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. · Nov 2018
Meta AnalysisAlcohol consumption and risk of tuberculosis: a systematic review and meta-analysis.
To perform a systematic review and meta-analysis of the association between alcohol consumption and risk of tuberculosis (TB). ⋯ Alcohol consumption is an important risk factor for the development of TB.
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Int. J. Tuberc. Lung Dis. · Oct 2014
ReviewAdvances in the management of pulmonary disease due to Mycobacterium abscessus complex.
Mycobacterium abscessus complex is a group of rapidly growing mycobacteria, and an emerging cause of non-tuberculous mycobacterial lung disease in patients with cystic fibrosis and chronic lung diseases, such as bronchiectasis. M. abscessus complex is the most drug-resistant of the mycobacterial pathogens, resulting in limited therapeutic options and a high treatment failure rate. M. abscessus complex is comprised of three closely related subspecies: M. abscessus (sensu stricto), M. massiliense and M. bolletii. ⋯ However, this inducible macrolide resistance is not seen in M. massiliense, as the erm(41) gene of this subspecies is non-functional. Accordingly, treatment success rates with macrolide-based antibiotic treatment are much higher in patients with M. massiliense infections than in those infected with M. abscessus. Precise speciation of M. abscessus complex is important for predicting antibiotic susceptibilities and patient outcome.
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Int. J. Tuberc. Lung Dis. · May 2014
ReviewHow can mathematical models advance tuberculosis control in high HIV prevalence settings?
Existing approaches to tuberculosis (TB) control have been no more than partially successful in areas with high human immunodeficiency virus (HIV) prevalence. In the context of increasingly constrained resources, mathematical modelling can augment understanding and support policy for implementing those strategies that are most likely to bring public health and economic benefits. ⋯ Efficient and rapid progress towards completion of this modelling agenda will require co-ordination between the modelling community and key stakeholders, including advocates, health policy makers, donors and national or regional finance officials. A continuing dialogue will ensure that new results are effectively communicated and new policy-relevant questions are addressed swiftly.
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Int. J. Tuberc. Lung Dis. · Apr 2014
Review Meta AnalysisValue of procalcitonin in differentiating pulmonary tuberculosis from other pulmonary infections: a meta-analysis.
To systematically and quantitatively summarise the current evidence on the utility of the procalcitonin test (PCT) in discriminating pulmonary tuberculosis (TB) from other pulmonary infections. ⋯ The results suggest consistently acceptable sensitivity and specificity of the PCT test in distinguishing TB from bacterial pneumonia. However, given the imperfect sensitivity and specificity of the test, medical decisions should be based on both the PCT test results as well as on clinical findings.
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Int. J. Tuberc. Lung Dis. · Sep 2013
ReviewTuberculosis screening in high human immunodeficiency virus prevalence settings: turning promise into reality.
Twenty years of sky-high tuberculosis (TB) incidence rates and high TB mortality in high human immunodeficiency virus (HIV) prevalence countries have so far not been matched by the same magnitude or breadth of responses as seen in malaria or HIV programmes. Instead, recommendations have been narrowly focused on people presenting to health facilities for investigation of TB symptoms, or for HIV testing and care. However, despite the recent major investment and scale-up of TB and HIV services, undiagnosed TB remains highly prevalent at community level, implying that diagnosis of TB remains slow and incomplete. ⋯ Ideally, we would systematically test, treat and prevent TB and HIV comprehensively, offering both TB and HIV screening to all health facility attendees, TB households and all adults in the highest risk communities. However, we are still held back by inadequate diagnostics, financing and paucity of population-impact data. Relevant contemporary research showing the high need for potential gains, and pitfalls from expanded and intensified TB screening in high HIV prevalence settings are discussed in this review.