MDR-TB Treatment & Prevention
[tb-update] Week of June 19 to June 25, 2011
TB-Related News and Journal Items Weekly Update
Week of June 19 to June 25, 2011
To subscribe to the list, or to change your subscription options, please visit: https://www.cdcnpin.org/framework/ui/login.aspx?re=/lyris/ui/subscriptions.aspx , CDC provides the TB-Related News and Journal Items Weekly Update as a public service only. This update is a compilation of TB-related articles published for the benefit and information of people interested in TB, and we do not confirm the accuracy of the data in the articles that are abstracted. Providing synopses of key scientific articles and lay media reports on TB does not constitute CDC endorsement. This update may also include information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases, and announcements. Reproduction of this text is encouraged; however, copies may not be sold. For those items reproduced from the first section of the TB weekly update, the CDC HIV/Hepatitis/STD/TB Prevention News Update should be cited. For any other items in the TB weekly update, you may cite the CDC TB-Related News and Journal Items Weekly Update.
The TB Update will be on hiatus next week, and will resume publication on July 8, 2011.
This Week's Contents
TB-Related Announcements
Headlines
Journal Articles
Job Announcements
Upcoming Conferences, Trainings, and Other Events
TB-Related Announcements
1. 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/.
2. 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 .
3. 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 web site: http://www.stoptb.org/global/awards/kochon/default.asp.
For further information, contact .
4. 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] for more information and application instructions.
5. 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
The Call to Action is now available on the Stop TB Partnership website. Click here to sign.
6. Microbiology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting
Federal Register, Vol. 76, No. 51, Wednesday, March 16, 2011, Notices, pp. 14414-14415
This notice announces a forthcoming meeting of a public advisory committee of the Food and Drug Administration (FDA). The meeting will be open to the public.
Name of Committee: Microbiology Devices Panel of the Medical Devices Committee.
General Function of the Committee: To provide advice and recommendations to the Agency on FDA’s regulatory issues.
Date and Time: The meeting will be held on June 29, 2011, from 8 a.m. to 6:00 p.m.
Location: Holiday Inn, Ballroom, 2 Montgomery Village Avenue, Gaithersburg, MD
Contact Person: Shanika Craig, Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Ave., Bldg.66, rm. 1613, Silver Spring, MD 20993-0002. Call 301-796-6639, or call the FDA Advisory Committee Information Line at 1-800-741-8138. (*301 443-0572 in the Washington, DC area), and follow the prompts to the desired center or product area. Please call the Information Line for up-to-date information on this meeting. A notice in the Federal Register about last minute modifications that impact a previously announced advisory committee meeting cannot always be published quickly enough to provide timely notice. Therefore, you should always check the Agency’s Web site and call the appropriate advisory committee hot line/phone line to learn about possible modifications before coming to the meeting.
Agenda: On June 29, 2011, the committee will discuss and make recommendations regarding the possible reclassification of molecular diagnostics for the rapid detection of Mycobacterium tuberculosis (M. tuberculosis) complex and the detection of genetic mutations, which confer antibiotic resistance in M. tuberculosis complex. Discussion would include the appropriate information and acceptable performance characteristics that would be required to assess the safety and effectiveness of rapid diagnostic tests for M. tuberculosis complex, and whether these can be sufficiently specified to support possible reclassification.
FDA intends to make background material available to the public no later than 2 business days before the meeting. If FDA is unable to post the background material on its Web site prior to the meeting, the background material will be made publicly available at the location of the advisory committee meeting, and the background material will be posted on FDA’s Web site after the meeting. Background material is available at http://www.fda.gov/AdvisoryCommittees/Calendar/default.htm.
Scroll down to the appropriate advisory committee link.
For full information on this Notice, including the Meeting Agenda, see http://www.gpo.gov/fdsys/pkg/FR-2011-03-16/pdf/2011-6081.pdf
Headlines
1. Four People from Gates Day Care Center Being Treated for Latent TB Infection (United States)
Democrat and Chronicle, www.democratandchronicle.com, June 15, 2011, by Chris Swingle, by
According to Monroe County Department of Public Health (New York), four individuals at a day care center that serves adults and children are being treated for latent TB infection (LTBI), after an adult was diagnosed with active TB disease in April. The four, which includes children and adults, will receive antibiotics for nine months. The four were diagnosed as part of two rounds of testing of 142 persons conducted by the health department after the initial infection was diagnosed. The monitoring was done either by public health workers at the center or by the patient’s own doctors, and was reported to the health department. No one tested positive for TB infection after the first round of tests in April, but 60 children received chest X-rays to detect active disease and were given three months of preventive treatment. The four positive skin tests were found in the second round of testing in late May.
2. New Molecule for TB and HIV (India)
The Hindu, www.thehindu.com, June 15, 2011, by M. Dinesh Varma
Scientists at the TB Research Center (TRC), India, have isolated a new molecule with antibacterial and antiviral properties. The molecule, “transitmycin,” was extracted from the marine microorganism “Streptomyces sp.” that was found in a soil sample off the Rameswaram coral reef. The molecule was found in vitro to be effective against dormant and active Mycobacterium tuberculosis. It is hoped that the dual antibacterial and antiviral action could lead to a drug that would treat patients coinfected with TB/HIV. Mukesh Dobe, Professor in the Department of Biotechnology of the Indian Institute of Technology, Madras, commented that further refinement of the compound could improve potency by 10 to 20 times. A drug from transitmycin could take time to develop, as it has to be tested in animal trials and clinical trials, and the project would cost about US $67,000,000. The researchers have filed for a patent and sent a proposal to the Indian Council of Medical Research to request funding for the project.
3. Hostels for MDR-TB Patients Ready (Nepal)
República, www.myrepublica.com, June 17, 2011
The government of Nepal will isolate patients in hostels to prevent transmission of multidrug-resistant TB. The National TB Center has prepared 10 hostels in 5 different regions, and will begin operations in a month. According to Badrinath Gyawali, a coordinator at NTC, the hostels are for patients who are unable to travel to the DOTS clinics. Each hostel can accommodate 10 patients, and so far, there are 1,000 reported MDR TB patients in Nepal. Financial assistance for the hostels was provided by the Global Fund, which has committed to providing assistance for at least five years.
4. 33% of Darwin Refugees Infected with TB (Australia)
TopNews, http://topnews.us, June 6, 2011, by Elina Needham
According to statistics from the Northern Territory Center for Disease Control, Australia, almost 33 percent of refugees coming to Darwin have latent TB infection (LTBI). At present, all refugees 11 years old and up are screened for TB before entering Australia. World Health Organization statistics indicate that this number (33 percent) matches the total number of persons in the world with LTBI. Dr. James Trauser, Public Health Registrar, emphasized the importance of identifying those who could develop TB in the future. He noted that the most important part of managing TB on a public health level and protecting the public from TB is identifying people who are infectious and providing the correct treatment. The next most important thing is to screen those who might become infectious later.
5. TB Awareness Seminar (Pakistan)
Pakistan Observer, http://pakobserver.net, June 17, 2011
A one-day TB awareness seminar for journalists was conducted recently as part of Pakistan’s Advocacy, Communication & Social Mobilization (ACSM) Project. A large number of journalists, scholars, teachers, and government officials participated. The campaign officer of the ACSM project informed attendees that TB was a fatal disease, and educated them on the TB bacteria, its transmission, treatment, cure, reactivation, the goal of treatment, and how patients’ non-adherence to treatment can create drug resistance. He emphasized that the purpose of the ACSM project was to create awareness about TB and its prevention among the population. He noted that journalists, teachers, and scholars could play an important role in disseminating information about TB. He explained that the aim of the organization was to declare Hunza-Nagar a TB-free district.
6. Unused TB Centres May Make Way for Clinics (India)
MidDay, www.mid-day.com, June 21, 2011, by Rinkita Gurav
The Brihanmumbai Municipal Corporation (BMC) is considering replacing TB clinics in the Khar, India, with medical facilities such as dispensaries and hospitals, as a means of improving public health care. Officials of BMC have agreed to inspect the clinics before deciding on the matter. City dwellers argued that better use should be made of the TB clinics since TB cases are hardly reported anymore because the disease has been brought under control. Also, patients now are given drugs at the clinics and are hardly ever admitted. According to Ashish Shelar, people want better equipped hospitals, especially for those who cannot afford the expensive private hospitals. Dr. P. Keskar, Deputy Health Officer, stated that there are five TB clinics in the city, one TB hospital, and 320 TB centers, which are maintained by the BMC and provide free medicine. She noted that 90 percent of TB patients are not admitted to hospitals, and approximately 29,000 patients receive TB treatment annually. Manisha Mhaiskar, Municipal Health Commissioner, agreed to visit the Khar TB clinic and review the feasibility of the conversion plans.
7. TB Alliance to Leverage SCYNEXIS’ HEOS Platform to Heighten Collaboration in Global TB Research (Switzerland)
infoTECH, http://it.tmcnet.com, June 21, 2011, by Madhubaanti Rudra
SCYNEXIS, a drug discovery and development company, has signed a collaboration agreement with the TB Alliance. The agreement gives TB Alliance access to SCYNEXIS’ proprietary HEOS drug discovery software platform for use in its global TB research activities. HEOS, a cloud-based drug research information software platform, is offered as software as a service (SaaS). The web portal was designed to support geographically dispersed project scientists from different organizations. HEOS helps researchers consolidate, manage, share, and analyze complex drug discovery information on a global basis, and offers a secure and user-friendly data handling system that allows all involved collaborators to view results and make informed decisions. SCYNEXIS was established in 2000 to deliver integrated, efficient, and innovative drug discovery and development solutions to global health and pharmaceutical partners.
Journal Articles
1. American Journal of Public Health. 2011 Jul; Volume 101, Number 7: 1256-63. Epub 2011 May 12. Epidemiology of Urban Tuberculosis in the United States, 2000-2007; Oren, E., Winston, C.A., Pratt, R., Robison, V.A., et al.
Click here for PubMed abstract: PubMed
The researchers investigated TB incidence rates and characteristics of patients with TB in large US cities. Using the Centers for Disease Control and Prevention's National Tuberculosis Surveillance System data, the researchers categorized 48 cities annually from 2000 to 2007 as reporting decreasing or nondecreasing rates with Joinpoint analysis. Demographic, clinical, and treatment characteristics of patients with TB were compared using bivariate and multivariate analyses. The researchers found that 42,448 patients with TB in 48 cities accounted for 36% of all US patients with TB; these cities comprised 15% of the US population. The average TB incidence rate in the 48 cities (12.1 per 100,000) was higher than that in the United States excluding the cities (3.8 per 100,000), but decreased at a faster rate. Nineteen cities had decreasing rates; 29 cities had nondecreasing rates. Patient characteristics did not conclusively distinguish decreasing and nondecreasing rate cities. A significant TB burden occurs in large US cities. More than half (60%) of the selected cities did not show decreasing TB incidence rates. Studies of city-level variations in migration, socioeconomic status, and resources are needed to improve urban TB control.
2. Antiviral Therapy. 2011; Volume 16, Number 3: 417-21. Lopinavir Exposure is Insufficient in Children Given Double Doses of Lopinavir/Ritonavir during Rifampicin-Based Treatment for Tuberculosis; McIlleron, H., Ren, Y., Nuttall, J., Fairlie, L., et al.
Click here for PubMed abstract: PubMed
Coadministration of rifampicin dramatically reduces the concentrations of protease inhibitors. A pharmacokinetic study in healthy adults showed that doubling the dose of coformulated lopinavir/ritonavir was able to overcome the inducing effect of rifampicin. The researchers evaluated this strategy in children treated with rifampicin-based antituberculosis therapy attending antiretroviral clinics in South Africa. Plasma concentrations of lopinavir were measured in children (aged 0.64-2.43 years) established on antituberculosis treatment who commenced antiretroviral therapy comprising double the usual recommended dose of lopinavir/ritonavir oral solution (460/115 mg/m(2) twice daily) plus two nucleoside reverse transcriptase inhibitors. Control children (0.57-4.23 years old) without TB received standard doses of lopinavir/ritonavir (230/57.5 mg/m(2) twice daily). Pre-dose lopinavir concentrations were reduced by >80% in children with TB (median 0.7 mg/l, IQR 0.1-2.0) compared with controls (4.2 mg/l, IQR 3.4-8.1; P<0.001) and were below the minimum recommended concentration of 1 mg/l in 12 of 20 (60%) children with TB versus 2 of 24 (8%) controls (P<0.001). Double doses of co-formulated lopinavir/ritonavir resulted in inadequate lopinavir concentrations in young children treated concurrently with rifampicin. Suitable regimens are urgently needed for treating young children with HIV-associated TB.
3. Asian Pacific Journal of Cancer Prevention. 2011; Volume 12, Number 2: 419-23. Predictive Role of Adenosine Deaminase for Differential Diagnosis of Tuberculosis and Malignant Pleural Effusion in Turkey; Yildiz, P.B., Yazar, E.E., Gorgun, D., Secik, F., et al.
Click here for PubMed abstract: PubMed
Tuberculous pleural effusion (TPE) is a common problem for differential diagnosis from malignant effusion (MPE) in epidemic areas of TB. Prediction based on adenosine deaminase (ADA) is dependent on age as well as the TB incidence. The study evaluated cutoff values for ADA with sensitivity and specificity results for the differential diagnosis of MPE and TPE in a population with intermediate incidence of TB. The researchers retrospectively analyzed 196 patients with a definitive diagnosis of TPE (n=114) and MPE (n= 82). The optimal cutoff value of ADA was determined using the receiver operating characteristic (ROC) curve. There was a statistically significant difference according to the levels of pleural fluid ADA between TPE and MPE groups (p<0.0001). The cutoff value for diagnosing TPE was > 55U/L, with a sensitivity = 86.8%, specificity = 86.6%, positive predictive value (PPV) = 90%, negative predictive value (NPV) = 82.6% and accuracy = 82.6%. The researchers then combined ADA> 55U/L and age< 50 and were able to discriminate the TPE group with increased specifity (95.7 %) and PPV (98.8%) results. The model could correctly classify 21 MPE out of 23 and 82 TPE out of 94 patients. A pleural fluid ADA value < 31U/L suggests that TPE is highly unlikely with a sensitivity = 43.9 %, specificity = 100%, PPV = 100%, NPV = 71.3% and accuracy = 76.6%. It can be concluded that ADA is a very useful parameter for the differential diagnosis of TPE and MPE, specifically in younger persons with a higher incidence of TB.
4. Bulletin of the World Health Organization. 2011 May 1; Volume 89, Number 5: 352-9. Epub 2011 Mar 30. Cross-Sectional Assessment Reveals High Diabetes Prevalence among Newly-Diagnosed Tuberculosis Cases; Restrepo, B.I., Camerlin, A.J., Rahbar, M.H., Wang, W., et al.
Click here for PubMed abstract: PubMed
This study estimated the contribution of clinically-confirmed Diabetes mellitus to TB rates in communities where both diseases are prevalent as a way to identify opportunities for TB prevention among diabetic patients. This is a prospective study in which TB patients ≥ 20 years old at TB clinics in the Texas-Mexico border were tested for diabetes. The risk of TB attributable to diabetes was estimated from statistics for the corresponding adult population. The prevalence of diabetes among TB patients was 39% in Texas and 36% in Mexico. Diabetes contributed 25% of the TB cases studied, whereas HIV infection contributed 5% or fewer. Among TB patients, fewer Mexicans than Texans were aware that they had diabetes before this study (4% and 19%, respectively). Men were also less frequently aware than women that they had diabetes (P = 0.03). Patients who knew that they had diabetes before the study had an 8-year history of the disease, on average, before being diagnosed with TB. Patients with diabetes are at higher risk of contracting TB than non-diabetic patients. Integrating TB and diabetes control programs worldwide would facilitate TB prevention among diabetes patients and increase the number of diabetics who learn of their condition, particularly among males. Such a strategy would lead to earlier case detection and improve the management of both TB and diabetes.
5. Japanese Journal of Infectious Diseases. 2011 Mar; Volume 64, Number 2: 139-42. Tuberculous Ankle Versus Pyogenic Septic Ankle Arthritis: A Retrospective Comparison; Chen, S.H., Wang, T., Lee, C.H.
Click here for PubMed abstract: PubMed
Ankle TB manifests with varying symptoms and is easily confused with pyogenic septic ankle arthritis. In this study, all patients with either ankle TB or pyogenic septic ankle arthritis who were admitted to a medical center in southern Taiwan between May 1986 and October 2006 were reviewed retrospectively to identify risk factors for ankle TB. Compared with the 42 patients with culture-confirmed pyogenic septic ankle arthritis, the 26 patients with ankle TB (12 definitive, 5 probable, and 9 possible) were significantly more likely to have evidence of TB on chest radiographs (50 versus 10%; P<0.01), a history of trauma (58 versus 17%; P<0.01), presentation with sinus discharge (50 versus 12%; P<0.01), duration of symptoms of more than 3 months (69 versus 12%; P<0.01), a leukocyte count of <10,000/μL (58 versus 29%; P=0.03), and C-reactive protein of <5 mg/dL (42 versus 17%; P=0.03). Evidence of TB on chest radiographs was identified as an independent risk factor for ankle TB (odds ratio=35.1; 95% confidence interval=1.6-779.8; P=0.02) by multiple logistic regression analysis. Awareness of these factors is essential for the accurate and timely diagnosis of ankle TB.
6. Japanese Journal of Infectious Diseases. 2011 Mar; Volume 64, Number 2: 133-8. Analysis of an Interferon-Gamma Release Assay for Monitoring the Efficacy of Anti-Tuberculosis Chemotherapy; Takayanagi, K., Aoki, M., Aman, K., Mitarai, S., et al.
Click here for PubMed abstract: PubMed
The reported effect of antituberculosis chemotherapy on interferon-gamma (IFN-γ) release in response to specific Mycobacterium tuberculosis antigens has been inconsistent. This study was therefore to determine the effect of antituberculosis chemotherapy on IFN-γ response to ESAT-6 and CFP-10. QuantiFERON®-TB Gold (QFT-G) was performed, and the IFN-γ response to ESAT-6 and CFP-10 were measured, for 50 people with culture-confirmed TB prior to initiating treatment and periodically for up to 120 weeks following initiation of said treatment. IFN-γ responses and bacteriological response were compared. The average IFN-γ response to ESAT-6 and CFP-10 and the proportion of QFT-G results that were positive decreased during chemotherapy and for several weeks thereafter, reaching lows at weeks 48 to 56. Furthermore, these measures were lower at 48 weeks for those with bacteriological reversion prior to the second monthly visit than for those with slower reversion. Although it was shown that antituberculosis treatment generally reduced the specific release of IFN-γ, the effect is so variable that it could be used as a monitor of progress of chemotherapy with great care and reservation.
7. Journal of the Formosan Medical Association. 2011 Apr; Volume 110, Number 4: 239-46. Factors Associated with in Vitro Interferon-Gamma Production in Tuberculosis; Yu, C.C., Liu, Y.C., Chu, C.M., Chuang, D.Y., et al.
Click here for PubMed abstract: PubMed
Macrophage activation assisted by interferon-gamma (IFN-γ) is a primary mechanism by which Mycobacterium tuberculosis is killed, but IFN-γ (production is inhibited in TB patients. The production of IFN-γ is influenced by many factors, such as interleukin (IL)-10, IL-12, IL-18, and clinical diseases; but the relative importance of each factor is unclear. The researchers evaluated the effects of these factors in 46 healthy individuals, 81 patients with TB, and 88 patients with non-TB pneumonia. The responses of IFN-γ, IL-10, IL-12, and IL-18 were determined from phytohemagglutinin-stimulated peripheral blood mononuclear cells (PBMCs). General linear model analysis showed that disease status and IL-12 response were the independent factors associated with the IFN-γ response. The production of IFN-γ was not affected by IL-10 and IL-18. There was a significant relationship between the IFN-γ response and the IL-12 response among patients with non-TB pneumonia, patients with TB, and healthy participants (Pearson's correlation coefficients of 0.466, 0.483, and 0.464, respectively). Production of IFN-γ in PBMCs was associated with active pulmonary TB and IL-12 response.
8. Journal of Health, Population, and Nutrition. 2011 Feb; Volume 29, Number 1: 20-5. Evaluation of the Performance of Nitrate Reductase Assay for Rapid Drug-Susceptibility Testing of Mycobacterium tuberculosis in North India; Gupta, A., Sen, M.R., Mohapatra, T.M., Anupurba, S.
Click here for PubMed abstract: PubMed
This study evaluated the performance of nitrate reductase assay (NRA) as a rapid, reliable and inexpensive method for drug-susceptibility testing (DST) of Mycobacterium tuberculosis against first-line antitubercular drugs, such as rifampicin (RIF), isoniazid (INH), streptomycin (STR), and ethambutol (EMB). In total, 286 isolates were subjected to test by proportion method (PM) and NRA. By comparing the results of NRA with those of the gold standard PM, sensitivities and specificities were 98.4%, 97%, 88.5%, and 94.2% and 100%, 100%, 94%, and 99% for RIF, INH, STR, and EMB respectively. The positive predictive values were 100%, 100%, 95%, and 98% for RIF, INH, STR, and EMB respectively. The negative values were 99%, 98%, 87%, and 96% for RIF, INH, STR, and EMB respectively. The median time of obtaining results was shorter using NRA (10 days) compared to PM (28 days). An excellent agreement was observed between the two phenotypic tests with the K values of 0.98, 0.97, 0.81, and 0.93 for RIF, INH, STR, and EMB respectively. The results demonstrated that NRA is suitable for the early determination of INH and RIF resistance and has the potential to be a useful tool for rapid drug-sensitivity test of M. tuberculosis in resource-constrained settings.
9. Lancet. 2011 Apr 30; Volume 377, Number 9776: 1495-505. Epub 2011 Apr 18. Feasibility, Diagnostic Accuracy, and Effectiveness of Decentralised Use of the Xpert MTB/RIF Test for Diagnosis of Tuberculosis and Multidrug Resistance: A Multicentre Implementation Study; Boehme, C.C., Nicol, M.P., Nabeta, P., Michael, J.S., et al.
Click here for PubMed abstract: PubMed
The Xpert MTB/RIF test (Cepheid, Sunnyvale, CA, USA) can detect TB and its multidrug-resistant form with very high sensitivity and specificity in controlled studies, but no performance data exist from district and subdistrict health facilities in tuberculosis-endemic countries. The researchers assessed operational feasibility, accuracy, and effectiveness of implementation in such settings. They assessed adults (≥18 years) with suspected TB or multidrug-resistant TB (MDR TB) consecutively presenting with cough lasting at least 2 weeks to urban health centers in South Africa, Peru, and India, drug-resistance screening facilities in Azerbaijan and the Philippines, and an emergency room in Uganda. Patients were excluded from the main analyses if their second sputum sample was collected more than 1 week after the first sample, or if no valid reference standard or MTB/RIF test was available. The researchers compared one-off direct MTB/RIF testing in nine microscopy laboratories adjacent to study sites with 2-3 sputum smears and 1-3 cultures, dependent on site, and drug-susceptibility testing. They assessed indicators of robustness including indeterminate rate and between-site performance, and compared time to detection, reporting, and treatment, and patient dropouts for the techniques used. The researchers enrolled 6,648 participants between Aug 11, 2009, and June 26, 2010. One-off MTB/RIF testing detected 933 (90.3%) of 1,033 culture-confirmed cases of TB, compared with 699 (67.1%) of 1,041 for microscopy. MTB/RIF test sensitivity was 76.9% in smear-negative, culture-positive patients (296 of 385 samples), and 99.0% specific (2,846 of 2,876 non-tuberculosis samples). MTB/RIF test sensitivity for rifampicin resistance was 94.4% (236 of 250) and specificity was 98.3% (796 of 810). Unlike microscopy, MTB/RIF test sensitivity was not significantly lower in patients with HIV coinfection. Median time to detection of TB for the MTB/RIF test was 0 days (IQR 0-1), compared with 1 day (0-1) for microscopy, 30 days (23-43) for solid culture, and 16 days (13-21) for liquid culture. Median time to detection of resistance was 20 days (10-26) for line-probe assay and 106 days (30-124) for conventional drug-susceptibility testing. Use of the MTB/RIF test reduced median time to treatment for smear-negative TB from 56 days (39-81) to 5 days (2-8). The indeterminate rate of MTB/RIF testing was 2.4% (126 of 5,321 samples) compared with 4.6% (441 of 9,690) for cultures. The MTB/RIF test can effectively be used in low-resource settings to simplify patients' access to early and accurate diagnosis, thereby potentially decreasing morbidity associated with diagnostic delay, dropout, and mistreatment.
10. Memorias do Instituto Oswaldo Cruz. 2011 Mar; Volume 106, Number 2: 194-9. Colorimetric Microwell Plate Reverse-Hybridization assay for Mycobacterium tuberculosis Detection; Michelon, C.T., Rosso, F., Schmid, K.B., Sperhacke, R.D., et al.
Click here for PubMed abstract: PubMed
Direct smear examination using Ziehl-Neelsen staining for pulmonary TB (PTB) diagnosis is inexpensive and easy to use, but has the major limitation of low sensitivity. Rapid molecular methods are becoming more widely available in centralized laboratories, but they depend on timely reporting of results and strict quality assurance obtainable only from costly commercial kits available in high burden nations. This study described a pre-commercial colorimetric method, Detect-TB, for detecting Mycobacterium tuberculosis DNA in which an oligonucleotide probe is fixed onto wells of microwell plates and hybridized with biotinylated polymerase chain reaction amplification products derived from clinical samples. The probe is capable of hybridizing with the IS6110 insertion element and was used to specifically recognize the M. tuberculosis complex. When combined with an improved silica-based DNA extraction method, the sensitivity of the test was 50 colony-forming units of the M. tuberculosis reference strain H37Rv. The results that were in agreement with reference detection methods were observed in 95.2% (453/476) of samples included in the analysis. Sensitivity and specificity for 301 induced sputum samples and 175 spontaneous sputum samples were 85% and 98%, and 94% and 100%, respectively. This colorimetric method showed similar specificity to that described for commercially available kits and may provide an important contribution for PTB diagnosis.
11. Memorias do Instituto Oswaldo Cruz. 2011 Mar; Volume 106, Number 2: 139-45. Detection of Rifampin-Resistant Genotypes in Mycobacterium tuberculosis by Reverse Hybridization Assay; Maschmann Rde, A., Verza, M., Silva, M.S., Sperhacke, R.D., et al.
Click here for PubMed abstract: PubMed
The researchers used a colorimetric reverse dot blot hybridization (CRDH) assay to detect the presence of mutations in a specific region of the rpoB gene, associated with rifampin (RIF) resistance, in a panel of 156 DNAs extracted from 103 RIF-sensitive and 53 RIF-resistant cultures of Mycobacterium tuberculosis. When compared with the antimicrobial susceptibility test (AST), the sensitivity and specificity of the CRDH were 92.3% and 98.1%, respectively. When compared with sequencing, the sensitivity and specificity of the CRDH were 90.6% and 100%, respectively. To evaluate the performance of the assay directly in clinical specimens, 30 samples from TB patients were used. For these samples, the results of the CRDH were 100% consistent with the results of the AST and sequencing. These results indicate that the rate of concordance of the CRDH is high when compared to conventional methods and sequencing data. The CRDH can be successfully applied when a rapid test is required for the identification of RIF resistance in M. tuberculosis.
12. Mymensingh Medical Journal. 2011 Apr; Volume 20, Number 2: 233-7. Tubercular Lymphadenitis - Diagnostic Evaluation; Datta, P.G., Hossain, M.D., Amin, S.A., Rahman, M.K., et al.
Click here for PubMed abstract: PubMed
TB is one the commonest disease affecting peripheral lymph node and cervical tubercular lymphadenitis are frequently encountered in otolaryngological practice. Three hundred fifty six (356) cases of Fine Needle Aspiration for Cytology (FNAC) positive tubercular lymphadenitis were studied from January 2006 to December 2008. FNAC positive but histopathologically negative cases were excluded from the study. Among 356 cases of FNAC positive cervical lymphadenopathy, 300 cases (84.27%) were confirmed TB on histopathological examination. Of the remaining cases, 50 (15.73%) were diagnosed as nontubercular lymphadenitis where nonspecific lymphadenitis was the commonest finding 34(9.55%) followed by metastatic carcinoma 7 (1.97%), lymphoma 6 (1.08%), Kikuchiz's disease 6 (1.08%), Kala-Azar 2 (0.56%) & Leukemia 1(0.28%). Most of the patients presented with only multiple lymph node swelling with other symptoms, such as fever 18 (5.06%), pain (15.7%), tenderness 53 (14.88%), weight loss 29 (8.14%), anorexia 33 (9.26%). The following observations are evident from this study: (i) disease is comparatively common between 12-35 years; (ii) multiple matted/discrete lymph nodes are the earliest presentation; (iii) multiple lymph node is the most consistent finding for clinical diagnosis; (iv) very few patients have constitutional symptoms; and (v) suppuration with or without abscess formation, although it confirms the diagnosis, even then, certainty is very essential. Though the evidence of cervical TB was thought to be decreasing in developing countries the real picture seems to be different. Random survey among the whole population was not done in any country rather hospital based laboratory research was made.
13. Nature Genetics. 2011 May; Volume 43, Number 5: 482-6. Epub 2011 Apr 24. Use of Whole Genome Sequencing to Estimate the Mutation Rate of Mycobacterium tuberculosis during Latent Infection; Ford, C.B., Lin, P.L., Chase, M.R., Shah, R.R., et al.
Click here for PubMed abstract: PubMed
TB poses a global health emergency, which has been compounded by the emergence of drug-resistant Mycobacterium tuberculosis (Mtb) strains. The researchers used whole-genome sequencing to compare the accumulation of mutations in Mtb isolated from cynomolgus macaques with active, latent or reactivated disease. They sequenced 33 Mtb isolates from nine macaques with an average genome coverage of 93% and an average read depth of 117×. Based on the distribution of SNPs observed, the researchers calculated the mutation rates for these disease states. They found a similar mutation rate during latency as during active disease or in a logarithmically growing culture over the same period of time. The pattern of polymorphisms suggests that the mutational burden in vivo is because of oxidative DNA damage. The researchers show that Mtb continues to acquire mutations during disease latency, which may explain why isoniazid monotherapy for latent TB is a risk factor for the emergence of isoniazid resistance.
14. PLoS One. 2011 Apr 19; Volume 6, Number 4: e18614. Investigation Outcomes of Tuberculosis Suspects in the Health Centers of Addis Ababa, Ethiopia; Deribew, A., Negussu, N., Melaku, Z., Deribe, K.
Click here for PubMed abstract: PubMed
Little is known about the prevalence of TB and HIV among TB suspects in primary health care units in Ethiopia. In the period of February to March, 2009, a cross sectional survey was done in 27 health centers of Addis Ababa to assess the prevalence of TB and HIV among TB suspects who have > = 2 weeks symptoms of TB such as cough, fever, and weight loss. Diagnosis of TB and HIV was based on the national guidelines. Information concerning socio-demographic variables and knowledge of the respondents about TB was collected using pretested questionnaire. Of the 545 TB suspects, 506 (92.7%) of them participated in the study. The prevalence of both pulmonary and extra pulmonary TB was 46.0% (233/506). The smear positivity rate among pulmonary TB suspect was 21.3%. Of the TB suspects, 298 (58.9%) of them were tested for HIV and 27.2% (81/298) were HIV seropositive. Fifty percent of the HIV positive TB suspects had TB. TB suspects who had a contact history with a TB patient in the family were 9 times more likely to have TB than those who did not have a contact history, [OR = 9.1, (95%CI:4.0, 20.5)]. Individuals who had poor [OR = 5.2, (95%CI: 2.3, 11.2)] and fair knowledge [OR = 3.7, (95%CI: 1.3, 10.4)] about TB were more likely to have TB than individuals who had good knowledge. In conclusion, the prevalence of TB among TB suspects with duration of 2 or more weeks is high. Fifty percent of the HIV positive TB suspects had TB. Case finding among TB suspects with duration of 2 or more weeks should be intensified particularly among those who have a contact history with a TB patient.
15. PLoS One. 2011 Apr 18; Volume 6, Number 4: e18773. Latency Antigen α-Crystallin Based Vaccination Imparts a Robust Protection against TB by Modulating the Dynamics of Pulmonary Cytokines; Dey, B., Jain, R., Khera, A., Gupta, U.D., et al.
Click here for PubMed abstract: PubMed
Efficient control of TB requires development of strategies that can enhance efficacy of the existing vaccine Mycobacterium bovis Bacille Calmette Guerin (BCG). To date only a few studies have explored the potential of latency-associated antigens to augment the immunogenicity of BCG. The researchers evaluated the protective efficacy of a heterologous prime boost approach based on recombinant BCG and DNA vaccines targeting α-crystallin, a prominent latency antigen. They show that "rBCG prime - DNA boost" strategy (R/D) confers a markedly superior protection along with reduced pathology in comparison to BCG vaccination in guinea pigs (565 fold and 45 fold reduced CFU in lungs and spleen, respectively, in comparison to BCG vaccination). In addition, R/D regimen also confers enhanced protection in mice. Results in guinea pig model show a distinct association of enhanced protection with an increased level of interleukin (IL)12 and a simultaneous increase in immuno-regulatory cytokines such as transforming growth factor (TGF)β and IL10 in lungs. The T cell effector functions, which could not be measured in guinea pigs due to technical limitations, were characterized in mice by multi-parameter flow cytometry. The researchers show that R/D regimen elicits a heightened multi-functional CD4 Th1 cell response leading to enhanced protection. These results clearly indicate the superiority of α-crystallin based R/D regimen over BCG. The researchers’ observations from guinea pig studies indicate a crucial role of IL12, IL10, and TGFβ in vaccine-induced protection. Further, characterization of T cell responses in mice demonstrates that protection against TB is predictable by the frequency of CD4 T cells simultaneously producing interferon (IFN)γ, tumor necrosis factor (TNF)α and IL2. The researchers anticipate that this study will not only contribute toward the development of a superior alternative to BCG, but will also stimulate designing of TB vaccines based on latency antigens.
16. PLoS One. 2011 Apr 13;6(4):e18524. IL-12Rβ1 Deficiency in Two of Fifty Children with Severe Tuberculosis from Iran, Morocco, and Turkey; Boisson-Dupuis, S., El Baghdadi, J., Parvaneh, N., Bousfiha, A., et al.
Click here for PubMed abstract: PubMed
In the last decade, autosomal recessive IL-12Rβ1 deficiency has been diagnosed in four children with severe TB from three unrelated families from Morocco, Spain, and Turkey, providing proof-of-principle that TB in otherwise healthy children may result from single-gene inborn errors of immunity. The researchers estimated the fraction of children developing severe TB due to IL-12Rβ1 deficiency in areas endemic for TB and where parental consanguinity is common. The researchers searched for IL12RB1 mutations in a series of 50 children from Iran, Morocco, and Turkey. All children had established severe pulmonary and/or disseminated TB requiring hospitalization and were otherwise normally resistant to weakly virulent BCG vaccines and environmental mycobacteria. In one child from Iran and another from Morocco, homozygosity for loss-of-function IL12RB1 alleles was documented, resulting in complete IL-12Rβ1 deficiency. Despite the small sample studied, findings suggest that IL-12Rβ1 deficiency is not a very rare cause of pediatric TB in these countries, where it should be considered in selected children with severe disease. This finding may have important medical implications, as recombinant IFN-γ is an effective treatment for mycobacterial infections in IL-12Rβ1-deficient patients. It also provides additional support for the view that severe tuberculosis in childhood may result from a collection of single-gene inborn errors of immunity.
17. Social Science & Medicine (1982). 2011 Mar; Volume 72, Number 5: 733-8. Epub 2011 Jan 19. A Process for the Inclusion of Aboriginal People in Health Research: Lessons from the Determinants of TB Transmission Project; Boffa, J., King, M., McMullin, K., Long, R.
Click here for PubMed abstract: PubMed
The Determinants of TB Transmission (DTT) project, a federally-funded study covering the period April 1, 2006-March 31, 2013, and examining the determinants of TB transmission amongst the Canadian-born population (Aboriginal and non-Aboriginal) in the prairie provinces of Canada, took a novel approach to health research involving Aboriginal people. The methodology aligned itself with the recently published Canadian Institutes of Health Research (CIHR) Guidelines for Health Research Involving Aboriginal People and the established principles of Ownership, Control, Access, and Possession (OCAP). This article describes the process by which collaboration with Aboriginal peoples was achieved, including the involvement of Aboriginal researchers, the development of Provincial Network Committees (PNCs), and communications with First Nations Chiefs and Council. Strengths of this methodology included Aboriginal organizational and community support with a high rate of participation; PNC leadership, which brought together Aboriginal stakeholders with provincial and federal TB program planners; and the exploration of both on and off-reserve transmission factors. Challenges of the methodology included meeting funding agency timelines and expectations given the gradual process of trust development and PNC-reviewed publication; respecting both community and individual participants' autonomy regarding study participation; and political discomfort with strong Aboriginal involvement. While the methodology required a dedicated investment from researchers and funding agencies alike, the process was worthwhile and achieved a high degree of support from its major collaborators: the Aboriginal peoples.
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 NEW
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. Senior Technical Advisor Infectious Diseases
Sponsor: USAID/East Africa/Regional Health and HIV/AIDS Office/AFR
Location: Nairobi, Kenya
Application Deadline: July 8, 2011
The United States Agency for International Development (USAID) has contracted through CAMRIS International partnered with IAP World Services Inc, (IAPWS), to recruit and hire qualified individuals for this position.
ROLES AND RESPONSIBILITIES:
The Infectious Diseases (ID) Advisor will provide leadership and technical expertise on the full range of TB prevention and care and support activities, including TB program management, TB/HIV interventions, TB in children, community-based DOTS, MDR TB, and laboratory strengthening. The ID Advisor will bring strong technical expertise to the region on the latest developments in intensified case finding and infection control. Because of the increasing cases of MDR TB, the RHH Office has placed particular emphasis on laboratory strengthening of National TB Reference Laboratories in the region with the aim of developing a Supranational Reference Laboratory for the sub-region. USAID programs in the region also need assistance in scaling up to offer quality MDR TB treatment.
The ID Advisor will also bring strong technical expertise in other health areas and issues, such as malaria program management, case management and treatment, intermittent preventive treatment of malaria in pregnancy, promotion of long lasting insecticide-treated nets, Artemisinin combination therapies, maternal and child health (MCH), child survival interventions such as expanded programs on immunization (EPI) and control of diarrheal disease (CDD), polio elimination, highly pathogenic Avian Influenza (HPAI), and emerging pandemic threats.
The ID Advisor will provide state of the art technical support to the bilateral Missions as well as supporting and developing regional TB programming that complements programs of the region’s bilateral Missions.
The position is located in the RHH Office, USAID/EA in Nairobi, Kenya. The ID Advisor will work at a senior level within the region serving high-priority USG foreign assistance programs that require knowledge, experience, maturity, and an ability to function independently within a complex, highly demanding, frequently changing environment. S/he will be expected to participate on a multi-cultural team contributing to multiple results packages. S/he will advise USAID/EA on all aspects of TB prevention, care and support. The incumbent will represent USAID at the highest government and donor levels. Per ADS 103.3.1.1b(4), s/he will not be authorized to sign (1) obligations that require a warrant, and (2) grants to foreign governments and public international organizations, thereby prohibiting her/him from obligating USG funds in these instances. The ID Advisor will have no supervisory duties but will be an Activity Manager.
For more information about the job requirements and online application, submit the resume and visit http://www.iapws.com . Candidates meeting the requirements for the position will be required to provide a USAID 1420-17 Contractor Employee Biographical Data Sheet to document employment and salary history.
3. 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=
4. Deputy Director, Field Projects, TB Team, HIV/TB Global Team (Tracking Code 4477)
Sponsor: PATH
Location: Washington, DC
PATH is an international, nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health. PATH's mission is to improve the health of people around the world by advancing technologies, strengthening systems, and encouraging healthy behaviors. PATH is seeking a Deputy Director for TB field projects with experience managing USAID projects, excellent organizational and leadership skills, strong writing and reporting skills, and TB expertise to provide program management support to PATH's growing TB portfolio within the HIV/TB Global Program. S/he will report to the TB Team Leader.
Responsibilities will include:
(1) Assume direct management responsibilities for a portion of the TB portfolio and backstop other portfolio activities.
(2) Manage project start-up, documentation, and closeout activities in collaboration with other team members.
(3) Track work plan and budget progress and problem-solve implementation barriers with technical team members.
(4) Manage or backstop specific TB project technical activities, providing guidance on program development, implementation, and evaluation in the field.
(5) Support content development for work plans, reports, and other related documents.
(6) Act as the point person with donors and partners when the TB Team Leader is unavailable.
(7) Represent PATH on international working groups and task forces as appropriate and maintain contacts with other organizations working in TB control.
(8) Represent PATH at international conferences, in meetings with national TB programs, donors, technical partners, and elsewhere.
(9) Support business development and play a major role in proposal preparation for expansion of PATH’s TB work.
(10) Provide project management training and mentoring to PATH TB staff at headquarters and in the field.
(11) Contribute to the development, implementation, and evaluation of PATH’s TB program strategy.
(12) Other duties as appropriate.
Candidates can apply online at: Apply
5. Technical Officer, TB Team, HIV/TB Global Program (Tracking Code 4526)
Sponsor: PATH
Location: Washington, DC
PATH is an international, nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health. PATH's mission is to improve the health of people around the world by advancing technologies, strengthening systems, and encouraging healthy behaviors.
Based within the HIV/Tuberculosis Global Program, PATH's TB Portfolio consists of a dynamic and growing set of both global and country-focused technical assistance projects and short-term assignments. Such projects include supporting DOTS expansion and quality improvement, laboratory strengthening, surveillance, TB/HIV service integration, infection control, programmatic management of drug-resistant TB, public-private sector collaboration, and advocacy, communication and social mobilization.
PATH is seeking a Technical Officer with experience managing USAID projects, excellent organizational and leadership skills, and TB expertise to provide program management support. The Technical Officer will backstop the PATH TB project in the Democratic Republic of Congo. S/he will report to the TB Team Leader.
Specific responsibilities include:
(1) Provide intensive technical and management support to the PATH TB and TB/HIV project in the Democratic Republic of Congo, including:
• Work with PATH HQ and the country team to support rapid start-up of new project office and placement of staff in the field.
• Work with country team on project design, implementation, monitoring and evaluation.
• Support development of annual work plans, budgets, reports, and all deliverables.
• Work with country staff to ensure timely completion of project activities and problem-solve barriers.
• Work with country staff to ensure compliance with USAID contract rules and regulations and monitor budgets.
• Conduct quarterly (or more frequent as needed) project review with in-country staff and develop action plans for any improvements.
• Build in-country staff capacity in TB control and TB/HIV integration through mentorship or trainings.
• Work with PATH HQ to ensure the security of staff and offices in the field.
(2) Contribute to responding to new opportunities, including developing proposals in response to global and country-based solicitations.
(3) Represent PATH at international conferences, in meetings with national TB programs, donors, technical partners, and elsewhere.
(4) Manage and participate in global project work as a technical expert (e.g., national tuberculosis program evaluations, Global Fund to Fight AIDS, Tuberculosis and Malaria grant preparation).
(5) Contribute to the development, implementation, and evaluation of PATH’s TB program strategy.
(6) Other duties as appropriate, including backstopping additional field projects.
Candidates can apply online at: Apply
6. Technical Officer, TB Team, HIV/TB Global Program (Tracking Code 4590)
Sponsor: PATH
Location: Washington, DC
Please note, work visas will not be provided for this position.
PATH is an international, nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health. PATH's mission is to improve the health of people around the world by advancing technologies, strengthening systems, and encouraging healthy behaviors.
Based within the HIV/Tuberculosis Global Program, PATH's TB Portfolio consists of a dynamic and growing set of both global and country-focused technical assistance projects and short-term assignments. Such projects include supporting DOTS expansion and quality improvement, laboratory strengthening, surveillance, TB/HIV service integration, infection control, programmatic management of drug-resistant TB, public-private sector collaboration, and advocacy, communication and social mobilization.
PATH is seeking a Technical Officer with experience managing USAID projects, excellent organizational and leadership skills, and strong TB control expertise to provide program management and senior technical support. The Technical Officer will backstop the large PATH TB project in India. S/he will report to the TB Team Leader.
Specific responsibilities include:
(1) Provide intensive technical and management support to the PATH TB project in India, including:
• Work with country team on project design, implementation, monitoring and evaluation.
• Support development and tracking of annual work plans, budgets, reports, and all deliverables.
• Work with country staff to ensure timely completion of project activities and problem-solve barriers.
• Work with country staff to ensure compliance with USAID contract rules and regulations and monitor budgets.
• Conduct quarterly (or more frequent as needed) project review with in-country staff and develop action plans for any improvements.
• Build in-country staff capacity in TB control and TB/HIV integration through mentorship or trainings.
(2) Contribute to responding to new opportunities, including developing proposals in response to global and country-based solicitations.
(3) Represent PATH at international conferences, in meetings with national TB programs, donors, technical partners, and elsewhere.
(4) Manage and participate in global project work as a technical expert (e.g., national tuberculosis program evaluations, Global Fund to Fight AIDS, Tuberculosis and Malaria grant preparation).
(5) Contribute to the development, implementation, and evaluation of PATH’s TB program strategy.
(6) Other duties as appropriate, including backstopping additional field projects.
Candidates can apply online at: Apply
7. Nurse Practitioner
Sponsor: Olive View UCLA Medical Center Infectious Disease Tuberculosis Care Unit
Location: Los Angeles, California
Olive View UCLA Medical Center (a unit of the Los Angeles County Department of Health Services) is recruiting a Nurse Practitioner for a new long-term TB care unit. The nurse will care for approximately 15-30 patients (depending upon the unit census) and will be supervised by the unit physician director. Daily responsibilities will include routine patient care, medication monitoring and collaborative care interactions with nursing, dietary, and social work personnel.
The NP will work closely with infection control personnel to maintain isolation procedures and will be expected to collaborate with LA County TB control personnel in facilitating long-term patient treatment plans. The nurse will also participate in a planned “PPD clinic” to help manage asymptomatic PPD+ patients. In addition to these clinical duties, the NP will be expected to participate in unit and hospital efforts to provide staff and patient education regarding TB.
Desirable qualifications include previous public health experience and a willingness to work with drug-resistant TB infected patients.
Interested applicants should contact Sylvia Anguiano in the Dept of Medicine at Olive View-UCLA Medical Center and send a c.v. with letter of intent.
Sylvia Anguiano
Dept of Medicine 2B182
Olive View-UCLA Medical Center
14445 Olive View Drive
Sylmar, Ca. 91342
Office: 818-364-3205
E-mail
In order to be considered for the position, the applicant must also apply for a nurse practitioner position with the Los Angeles County Department of Health Services through one of the following links: https://sjobs.brassring.com/1033/asp/tg/cim_jobdetail.asp?partnerid=25082&sit...
OR
May also apply for NP position at http://www.ladhs.org under employment opportunities.
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.
1. 42nd Union World Conference on Lung Health NEW
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 .
Early bird registration deadline: July 1, 2011.
For more information, contact the Conference Secretariat, The Union, 68, boulevard Saint-Michel, 75006 Paris, France; Email: ; Tel: (+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 .
2. Late-Breaker Session on Tuberculosis at the 42nd World Conference on Lung Health NEW
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: ; Tel: (404) 639-8123; or Fax: (404) 639-8961; or visit the website: http://www.worldlunghealth.org/confLille/index.php/Abstracts/the-unioncdc-lat... .
3. Targeted Testing and Treatment of Latent TB Infection: An Online Presentation (60 minutes)
Sponsor: The Francis J. Curry National Tuberculosis Center
This slide presentation is presented by L. Masae Kawamura, M.D., TB Controller of the San Francisco Department of Public Health and co-principal investigator of the Francis J. Curry National TB Center/UCSF. Dr. Kawamura explores the diagnosis and treatment of LTBI, including the rationale for TB screening and what is meant by "targeted testing," risk factors for TB, the tuberculin skin test and new interferon gamma release assays (IGRAs), current LTBI treatment guidelines, and how to counsel and motivate patients. This slide presentation with streaming audio provides information on how to effectively target test for TB as well as how to treat latent TB infection (LTBI). A question and answer guide, a printable PowerPoint slide file, and other useful resources are also included as supplemental materials.
For more information, visit http://www.nationaltbcenter.ucsf.edu/testing_ltbi/ .
4. 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/ .
5. 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/ .
6. 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 .
7. Leading Management Teams
Sponsor: International Union Against Tuberculosis and Lung Disease (The Union)
Dates: June 27 – July 9, 2011
Location: Bangkok, Thailand
Bringing measurable changes within a TB program requires a comprehensive approach to performance management. Participants in this course will learn how to more effectively guide groups of personnel through advanced management training by examining their own leadership styles. Key topics the course addresses include: (1) Creating measurable results in a TB program through long-term planning; (2) Leading changes in a health organization that build greater staff commitment, competence, and confidence; (3) Achieving higher success rates through enhanced team performance; and (4) Developing team members through coaching and mentoring.
Late applications accepted on a space-available basis. To register, E-mail
.
For more information, e-mail ; or visit the Web site at http://www.union-imdp.org/courses/leading-management-teams.
8. Introduction to Nurse Case Management: An Online Course
Sponsor: Heartland National TB Center
Dates: July 7, July 14, July 28, 2011
The goal of this on-line course is to provide an introduction to TB nurse case management, including the basic elements, knowledge, and skills essential for the nurse whose primary responsibility is the care and supervision of patients with active TB disease. This course is intended for the registered nurse with less than one year TB experience and greater than 25% of job duties in TB case management, including case identification, case management, and treatment of patients with TB infection or disease.
Space is limited to 15 participants. Continuing education credits are available.
For more information, contact Jessica Quintero. E-mail ; phone (210) 531-4568; or access the Web site at http://www.heartlandntbc.org/training/brochure_online_ncm_07_jul_2011.pdf.
9. 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
Application deadline: July 1, 2011
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 Web site at http://www.umdnj.edu/globaltb/courses/brochures/2011/tbcohortworkshop.html.
10. 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 Web site at http://africatb2011.wordpress.com./ .
11. TB? Maybe Not: the Differential Diagnosis of Tuberculosis
Sponsor: Curry International Tuberculosis Center
Date: July 20, 2011
Location: Nationwide, US
Application deadline: June 30, 2011
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
12. 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, Email: ; Phone: (602) 364-3846; Fax: (602) 364-3267; or access the Web site: http://www.surveymonkey.com/s/2011AZID
13. Strategic Planning and Innovation
Dates: August 15 – 20, 2011
Sponsor: International Union Against Tuberculosis and Lung Disease (The Union)
Location: Singapore
Application deadline: July 10, 2011
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 Web site at http://www.union-imdp.org/courses/strategic-planning-innovation.
14. Tuberculosis Program Manager’s Intensive
Sponsor: Curry International Tuberculosis Center
Dates: August 23 – 26, 2011
Location: San Francisco, California
Application Deadline: June 30, 2011
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 Web site: http://www.currytbcenter.ucsf.edu/training/tbpmi11.cfm.
15. 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. Registration form available at: http://www.sjri.res.in.
For more information, contact Dr. John Kenneth, SJRI, Bangalore, Meeting Coordinator. Email ; phone +91 80 25532037 Ext 139; or access the Web site at http://www.sjri.res.in/html/2days_conference_new.html.
16. 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 Web site at http://www.virology-education.com/.
17. 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 .
18. 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 Web site: http://www.cdc.gov/tb/education/tbetn/conference.htm .
19. 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 Web site at http://www.njhealth.org/TBCourse.
20. 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 Web site at.
http://www.union-imdp.org/courses/human-resources-management.
21. 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/ .
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