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Titre : C-Tb: a latent tuberculosis skin test for the 21st century? Type de document : document électronique Auteurs : Ibrahim Abubakar, Auteur ; Charlotte Jackson, Auteur ; Molebogeng X. Rangaka, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 5(4) Importance : p.236-237 Langues : Anglais (eng) Catégories : [TUBER] diagnostic
[TUBER] type de tuberculose:tuberculose-maladieIndex. décimale : TU 5. Méthodes de diagnostic Résumé : The UN Sustainable Development Goals have led to global plans to end the tuberculosis epidemic. Individuals with latent tuberculosis infection are at risk of reactivation disease and onward transmission to contacts. Identification of these people before they develop active tuberculosis will, therefore, help to control the epidemic. Unfortunately, there is no gold standard diagnostic test for latent tuberculosis infection, and existing tests have poor ability to predict which individuals will go on to develop active tuberculosis. Those used at present are the tuberculin skin test (TST), which is cheap and simple to administer in the field but can be falsely positive in people who have received BCG vaccination or been exposed to non-tuberculous mycobacteria,1 and interferon γ release assays (IGRAs), which are more specific but are expensive and need specialist laboratory processing.
En ligne : http://dx.doi.org/10.1016/ S2213-2600(17)30012-7 Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10870 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : E-cigarettes and smoking cessation in real-world and clinical settings : a systematic review and meta-analysis Type de document : document électronique Auteurs : Sara Kalkhoran, Auteur ; Stanton A. Glantz, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 4(2) Importance : p.116-128 Langues : Anglais (eng) Catégories : [TABAC] chimie du tabac:tabac fumé:cigarette:cigarette électronique
[TABAC] étude:méta-analyse
[TABAC] sevrage tabagiqueIndex. décimale : TA 6.2.3.2 Autres produits En ligne : https://doi.org/10.1016/s2213-2600(15)00521-4 Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9428 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Supplément de E-cigarettes and smoking cessation in real-world and clinical settings / Sara Kalkhoran (2016)
Titre : Electronic cigarettes: more light, less heat needed Type de document : document électronique Auteurs : Steven L. Bernstein, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 4(2) Importance : p.85-87 Langues : Anglais (eng) Catégories : [TABAC] chimie du tabac:tabac fumé:cigarette:cigarette électronique Index. décimale : TA 1.1.1 Cigarettes (« normales », électroniques, aromatisées,…) En ligne : https://doi.org/10.1016/s2213-2600(16)00010-2 Format de la ressource électronique : Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9427 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Expected effects of adopting a 9 month regimen for multidrug-resistant tuberculosis / Emily A. Kendall (2016)
Titre : Expected effects of adopting a 9 month regimen for multidrug-resistant tuberculosis : a population modelling analysis Type de document : document électronique Auteurs : Emily A. Kendall, Auteur ; Anthony T. Fojo, Auteur ; David W. Dowdy, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 16 Importance : p.P191-199 Présentation : ill. ; tab. ; graph. Langues : Anglais (eng) Catégories : [DIVERS] association:association internationale:Organisation Mondiale de la Santé
[TUBER] traitement:résistance:multirésistance
[TUBER] traitement:traitement curatifIndex. décimale : TU 8.5.1. MDR (Multi Drug Resistance / XDR (X-treme Drug Resistance) Résumé : Background
In May, 2016, WHO endorsed a 9 month regimen for multidrug-resistant tuberculosis that is cheaper and potentially more effective than the conventional, longer (20–24 month) therapy. We aimed to investigate the population-level implications of scaling up this new regimen.
Methods
In this population modelling analysis, we developed a dynamic transmission model to simulate the introduction of this short-course regimen as an instantaneous switch in 2016. We projected the corresponding percentage reduction in the incidence of multidrug-resistant tuberculosis by 2024 compared with continued use of longer therapy. In the primary analysis in a representative southeast Asian setting, we assumed that the short-course regimen would double treatment access (through savings in resources or capacity) and achieve long-term efficacy at levels seen in preliminary cohort studies. We then did extensive sensitivity analyses to explore a range of alternative scenarios.
Findings
Under the optimistic assumptions in the primary analysis, the incidence of multidrug-resistant tuberculosis in 2024 would be 3·3 (95% uncertainty range 2·2–5·6) per 100 000 population with the short-course regimen and 4·3 (2·9–7·6) per 100 000 population with continued use of longer therapy—ie, the short-course regimen could reduce incidence by 23% (10–38). Incidence would be reduced by 14% (4–28) if the new regimen affected only treatment effectiveness and by 11% (3–24) if it affected only treatment availability. Under more pessimistic assumptions, the short-course regimen would have minimal effect and even potential for harm—eg, when 30% of patients are ineligible for the new regimen because of second-line drug resistance, we projected a change in incidence of −2% (−20 to +28). The new regimen's effect was greater in settings with more ongoing transmission of multidrug-resistant tuberculosis, but results were otherwise similar across settings with different levels of tuberculosis incidence and prevalence of multidrug resistance.
Interpretation
The short-course regimen has potential to substantially lessen the multidrug-resistant tuberculosis epidemic, but this effect depends on its long-term efficacy, its ability to expand treatment access, and the role of second-line drug resistance.
Funding
US National Institutes of Health and Bill & Melinda Gates Foundation.En ligne : http://dx.doi.org/10.1016/S2213-2600(16)30423-4 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10864 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Safety and efficacy of the C-Tb skin test to diagnose Mycobacterium tuberculosis infection, compared with an interferon γ release assay and the tuberculin skin test : a phase 3, double-blind, randomised, controlled trial Type de document : document électronique Auteurs : Morten Ruhwald, Auteur ; Henrik Aggerbeck, Auteur ; Rafael Vázquez Gallardo, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 5 Importance : p. 259-68 Présentation : ill. ; tab. ; graph. Langues : Anglais (eng) Catégories : [TUBER] dépistage
[TUBER] dépistage:test tuberculinique
[TUBER] étude:recherche:recherche clinique:essai clinique randomisé
[TUBER] traitement:traitement curatif
[TUBER] type de tuberculose:tuberculose-maladie:tuberculose pulmonaireIndex. décimale : TU 6. Méthodes de dépistage Résumé : Background
Targeted screening and treatment of Mycobacterium tuberculosis infection substantially reduces the risk of developing active tuberculosis. C-Tb (Statens Serum Institute, Copenhagen, Denmark) is a novel specific skin test based on ESAT-6 and CFP10 antigens. We investigated the safety and diagnostic potential of C-Tb compared with established tests in the contact-tracing setting.
Methods
Negative controls, close contacts, occasional contacts, and patients with active pulmonary tuberculosis were enrolled at 13 centres in Spain. We compared C-Tb with the QuantiFERON-TB Gold In-Tube ([QFT] Qiagen, Hilden, Germany) interferon γ release assay (IGRA) and the purified protein derivative (PPD) RT 23 tuberculin skin test ([TST] Statens Serum Institute). All participants older than 5 years were tested with QFT. Some participants in the negative control group received C-Tb without the TST to test for potential interactions between C-Tb and PPD RT 23. The rest were randomly assigned in blocks of ten and tested with both C-Tb and TST, with five in each block receiving injection of C-Tb in the right arm and the TST in the left arm and five vice versa. The primary and safety analyses were done in all participants randomly assigned to a group who received any test. This trial is registered with ClinicalTrials.gov, number NCT01631266, and with EudraCT, number 2011-005617-36.
Findings
From July 24, 2012, to Oct 2, 2014, 979 participants were enrolled, of whom 263 were negative controls, 299 were occasional contacts, 316 were close contacts, and 101 were patients with tuberculosis. 970 (99%) participants completed the trial. Induration sizes were similar for C-Tb and TST, but TST positivity was affected by BCG vaccination status. We found a strong positive trend towards C-Tb test positivity with increasing risk of infection, from 3% in negative controls to 16% in occasional contacts, to 43% in close contacts. C-Tb and QFT results were concordant in 785 (94%) of 834 participants aged 5 years and older, and results did not differ significantly between exposure groups. The safety profile of C-Tb was similar to that for the TST.
Interpretation
C-Tb delivered IGRA-like results in a field-friendly format. Being unaffected by BCG vaccination status, the C-Tb skin test might provide more accurate treatment guidance in settings where the TST is commonly used.
Funding
Statens Serum Institut.En ligne : http://dx.doi.org/10.1016/ S2213-2600(16)30436-2 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10872 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Whole-genome sequencing of Mycobacterium tuberculosis for rapid diagnostics and beyond Type de document : document électronique Auteurs : Caroline Colijn, Auteur ; Ted Cohen, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. 4(1) Importance : p.6-8 Langues : Français (fre) Catégories : [TUBER] diagnostic
[TUBER] étude:épidémiologie:génétique
[TUBER] type de tuberculose:tuberculose-maladieIndex. décimale : TU 5. Méthodes de diagnostic En ligne : http://dx.doi.org/10.1016/ S2213-2600(15)00510-X Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9424 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
