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Titre : Association between spending on social protection and tuberculosis burden : a global analysis Type de document : document électronique Auteurs : Andrew Siroka, Auteur ; Ninez A. Ponce, Auteur ; Knut Lönnroth, Auteur Editeur : Lancet Année de publication : 2015 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 16(4) Importance : p.473-479 Langues : Anglais (eng) Catégories : [TUBER] aspect socio-économique
[TUBER] surveillanceIndex. décimale : TU 3. Stratégies et programmes de prévention et de contrôle Résumé : The End TB Strategy places great emphasis on increasing social protection and poverty alleviation programmes. However, the role of social protection on controlling tuberculosis has not been examined fully. We analysed the association between social protection spending and tuberculosis prevalence, incidence, and mortality globally. En ligne : https://doi.org/10.1016/S1473-3099(15)00401-6 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10028 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : High-dose rifampicin, moxifloxacin, and SQ109 for treating tuberculosis : a multi-arm, multi-stage randomised controlled trial Type de document : document électronique Auteurs : Martin J. Boeree, Auteur ; Norbert Heinrich, Auteur ; Rob Aarnoutse, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 17 Importance : p. 39-49 Présentation : ill. ; tab. ; graph. Langues : Anglais (eng) Catégories : [TUBER] étude:recherche:recherche clinique:essai clinique randomisé
[TUBER] traitement:traitement curatif
[TUBER] type de tuberculose:tuberculose-maladie:tuberculose pulmonaireIndex. décimale : TU 8.2. Traitement curatif Résumé : Background: Tuberculosis is the world’s leading infectious disease killer. We aimed to identify shorter, safer drug regimens for the treatment of tuberculosis.
Methods: We did a randomised controlled, open-label trial with a multi-arm, multi-stage design. The trial was done in seven sites in South Africa and Tanzania, including hospitals, health centres, and clinical trial centres. Patients with newly diagnosed, rifampicin-sensitive, previously untreated pulmonary tuberculosis were randomly assigned in a 1:1:1:1:2 ratio to receive (all orally) either 35 mg/kg rifampicin per day with 15–20 mg/kg ethambutol, 20 mg/kg rifampicin per day with 400 mg moxifl oxacin, 20 mg/kg rifampicin per day with 300 mg SQ109, 10 mg/kg rifampicin per day with 300 mg SQ109, or a daily standard control regimen (10 mg/kg rifampicin, 5 mg/kg isoniazid, 25 mg/kg pyrazinamide, and 15–20 mg/kg ethambutol). Experimental treatments were given with oral 5 mg/kg isoniazid and 25 mg/kg pyrazinamide per day for 12 weeks, followed by 14 weeks of 5 mg/kg isoniazid and 10 mg/kg rifampicin per day. Because of the orange discoloration of body fluids with higher doses of rifampicin it was not possible to mask patients and clinicians to treatment allocation. The primary endpoint was time to culture conversion in liquid media within 12 weeks. Patients without evidence of rifampicin resistance on phenotypic test who took at least one dose of study treatment and had one positive culture on liquid or solid media before or within the fi rst 2 weeks of treatment were included in the primary analysis (modified intention to treat). Time-to-event data were analysed using a Cox proportional-hazards regression model and adjusted for minimisation variables. The proportional hazard assumption was tested using Schoelfeld residuals, with threshold p<0·05 for non-proportionality. The trial is registered with ClinicalTrials.gov (NCT01785186).
Findings: Between May 7, 2013, and March 25, 2014, we enrolled and randomly assigned 365 patients to diff erent treatment arms (63 to rifampicin 35 mg/kg, isoniazid, pyrazinamide, and ethambutol; 59 to rifampicin 10 mg/kg, isoniazid, pyrazinamide, SQ109; 57 to rifampicin 20 mg/kg, isoniazid, pyrazinamide, and SQ109; 63 to rifampicin 10 mg/kg, isoniazid, pyrazinamide, and moxifl oxacin; and 123 to the control arm). Recruitment was stopped early in the arms containing SQ109 since prespecifi ed effi cacy thresholds were not met at the planned interim analysis. Time to stable culture conversion in liquid media was faster in the 35 mg/kg rifampicin group than in the control group (median 48 days vs 62 days, adjusted hazard ratio 1·78; 95% CI 1·22–2·58, p=0·003), but not in other experimental arms. There was no diff erence in any of the groups in time to culture conversion on solid media. 11 patients had treatment failure or recurrent disease during post-treatment follow-up: one in the 35 mg/kg rifampicin arm and none in the moxifl oxacin arm. 45 (12%) of 365 patients reported grade 3–5 adverse events, with similar proportions in each arm.
Interpretation: A dose of 35 mg/kg rifampicin was safe, reduced the time to culture conversion in liquid media, and could be a promising component of future, shorter regimens. Our adaptive trial design was successfully implemented in a multi-centre, high tuberculosis burden setting, and could speed regimen development at reduced cost.
Funding: The study was funded by the European and Developing Countries Clinical Trials partnership (EDCTP), the German Ministry for Education and Research (BmBF), and the Medical Research Council UK (MRC).En ligne : http://dx.doi.org/10.1016/ S1473-3099(16)30274-2 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10863 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Mortality in children diagnosed with tuberculosis : a systematic review and meta-analysis Type de document : document électronique Auteurs : Helen E. Jenkins, Auteur ; Courtney M. Yuen, Auteur ; Carly A. Rodriguez, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 17 Importance : p. p285-295 Présentation : tab. ; graph. Langues : Anglais (eng) Catégories : [DIVERS] personne:famille:enfant
[TUBER] étude:statistique
[TUBER] type de tuberculose:tuberculose-maladieIndex. décimale : TU 4.2. Enfants Résumé : Background
Case fatality ratios in children with tuberculosis are poorly understood—particularly those among children with HIV and children not receiving tuberculosis treatment. We did a systematic review of published work to identify studies of population-representative samples of paediatric (ie, <15 years) tuberculosis cases.
Methods
We searched PubMed and Embase for reports published in English, French, Portuguese, or Spanish before Aug 12, 2016, that included terms related to tuberculosis, children, mortality, and population representativeness. We also reviewed our own files and reference lists of articles identified by this search. We screened titles and abstracts for inclusion, excluding studies in which outcomes were unknown for 10% or more of the children and publications detailing non-representative samples. We used random-effects meta-analysis to produce pooled estimates of case fatality ratios from the included studies, which we divided into three eras: the pre-treatment era (ie, studies before 1946), the middle era (1946–80), and the recent era (after 1980). We stratified our analyses by whether or not children received tuberculosis treatment, age (0–4 years, 5–14 years), and HIV status.
Findings
We identified 31 papers comprising 35 datasets representing 82 436 children with tuberculosis disease, of whom 9274 died. Among children with tuberculosis included in studies in the pre-treatment era, the pooled case fatality ratio was 21·9% (95% CI 18·1–26·4) overall. The pooled case fatality ratio was significantly higher in children aged 0–4 years (43·6%, 95% CI 36·8–50·6) than in those aged 5–14 years (14·9%, 11·5–19·1). In studies in the recent era, when most children had tuberculosis treatment, the pooled case fatality ratio was 0·9% (95% CI 0·5–1·6). US surveillance data suggest that the case fatality ratio is substantially higher in children with HIV receiving treatment for tuberculosis (especially without antiretroviral therapy) than in those without HIV.
Interpretation
Without adequate treatment, children with tuberculosis, especially those younger than 5 years, are at high risk of death. Children with HIV have an increased mortality risk, even when receiving tuberculosis treatment.
Funding
US National Institutes of Health, Janssen Global Public Health.En ligne : http://dx.doi.org/10.1016/ S1473-3099(16)30474-1 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10868 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Multidrug resistant tuberculosis : a continuing crisis Type de document : document électronique Auteurs : Talha Burki, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 16 Importance : p.1337-1338 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 : The multidrug resistant tuberculosis epidemic is a crisis. Despite promising new treatments, gaps in
funding and political attention are hampering eff orts to stem the disease.En ligne : https://doi.org/10.1016/S1473-3099(16)30479-0 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10861 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Population-based resistance of Mycobacterium tuberculosis isolates to pyrazinamide and fluoroquinolones / Matteo Zignol (2016)
Titre : Population-based resistance of Mycobacterium tuberculosis isolates to pyrazinamide and fluoroquinolones : results from a multicountry surveillance project Type de document : document électronique Auteurs : Matteo Zignol, Auteur ; Anna Dean, Auteur ; Natavan Alikhanova, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 16(10) Importance : p. 1185–1192 Langues : Anglais (eng) Catégories : [DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du Sud
[DIVERS] géographie:Europe:Europe centrale et orientale
[TUBER] traitement:résistance
[TUBER] traitement:traitement curatif
[PROMOSAN] étude:enquêteIndex. décimale : TU 8.2. Traitement curatif Résumé : Background
Pyrazinamide and fluoroquinolones are essential antituberculosis drugs in new rifampicin-sparing regimens. However, little information about the extent of resistance to these drugs at the population level is available.
Methods
In a molecular epidemiology analysis, we used population-based surveys from Azerbaijan, Bangladesh, Belarus, Pakistan, and South Africa to investigate resistance to pyrazinamide and fluoroquinolones among patients with tuberculosis. Resistance to pyrazinamide was assessed by gene sequencing with the detection of resistance-conferring mutations in the pncA gene, and susceptibility testing to fluoroquinolones was conducted using the MGIT system.
Findings
Pyrazinamide resistance was assessed in 4972 patients. Levels of resistance varied substantially in the surveyed settings (3·0–42·1%). In all settings, pyrazinamide resistance was significantly associated with rifampicin resistance. Among 5015 patients who underwent susceptibility testing to fluoroquinolones, proportions of resistance ranged from 1·0–16·6% for ofloxacin, to 0·5–12·4% for levofloxacin, and 0·9–14·6% for moxifloxacin when tested at 0·5 μg/mL. High levels of ofloxacin resistance were detected in Pakistan. Resistance to moxifloxacin and gatifloxacin
when tested at 2 μg/mL was low in all countries.
Interpretation
Although pyrazinamide resistance was significantly associated with rifampicin resistance, this drug may still be effective in 19–63% of patients with rifampicin-resistant tuberculosis. Even though the high level of resistance to ofloxacin found in Pakistan is worrisome because it might be the expression of extensive and unregulated use of fluoroquinolones in some parts of Asia, the negligible levels of resistance to fourth-generation fluoroquinolones documented in all survey sites is an encouraging finding. Rational use of this class of antibiotics should therefore be ensured to preserve its effectiveness.En ligne : https://doi.org/10.1016/S1473-3099(16)30190-6 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10783 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Prevalence of and risk factors for active tuberculosis in migrants screened before entry to the UK : a population-based cross-sectional study Type de document : document électronique Auteurs : Robert W. Aldridge, Auteur ; Dominik Zenner, Auteur ; Peter J. White, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. vol. 16 nr 8 Importance : p.962-970 Langues : Anglais (eng) Catégories : [DIVERS] géographie:Europe:Europe occidentale:Royaume-Uni
[DIVERS] personne:migrant
[TUBER] diagnostic
[TUBER] étude:statistique:prévalence
[TUBER] type de tuberculose:tuberculose-maladieIndex. décimale : TU 3.6.b. Réfugiés / migrants En ligne : https://doi.org/10.1016/S1473-3099(16)00072-4 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10157 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Accompagne Prevalence of and risk factors for active tuberculosis in migrants screened before entry to the UK / Robert W. Aldridge (2016)
Titre : Tackling tuberculosis in migrants Type de document : document électronique Auteurs : Marieke van der Werf, Auteur ; Piotr Kramarz, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. vol. 16 nr 8 Importance : p.877-878 Présentation : ill. Langues : Anglais (eng) Catégories : [TUBER] traitement
[TUBER] type de tuberculose:tuberculose-maladie
[DIVERS] personne:migrantIndex. décimale : TU 3.6.b. Réfugiés / migrants Résumé : Commentaire sur un article En ligne : http://dx.doi.org/10.1016/ S1473-3099(16)00148-1 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10156 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
fait partie de Association between spending on social protection and tuberculosis burden / Andrew Siroka (2015)
Titre : The impact of social protection on tuberculosis rates : a global analysis Type de document : document électronique Auteurs : Andrew Siroka, Auteur ; Knut Lönnroth, Auteur ; Ninez A. Ponce, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. vol.16 nr 4 Importance : p. 473–479 Présentation : ill. ; tab. ; graph. Langues : Anglais (eng) Catégories : [DIVERS] association:association internationale:Organisation Mondiale de la Santé
[TUBER] aspect socio-économique
[TUBER] étude:épidémiologie:groupe à risque:précaritéIndex. décimale : TU 4.4.f. Milieu précarisé (sans abris, drogués,...) Résumé : Background
The End TB Strategy places great emphasis on increasing social protection and poverty alleviation programmes. However, the role of social protection on controlling tuberculosis has not been examined fully. We analysed the association between social protection spending and tuberculosis prevalence, incidence, and mortality globally.
Methods
We used publicly available data from WHO's Global Tuberculosis Programme for tuberculosis burden in terms of yearly incidence, prevalence, and mortality per 100 000 people, and social protection data from the International Labour Organization (ILO), expressed as the percentage of national gross domestic product (GDP) spent on social protection programmes (excluding health). Data from ILO were from 146 countries covering the years between 2000 and 2012. We used descriptive assessments to examine levels of social protection and tuberculosis burden for each country, then used these assessments to inform our fully adjusted multivariate regression models. Our models controlled for economic output, adult HIV prevalence, health expenditure, population density, the percentage of foreign-born residents, and the strength of the national tuberculosis treatment programme, and also incorporated a country-level fixed effect to adjust for clustering of datapoints within countries.
Findings
Overall, social protection spending levels were inversely associated with tuberculosis prevalence, incidence, and mortality. For a country spending 0% of their GDP on social protection, moving to spending 1% of their GDP was associated with a change of −18·33 per 100 000 people (95% CI −32·10 to −4·60; p=0·009) in prevalence, −8·16 per 100 000 people (−16·00 to −0·27; p=0·043) in incidence, and −5·48 per 100 000 people (−9·34 to −1·62; p=0·006) in mortality. This association was mitigated at higher levels of social protection spending, and lost significance when more than 11% of GDP was spent.
Interpretation
Our findings suggest that investments in social protection could contribute to a reduced tuberculosis burden, especially in countries that are investing a small proportion of their GDP in this area. However, further research is needed to support these ecological associations.En ligne : https://doi.org/10.1016/S1473-3099(15)00401-6 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10152 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : The transmission of Mycobacterium tuberculosis in high burden settings Type de document : document électronique Auteurs : Tom A. Yates, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 16 Importance : p.227-238 Langues : Anglais (eng) Catégories : [TUBER] cause:contagion Index. décimale : TU 3.6. Groupes à risques En ligne : https://doi.org/10.1016/S1473-3099(15)00499-5 Format de la ressource électronique : HTML, PDF Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=9426 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
