The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
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Int. J. Tuberc. Lung Dis. · Jan 2004
Prospects for new TB vaccines: Stop TB Working Group on TB Vaccine Development.
Research towards the development of improved TB vaccines has reached an important turning point. A large number of vaccine candidates such as modified BCG, attenuated Mycobacterium tuberculosis and protein or DNA subunit vaccines, resulting from over a decade of work in experimental laboratory models, are now getting ready for clinical testing. ⋯ Facilities and funding need to be identified for the production of clinical vaccine lots, an issue that is difficult to tackle due to the live organisms in some of the new vaccine candidates; regulatory hurdles need to be overcome; protocols and trial sites need to be developed, for phase III clinical efficacy trials in particular. The Stop TB Working Group on TB Vaccine Development provides a global forum that brings laboratory and clinical researchers together with experts in tuberculosis control and representatives from commercial and non-profit funding agencies to address these issues and to facilitate progress towards the common goal of improved vaccination strategies for tuberculosis.
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Int. J. Tuberc. Lung Dis. · Dec 2003
ReviewThe role of molecular epidemiology in contact investigations: a US perspective.
Preventing tuberculosis (TB) transmission through treatment of active cases and contact investigation is the highest priority of TB control programs in the United States. The role of contact investigation is becoming increasingly important as the number of TB cases declines nationally. ⋯ Molecular epidemiology has added a new dimension by enabling the recognition of unsuspected transmission, likely locations of transmission, and quantification of the extent of transmission that is occurring within a given population. In the future, as real-time genotyping becomes more available, the role of molecular epidemiology is likely to expand.
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HIV partner notification can help patients, partners, and disease control efforts in the community. The emphasis on HIV partner notification has varied widely in the United States. Stigma, denial, and competing priorities have limited the use of partner notification in many areas. ⋯ Understanding these forces will help predict where partner notification is headed and may help make it more effective. In this paper we review partner notification for HIV, discuss effectiveness, and outline changes over time. A comparison with contact tracing for TB leads us to conclude that partner notification for HIV is very different from contact tracing for TB.
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Int. J. Tuberc. Lung Dis. · Dec 2003
Using the CDC framework for program evaluation in public health to assess tuberculosis contact investigation programs.
In Massachusetts, despite the efforts of state and local health department tuberculosis (TB) programs, the rates of contact testing and follow-up remain below the state and national objectives. Changes in contact investigation practices are therefore needed to achieve these objectives. ⋯ The CDC's framework provided a useful methodology for beginning the assessment process for evaluating TB contact investigation programs. When the contact investigation self-evaluation tools are implemented statewide, the findings will be used to target areas in need of improvement and develop strategies to make noteworthy changes.
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Five state tuberculosis (TB) control programs in the United States. ⋯ Factors contributing to LTBI among workplace contacts may include the presence of persons with pre-existing LTBI or a positive skin test as a result of BCG vaccination, clinical characteristics of the index case, and workplace environmental characteristics conducive to transmission. Standard guidelines for workplace investigations, written workplace investigation policies, and standard data collection practices are needed to better apportion the causes of observed infection rates in the workplace.