential difficulties and
confidently meet them by developing successful health program strategies.
This course will help them to become stronger leaders within their health
organizations The course focuses on creating a learning organization that
has the capacity to identify key issues blocking organizational progress –
whether operational, strategic, or policy-related. Key topics the course
addresses: (1) learning how to lead a participative strategic planning
activity within your TB program, (2) developing a focused approach to
strategy implementation, (3) expanding your operations by creatively using
simple tools and techniques, and (4) strengthening health systems through
exploration of innovative and creative practices.
Late applications accepted on a space-available basis. To register, e-mail
.
For more information, e-mail ; or visit the
website at http://www.union-imdp.org/courses/strategic-planning-innovation
.
*11. Tuberculosis Program Manager’s Intensive *
Sponsor: Curry International Tuberculosis Center
Dates: August 23 – 26, 2011
Location: San Francisco, California
This course is for nurses, physicians, and other health professionals
working as TB program managers. The training will cover the role of the
program manager, epidemiology of TB, treatment completion strategies, TB
outbreaks, contact investigation, quality assurance, staff training and
budgeting, infection control, program planning/grants, and program
evaluation.
Enrollment is limited and pre-registration is required. There is no fee for
this course. Continuing education credits are available.
For more information, contact the Curry International Tuberculosis Center.
E-mail ; phone (415) 502-4600; fax (415)
502-4620; or access the website at
http://www.currytbcenter.ucsf.edu/training/tbpmi11.cfm.
*12. TB Diagnostics in India: From Importation and Imitation to Innovation*
Sponsors: McGill University. Global Health Strategies.
Dates: August 25 – 26, 2011
Location: Bangalore, India
This conference will convene industry leaders, innovative thinkers,
researchers, funders, TB controllers, and policy makers to stimulate
increased industry/biotech engagement in diagnostic innovations that can
help TB control in India and elsewhere. Sessions will focus on topics such
as market size for TB diagnostics, IVD market analysis and value chain,
target product profiles and market needs, frugal innovation and affordable
diagnostics, intellectual property issues, regulation of diagnostics,
sources of funding, prize models, business models for engaging private
sector, scientific obstacles for R&D, barriers to innovation in India,
improving academia-industry relations, and role of emerging economies and
BRICS in the next wave of TB innovations.
Space is limited. A registration form is available at http://www.sjri.res.in
.
For more information, contact Dr. John Kenneth, SJRI, Bangalore, Meeting
Coordinator. E-mail ; phone +91 80 25532037, Ext 139; or
access the website at http://www.sjri.res.in/html/2days_conference_new.html.
*13. 4th International Workshop on Clinical Pharmacology of Tuberculosis
Drugs *
Sponsor: Virology Education
Date: September 16, 2011
Location: Chicago, Illinois
Early registration deadline: July 10, 2011
Abstract submission deadline: July 22, 2011
The aim of this abstract-driven workshop is to make a significant
contribution to the optimization of TB treatment, by bringing experts
together and having them present and discuss the latest important scientific
findings in the TB clinical pharmacology field. Additionally, scientific,
regulatory, or strategy issues that are highly relevant to the optimization
of TB treatment will be exchanged and discussed. Topics that will be
addressed include pharmacokinetics and pharmacodynamics of new TB drugs,
pharmacokinetics and pharmacodynamics of approved TB drugs, new developments
in pediatric TB, and interactions between TB drugs and MDR- and XDR-TB.
For more information, contact Virology Education B.V. E-mail
; phone +31 (0)30 230 7140; fax: +31 (0)30 230
7148; or access the website at http://www.virology-education.com/.
*14. Budget and Financial Management *
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: September 19 – 24 2011
Location: Bangkok, Thailand
This course provides participants advanced training in budget development
processes for national health programs. The course also is ideal for those
tasked with creating international donor applications. Participants will
also learn to conduct accurate and clear financial reporting, as well as
techniques on how to monitor funds throughout the duration of a project.
Participants will engage in simulated work projects that mirror situations
they will encounter in the workplace. Making use of lectures, in-class
discussions, and exercises incorporating real-life situations, this course
will guide participants to higher levels of financial expertise and
responsibility.
Participants will create solid budgets for international donor applications;
compare and improve current budget practices using effective international
standards; learn to perform a workload analysis; monitor budgets throughout
a project cycle; understand how Excel functions and develop budgets with it;
comprehend budget costs, issues related to cost allocation, and cost
drivers; create cash flow analyses and budget forecasts; and design
effective financial reports and incorporate useful reporting techniques.
To register and learn more about the course, please visit
http://www.theunion.org/index.php/en/courses/international-management-develop...,
or e-mail .
*15. 11th Annual TB Education and Training Network (TB ETN) *
Sponsor: Centers for Disease Control and Prevention (CDC)
Dates: September 20 – 22, 2011
Location: Atlanta, Georgia
Abstract submission deadline: July 21, 2011
The 11th annual TB Education and Training Network (TB ETN) Conference will
highlight the common aspects of TB education, training, and evaluation. The
conference will focus on a variety of topics including public health
workforce development in response to health care system changes, effective
health education messages, and new technology tools for TB education,
training, and evaluation. Conference activities will also include
skills-based workshops, informational presentations, and networking
opportunities.
Please consider developing an abstract for a poster presentation on a
significant or innovative aspect of TB education and training or program
evaluation. Posters that have been presented at other conferences may be
submitted. Appropriate topics for TB ETN posters include techniques
associated with the systematic health education process (needs assessment,
development, implementation, and evaluation). Abstract submission deadline:
July 21, 2011. Registration fee: $50.00/TB ETN members; $75.00/Non-members.
For more information, contact CDC DTBE, E-mail: ; phone
800-CDC-INFO (800-232-4636), TTY: (888) 232-6348; or access the website at
http://www.cdc.gov/tb/education/tbetn/conference.htm.
*16. The Denver TB Course *
Sponsor: National Jewish Health
Dates: October 12 – 15, 2011
Location: Denver, Colorado
The purpose of this course is to present knowledge about the management of
TB to general internists, public health workers, infectious diseases and
chest specialists, registered nurses, and other healthcare providers who
will be responsible for the management and care of patients with TB. This
event includes the following course highlights: Transmission and
pathogenesis of adult and pediatric TB; MDR TB and XDR TB; Screening for and
treatment of latent TB infection; Factors influencing TB infections;
Planning TB control programs with particular emphasis on organization of
outpatient chemotherapy; TB and HIV co-infection; and Mycobacteriology
Laboratory Tour.
Continuing education credits are available.
For more information, contact Nicole Austin Ross, National Jewish Health.
E-mail ; phone (303) 398-1110; fax (303) 270-2239; or
access the website at http://www.njhealth.org/TBCourse.
*17. 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.
*18. 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
Abstract submission deadline: July 30, 2011
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. The presentations will be
selected from abstracts submitted to the late-breaker co-chairs by July 30,
2011. Persons submitting abstracts will be notified of acceptance or
rejection of their abstract by August 31, 2011.
A small number of travel grants are available for presenters of accepted
abstracts who require funding to attend the conference. If you intend to
request support, an indication of your desire and rationale for
consideration for a travel grant must be submitted with the abstract. The
reviewing committee will be blinded to the request for travel funds.
Submissions should include a cover letter with (i) a statement that the work
has not been previously submitted for consideration to the general portion
of The Union meeting, (ii) the date by which the work/analysis was mostly
complete, (iii) a request and rationale for travel support if so desired,
and (iv) the address, phone and Fax number, and e-mail address where the
submitter may be contacted the week of August 22, 2011.
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....
*19. Human Resources Management *
Sponsor: International Union Against Tuberculosis and Lung Disease (The
Union)
Dates: November 28 – December 3, 2011
Location: Bangkok, Thailand
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.
*20. 3rd Global Symposium on IGRAs 2012*
Sponsor: UC San Diego School of Medicine
Dates: January 12 - 15, 2012
Locations: Waikoloa, Hawaii
Abstracts submission deadline: September 1, 2011
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/ .
