Ending tuberculosis by 2030: can we do it?

Suthar, Amitabh B.; Zachariah, Rony; Harries, A. D.

doi:10.5588/ijtld.16.0142

Cited by 26 publications

(31 citation statements)

References 48 publications

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“…Herein, we described the first case of fulminant TB with progression from pulmonary to genitourinary infection. Genitourinary TB is a form of EPTB that compromises the kidneys, ureters, testis and vas deferens 1,2,4 . Isolated prostate and epididymis involvement is unusual, and differential diagnosis includes neoplasia, infarction, acute and granulomatous infections 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports found that one third of the world’s population is infected by Mycobacterium tuberculosis, and a very small inoculum is required for infection 1,2 . Serbia is a country with an intermediate to low TB incidence rate (18/ 100.000 inhabitants), low-middle HIV prevalence and has a 100% coverage of anti-TB treatment and vaccination at birth 3 .…”

Section: Introductionmentioning

confidence: 99%

“…Although tuberculosis (TB) is a curable disease, it continues to be one of the leading infections associated with death in the world 1 . Previous reports found that one third of the world’s population is infected by Mycobacterium tuberculosis, and a very small inoculum is required for infection 1,2 .…”

Section: Introductionmentioning

confidence: 99%

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First reported case of fulminant TB with progression of infection from lungs to the genitourinary region

Adžić-Vukičević

Barać²,

Ilić

et al. 2017

Rev. Inst. Med. trop. S. Paulo

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Although tuberculosis (TB) is a curable disease, it continues to be one of the leading infections associated with death in the world. Extra-pulmonary TB (EPTB) occurs in approximately 10% of the total cases, presenting with lymph nodes, pleura, bone and genitourinary tract as the most common locations. Genitourinary tuberculosis, the second most common EPTB, is very difficult to diagnose unless there is a high index of suspicion. Isolated TB orchitis or prostatitis without clinical evidence of renal involvement is a rare entity among genitourinary tuberculosis. We presented the first reported case of TB prostatitis and orchitis associated with pulmonary TB and the presence of an acute massive caseous pneumonia in an immunocompetent man. Despite the anti-TB therapy, the patient presented a rapid progression of disease and deterioration of general conditions taking to death, which occurred four days after TB treatment had started. Disseminated TB is a relatively uncommon cause of acute massive caseous pneumonia; however, there should always be suspicion of the disease, since it is a potentially treatable cause. This rare case supports the assertion that TB should be considered as an important differential diagnosis of genitourinary tumors irrespective of evidence of active TB elsewhere in the body.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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First reported case of fulminant TB with progression of infection from lungs to the genitourinary region

Adžić-Vukičević

Barać²,

Ilić

et al. 2017

Rev. Inst. Med. trop. S. Paulo

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“…The development of improved treatment regimens within the next decade is recognized as a critical component of efforts to achieve the drastic reductions in TB cases and deaths that have been set as targets by the global community [18]. The WHO’s End TB Strategy, adopted by the World Health Assembly in 2015, highlights new drugs and shorter regimens as part of the path to a 95% reduction in global TB deaths by 2035, relative to the estimated 1.4 million that occurred in 2015 [19,20].…”

Section: Introductionmentioning

confidence: 99%

Priority-Setting for Novel Drug Regimens to Treat Tuberculosis: An Epidemiologic Model

et al. 2017

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BackgroundNovel drug regimens are needed for tuberculosis (TB) treatment. New regimens aim to improve on characteristics such as duration, efficacy, and safety profile, but no single regimen is likely to be ideal in all respects. By linking these regimen characteristics to a novel regimen’s ability to reduce TB incidence and mortality, we sought to prioritize regimen characteristics from a population-level perspective.Methods and FindingsWe developed a dynamic transmission model of multi-strain TB epidemics in hypothetical populations reflective of the epidemiological situations in India (primary analysis), South Africa, the Philippines, and Brazil. We modeled the introduction of various novel rifampicin-susceptible (RS) or rifampicin-resistant (RR) TB regimens that differed on six characteristics, identified in consultation with a team of global experts: (1) efficacy, (2) duration, (3) ease of adherence, (4) medical contraindications, (5) barrier to resistance, and (6) baseline prevalence of resistance to the novel regimen. We compared scale-up of these regimens to a baseline reflective of continued standard of care.For our primary analysis situated in India, our model generated baseline TB incidence and mortality of 157 (95% uncertainty range [UR]: 113–187) and 16 (95% UR: 9–23) per 100,000 per year at the time of novel regimen introduction and RR TB incidence and mortality of 6 (95% UR: 4–10) and 0.6 (95% UR: 0.3–1.1) per 100,000 per year. An optimal RS TB regimen was projected to reduce 10-y TB incidence and mortality in the India-like scenario by 12% (95% UR: 6%–20%) and 11% (95% UR: 6%–20%), respectively, compared to current-care projections. An optimal RR TB regimen reduced RR TB incidence by an estimated 32% (95% UR: 18%–46%) and RR TB mortality by 30% (95% UR: 18%–44%). Efficacy was the greatest determinant of impact; compared to a novel regimen meeting all minimal targets only, increasing RS TB treatment efficacy from 94% to 99% reduced TB mortality by 6% (95% UR: 1%–13%, half the impact of a fully optimized regimen), and increasing the efficacy against RR TB from 76% to 94% lowered RR TB mortality by 13% (95% UR: 6%–23%). Reducing treatment duration or improving ease of adherence had smaller but still substantial impact: shortening RS TB treatment duration from 6 to 2 mo lowered TB mortality by 3% (95% UR: 1%–6%), and shortening RR TB treatment from 20 to 6 mo reduced RR TB mortality by 8% (95% UR: 4%–13%), while reducing nonadherence to the corresponding regimens by 50% reduced TB and RR TB mortality by 2% (95% UR: 1%–4%) and 6% (95% UR: 3%–10%), respectively. Limitations include sparse data on key model parameters and necessary simplifications to model structure and outcomes.ConclusionsIn designing clinical trials of novel TB regimens, investigators should consider that even small changes in treatment efficacy may have considerable impact on TB-related incidence and mortality. Other regimen improvements may still have important benefits for resource allocation and outcomes such as patient quality of ...

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“…A multisectorial action to accelerate socio-economic development and to develop new vaccines and novel diagnostics and medicines are the key advances needed to end TB transmission. Minimizing the costs associated with TB requires the expansion of health insurance coverage, comprehensive coverage of TB services and limited indirect costs by vulnerable and poor populations 72 . A very recent interim report from South India studying the effect of diabetes on tuberculosis severity (EDOTS) revealed a strikingly high prevalence of DM and pre-DM in adults with pulmonary TB.…”

Section: Recent Advancesmentioning

confidence: 99%

‘Diabetes and Tuberculosis’ – A Co-Epidemic of Public Health Importance in the Developing World

Kumpatla¹,

Viswanathan²

2017

Current Science

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With the rising epidemic of diabetes mellitus (DM) and tuberculosis (TB) already being a major infectious disease of the world, when put together, this coepidemic constitutes a threat to global public health. The situation is critical in countries like India which are facing the dual burden of non-communicable diseases and communicable diseases. This not only affects the national productivity, but also the national exchequer. Henceforth, a crucial health strategy is required to control this co-epidemic. This article reviews the epidemiology of DM and TB, TB and its characteristics, the effect of DM on TB treatment outcomes, screening methods and diagnosis, economic impact on the health sector and guidelines which could prevent this burden.

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Ending tuberculosis by 2030: can we do it?

Cited by 26 publications

References 48 publications

First reported case of fulminant TB with progression of infection from lungs to the genitourinary region

First reported case of fulminant TB with progression of infection from lungs to the genitourinary region

Priority-Setting for Novel Drug Regimens to Treat Tuberculosis: An Epidemiologic Model

‘Diabetes and Tuberculosis’ – A Co-Epidemic of Public Health Importance in the Developing World

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