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Tuberculosis
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Your search returned 91 results
from the time period: last 90 days.
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American journal of respiratory and critical care medicine
RATIONALE: Point-of-care (POC) diagnostics have the potential to reduce pretreatment loss to follow-up and delays to initiation of appropriate tuberculosis (TB) treatment. OBJECTIVES: To evaluate the effect of a POC diagnostic strategy on initiation of appropriate TB treatment. METHODS: We conducted a cluster-randomized trial of adults with cough who were HIV positive and/or at high risk of drug-resistant TB. Two-week time blocks were randomized to two strategies: (1) Xpert MTB/RIF test (Cepheid, Sunnyvale, CA) performed at a district hospital laboratory or (2) POC Xpert MTB/RIF test performed at a primary health care clinic. All participants provided two sputum specimens: one for the Xpert test and the other for culture as a reference standard. The primary outcome was the proportion of participants with culture-positive pulmonary tuberculosis (PTB) initiated on appropriate TB treatment within 30 days. MEASUREMENTS AND MAIN RESULTS: Between August 22, 2011, and March 1, 2013, 36 two-week blocks were randomized, and 1,297 individuals were enrolled (646 in the laboratory arm, 651 in the POC arm), 159 (12.4%) of whom had culture-positive PTB. The proportions of participants with culture-positive PTB initiated on appropriate TB treatment within 30 days were 76.5% in the laboratory arm and 79.5% in the POC arm (odds ratio, 1.13; 95% confidence interval, 0.51-2.53; P = 0.76; risk difference, 3.1%; 95% confidence interval, -16.2 to 10.1). The median time to initiation of appropriate treatment was 7 days (laboratory) versus 1 day (POC). CONCLUSIONS: POC positioning of the Xpert test led to more rapid initiation of appropriate TB treatment. Achieving one-stop diagnosis and treatment for all people with TB will require simpler, more sensitive diagnostics and broader strengthening of health systems. Clinical trial registered with www.isrctn.com (ISRCTN 18642314) and www.sanctr.gov.za (DOH-27-0711-3568).
Cardiovascular Diseases (7), Infectious Diseases (1)
Tuberculosis (5), Pulmonary Tuberculosis (1), Drug-Resistant Tuberculosis (1), more mentions
The Journal of infectious diseases
Given that mucosal organs are a principal target for HIV-mediated CD4 destruction, we investigated M.tuberculosis-specific responses in bronchoalveolar lavage (BAL), in persons with latent TB infection and untreated HIV-1 co-infection with preserved CD4 counts. M.tuberculosis-specific CD4+ cytokine responses (IFN-, TNF- and IL-2) were discordant in frequency and function between BAL and blood.
Cardiovascular Diseases (9), Immune System Diseases (1)
Tuberculosis (9), Infections (3), HIV Infections (2), more mentions
PloS one
OBJECTIVE: To evaluate the performance of Genotype MTBDRplus VER 2.0 in the diagnosis of Mycobacterium tuberculosis (MTB) in sputum smear-negative pulmonary TB cases. METHODS: A total of 572 Ziehl-Neelsen sputum smear-negative samples were selected and subjected to line probe assay (Genotype MTBDRplus VER 2.0), and culture in mycobacterial growth indicator tube (MGIT-960). Immunochromatographic test was used to confirm the MTB-complex (MTBC) in culture-positive samples and phenotypic drug-susceptibility testing was done using MGIT-960. RESULTS: The line probe assay was able to diagnose MTBC in 38.2% (213/558) of specimens after excluding 14 nontuberculous mycobacteria. Sensitivity and specificity of the assay were 68.4% and 89.3% respectively, considering MGIT-960 culture as gold standard after excluding contaminated and invalid results. On comparing with composite reference standard, the assay had 71.5% sensitivity and 100% specificity in the diagnosis of tuberculosis. The sensitivity and specificity for detecting resistance to rifampicin (RMP) were 100% and 99.24% respectively and for resistance to isoniazid (INH) were 97.62% and 98.55%, respectively. CONCLUSION: Genotype MTBDRplus VER 2.0 is a rapid and precise diagnostic tool for detection of MTB in sputum smear-negative samples. It also facilitates accurate diagnosis of RMP and INH resistance within turn around-time.
Cardiovascular Diseases (5)
Tuberculosis (4), Pulmonary Tuberculosis (1), more mentions
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
... tuberculosis (TB) but not to measure treatment response.To measure IFN-γ response to active anti-tuberculosis treatment.Patients from the Henan Provincial Chest Hospital, Henan, China, with TB symptoms and ... TB patients enrolled, 135 were eligible for this analysis: 118 pulmonary (PTB) and 17 extra-pulmonary TB (EPTB) patients.
Cardiovascular Diseases (5)
Tuberculosis (4), Pulmonary Tuberculosis (1), more mentions
The American journal of tropical medicine and hygiene
Contact tracing was conducted for patients with active TB... One hundred (25%) were diagnosed with active TB; 53 (53%) were smear positive. Ninety of these TB index cases provided 317 contacts, and 44 (14%) were diagnosed with active TB; 17 (39%) were smear positive. Overall, 144 TB cases were detected in 6 months (1,920/100,000; national estimate 200 ...
Cardiovascular Diseases (3)
Tuberculosis (3), Cough (3), more mentions
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
BACKGROUND: xtra-pulmonary tuberculosis (EPTB) is a growing public health concern, and data on drug resistance are limited. MATERIAL AND METHODS: Specimens from 2468 clinically diagnosed EPTB patients received at the Intermediate Reference Laboratory (IRL) of a tertiary centre in India were subjected to Ziehl-Neelsen staining, Xpert® MTB/RIF testing, liquid culture and drug susceptibility testing (DST) using automated BACTEC MGIT™ 960™. Line-probe assay (LPA) was performed on all culture-positive isolates. Gene sequencing was performed on rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB) and phenotypic/genotypic discrepant isolates. RESULTS: The culture positivity rate was 18.9% (483/2553). The sensitivity and specificity of Xpert in diagnosing EPTB were respectively 70.8% (95%CI 66.5-74.8) and 97.7% (95%CI 96.9-98.3), with liquid culture as the reference standard. Prevalence of RR/MDR-TB was 10.1% (49/483). Prevalence of pre-extensively drug-resistant TB (pre-XDR-TB) was 18.4% (09/49), whereas the prevalence of XDR-TB among MDR-TB patients was 2% (01/49). The sensitivity of genotypic DST for the detection of rifampicin resistance was 92.7% (95%CI 81.1-98.5) and specificity was 99.3% (95%CI 97.5-99.9), with 100% concordance between Xpert and LPA. CONCLUSION: The burden of drug resistance, including M/XDR-TB, among EPTB patients is high. Novel molecular tests can help in early diagnosis and treatment to prevent disease progression and amplification of resistance.
Cardiovascular Diseases (2)
Extensively Drug-Resistant Tuberculosis (3), Pulmonary Tuberculosis (2), more mentions
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
... TB strategy, there has been renewed interest in screening for active tuberculosis (TB), and particularly latent tuberculous infection (LTBI... review the effectiveness and cost-effectiveness of screening migrants for active TB LTBI to inform and support the TB elimination strategy in ... All studies that described the effectiveness or cost-effectiveness of active TB or LTBI screening among migrants were included.
Cardiovascular Diseases (2)
Infections (2), Tuberculosis (2), more mentions
PloS one
BACKGROUND: Improved systematic screening of high-risk groups is a key component of the tuberculosis (TB) elimination strategy endorsed by the World Health Organization (WHO). We used a multiplex microbead immunoassay to measure antibody responses to 28 M. tuberculosis (M.tb) antigens, and assessed whether combinations of antibody responses achieve accuracy thresholds required for a TB screening test. METHODS: A random selection of plasma samples obtained from consecutive HIV-negative adults who were admitted to Mulago Hospital in Kampala, Uganda with cough ≥2 weeks' but <6 months' duration were analyzed for serological response to 28 M.tb antigens using an in-house multiplex microbead immunoassay. We compared the median difference of the antibody response to each antigen between patients with and without culture-confirmed TB, ranked each antigen according to variable importance (VIM), and assessed the sensitivity and specificity of combinations of antibody responses using an advanced classification algorithm, SuperLearner. RESULTS: Among the 237 patients included in the analysis, 119 (50%) were female, median age was 32 years (IQR 25, 46), and 113 (48%) had TB. Median antibody levels to eight antigens were significantly different between patients with and without TB. A panel including eight of the top ranked antigens had a sensitivity of 90.6% (95% CI 89.4, 93.8) and a specificity of 88.6% (95% CI 78.2, 97.6) (Ag85B, Ag85A, Ag85C, Rv0934-P38, Rv3881, BfrB, Rv3873, and Rv2878c). With sensitivity constrained to be >90%, specificity remained close to 70% with as few as 3 antigens included in the panels. CONCLUSIONS: Measuring antibody responses to combinations of antigens could facilitate TB screening and should be further evaluated in populations being targeted for systematic screening.
Cardiovascular Diseases (5)
Tuberculosis (5), Cough (1), more mentions
AIDS (London, England)
OBJECTIVES: Tuberculosis (TB) is common in people living with HIV (PLHIV), leading to worse clinical outcomes including increased mortality. We investigated risk factors for developing TB following HIV diagnosis. DESIGN: Adults aged ≥15 years first presenting to health services for HIV care in England, Wales or Northern Ireland from 2000-2014 were identified from national HIV surveillance data and linked to TB surveillance data. METHODS: We calculated incidence rates for TB occurring >91 days after HIV diagnosis and investigated risk factors using multivariable Poisson regression. RESULTS: 95,003 adults diagnosed with HIV were followed for 635,591 person-years (PY); overall incidence of TB was 344/100,000PY (95% confidence interval 330-359). TB incidence was high for people who acquired HIV through injecting drugs (PWID; men 876 [696-1,104], women 605 [528-593]) and black Africans born in high TB incidence countries (644 [612-677]). The adjusted incidence rate ratio (IRR) for TB amongst PWID was 4.79 [3.35-6.85] for men and 6.18 [3.49-10.93] for women, compared to men who have sex with men. The adjusted IRR for TB in black Africans from high-TB countries was 4 27 (3 42-5 33), compared to white UK-born individuals. Lower time-updated CD4 count was associated with increased rates of TB. CONCLUSIONS: PWID had the greatest risk of TB; incidence rates were comparable to those in black Africans from high TB incidence countries. Most TB cases in PWID were UK-born, and likely acquired TB through transmission within the UK. Earlier HIV diagnosis and quicker initiation of ART should reduce TB incidence in these populations.
Cardiovascular Diseases (2)
Tuberculosis (2), more mentions
The European respiratory journal
... occur among non-UK born individuals, mostly as a result of reactivation of latent TB infection (LTBI... calculated.97 out of 1820 individuals screened for LTBI were reported to have active TB... individuals were 4.1 and 2.3 per 100 person-years in the QuantiFERON and tuberculin skin test cohorts, respectively.
Cardiovascular Diseases (2)
Infections (2), Tuberculosis (2), more mentions
PloS one
... AbstractText: A total of 525 participants were studied: (i) 175 active pulmonary TB patients and (ii) 350 individuals coming from contact tracing studies ... were processed according manufacturer's instructions AbstractText: In smoking patients with active TB, QFN-G-IT (34.4%) and T-SPOT.TB (19.5%) had ... Latent TB infection (LTBI) was favored in smoking contacts, being a risk ...
Smoking Cessation (3), Cardiovascular Diseases (2)
Infections (4), Tuberculosis (2), more mentions
Journal of clinical microbiology
Abstract: New non-sputum biomarker tests for active tuberculosis (TB) diagnostics are of highest priority for global TB control ... samples were from patients with symptoms and signs suggestive of active pulmonary TB that were systematically confirmed or ruled-out for TB by ... profiles (TPPs) for a non-sputum biomarker test to diagnose active TB for treatment initiation (TPP#1) and for a community-based ...
Cardiovascular Diseases (2)
Coinfections (1), Pulmonary Tuberculosis (1), Tuberculosis (1), more mentions
The American journal of tropical medicine and hygiene
Mass gatherings pose a risk for tuberculosis (TB) transmission and reactivation of latent TB infection... We evaluated the burden of undiagnosed active pulmonary TB in pilgrims attending the 2015 Hajj mass gathering... Fifteen pilgrims (1.4%) had active previously undiagnosed drug-sensitive pulmonary TB (Afghanistan [12; 80%], Pakistan [2; 13.3%], and Nigeria [1; 6.7 ...
Cardiovascular Diseases (3), Endocrine Disorders (1)
Hypertension (1), Tuberculosis (1), Pulmonary Tuberculosis (1), more mentions
BMJ open
Pharmaceutical treatment of latent tuberculosis infection (LTBI) reduces the risk of progression to active tuberculosis (TB); however, poor adherence tempers the protective effect. We aimed to estimate the health burden of non-adherence, the maximum allowable cost of hypothetical new adherence interventions to be cost-effective and the potential value of existing adherence interventions for patients with low-risk LTBI ...
Cardiovascular Diseases (3)
Tuberculosis (3), Infections (2), more mentions
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
This review compares the published literature on policies for tuberculosis (TB) and latent tuberculous infection (LTBI) screening in EU and European Free Trade ... of the literature on the yield of screening migrants for active TB and LTBI in Europe... and different definitions for coverage and yield of screening for active TB and LTBI.
Cardiovascular Diseases (2)
Infections (2), Tuberculosis (2), more mentions
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Of the 792 contacts analyzed, 65.3% in the TST arm and 42.2% in the TST/QFT arm were diagnosed with tuberculosis infection (23.1% difference; 97.5 ... AbstractText: In low-incidence settings, screening household contacts with the tuberculin skin test and using QuantiFERON®-TB Gold In-Tube as a confirmatory test is not inferior to TST-alone for preventing active tuberculosis, allowing a safe reduction of ...
Cardiovascular Diseases (8)
Tuberculosis (8), Infections (2), more mentions
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
We aimed to evaluate the risk of tuberculin skin test (TST) conversion and the risk of occupational TB infection among HCWs ... tertiary medical center in the US Midwest who had undergone TST screening during the study period January 1, 1998 to May ... 31, 2014 AbstractText: Among 40,142 HCWs who received a TST test, only 123 converted over 16.4 years.
Cardiovascular Diseases (1)
Infections (1), Tuberculosis (1), more mentions
Journal of immunology (Baltimore, Md. : 1950)
Abstract: Coinfection with HIV is the single greatest risk factor for reactivation of latent Mycobacterium tuberculosis infection (LTBI) and progression to active tuberculosis disease... specific CD4 T cell immunity that are impaired in HIV-infected individuals with LTBI, which may contribute to their increased risk of developing active tuberculosis disease.
Cardiovascular Diseases (15)
Tuberculosis (15), HIV Infections (3), Infections (3), more mentions
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
<h2>SETTING:</h2>A tertiary referral hospital in Bangkok, Thailand.<h2>OBJECTIVES:</h2>To evaluate the efficacy of a bronchoalveolar lavage fluid (BALF) tuberculosis (TB) polymerase chain reaction (PCR) assay for the diagnosis of sputum smear-negative pulmonary TB (PTB) and the usefulness of a drug-resistant (DR) TB-PCR assay compared with standard drug susceptibility testing (DST).<h2>DESIGN:</h2>BALF samples from 918 patients with acid-fast bacilli (AFB) negative sputum smears who underwent bronchoscopy for diagnostic evaluations of pulmonary diseases were prospectively determined for specific genetic elements of TB using the Anyplex(TM) MTB/NTM Real-Time Detection kit. Positive TB-PCR samples were subsequently evaluated for DR-TB using the Anyplex II MTB/MDR Detection kit.<h2>RESULTS:</h2>A total of 224 patients were finally diagnosed with PTB. The sensitivity, specificity, positive predictive value and negative predictive value of the TB-PCR assay were respectively 38.8&percnt;, 100&percnt;, 100&percnt;, and 83.5&percnt;. The TB-PCR assay was more sensitive than culture (30.4&percnt;) and smear (6.7&percnt;). Of the 68 TB-positive culture samples, three cases with either isoniazid (INH) or rifampicin (RMP) resistance were detected by DST. The Anyplex II MTB/MDR assay provided similar results.<h2>CONCLUSIONS:</h2>The BALF TB-PCR assay is a useful tool in the diagnosis of sputum smear-negative PTB. It can also provide INH and RMP susceptibility patterns similar to those of standard DST.
Cardiovascular Diseases (1)
Tuberculosis (1), Lung Diseases (1), more mentions
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
AbstractText: Systematic screening for active pulmonary tuberculosis (PTB) is recommended for high-risk populations, including people living with the human immunodeficiency virus (PLHIV); however, currently recommended TB screening ... point-of-care test, can be used to screen PLHIV presenting for routine HIV/AIDS (acquired immune-deficiency syndrome) care for active TB.
Immune System Diseases (6), Cardiovascular Diseases (2)
Pulmonary Tuberculosis (2), HIV Infections (1), Acquired Immunodeficiency Syndrome (1), more mentions
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