The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
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Drug-resistant tuberculosis (DR-TB) in adults is either acquired due to poor treatment management or transmitted from infectious DR-TB cases, while children mainly have transmitted disease. Diagnosis of DR-TB relies on drug susceptibility testing (DST), which is not routinely performed in high tuberculosis (TB) burden settings. The Category II retreatment regimen is inadequate for Category I failures if multidrug-resistant TB (MDR-TB) is present. ⋯ The presence of FQ resistance prior to MDR-TB treatment poses a serious challenge. To prevent the development of extensively drug-resistant TB, strategies to protect the FQs, the most important second-line agents, need to be developed. Clinical trials assessing MDR-TB treatment regimens are urgently needed.
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Int. J. Tuberc. Lung Dis. · Jan 2010
Review Meta AnalysisVitamin D receptor genetic polymorphisms and tuberculosis: updated systematic review and meta-analysis.
Host genetic susceptibility has been suggested as one of the most important explanations for inter-individual differences in tuberculosis (TB) risk. The vitamin D receptor (VDR) gene has been studied as a candidate locus due to genetic polymorphisms that affects the activity of the receptor and subsequent downstream vitamin D-mediated effects. ⋯ The association of VDR polymorphisms with risk of TB observed in our analyses supports the hypothesis that vitamin D deficiency might play a role as risk factor during the development of TB.
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Int. J. Tuberc. Lung Dis. · Dec 2009
Review Comparative StudyComparison of community-acquired pneumonia due to methicillin-resistant and methicillin-susceptible Staphylococcus aureus producing the Panton-Valentine leukocidin.
To investigate the clinical features and prognosis of patients with methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) community-acquired pneumonia (CAP) producing the Panton-Valentine leukocidin (PVL). ⋯ Patients with MRSA PVL-positive CAP did not have higher rates of mortality than patients with MSSA PVL-positive CAP.
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Int. J. Tuberc. Lung Dis. · Sep 2009
Review Historical ArticleThe value of tuberculosis elimination and of progress in tuberculosis control in twentieth-century England and Wales.
To calculate the monetary value of tuberculosis (TB) elimination and of progress in TB control in twentieth-century England and Wales. ⋯ Such significant results indicating the value of improvements in TB control have important implications for our understanding of these achievements and justify increased spending in developing countries that continue to be plagued by high rates of TB prevalence.
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Int. J. Tuberc. Lung Dis. · Mar 2009
ReviewThe measurement and estimation of tuberculosis mortality.
Tuberculosis (TB) ranks among the 10 principal causes of death and disability worldwide, largely on the basis of mortality estimates. These estimates have been derived by a variety of methods, from a limited database. Here we review the data and methods used to measure and estimate TB mortality in adults, assess the strengths and weaknesses of each and suggest ways to improve current mortality statistics. ⋯ At present, deaths in treatment cohorts cover a small subset of all estimated TB deaths (<13% in 2006), as deaths are missed among patients who are never diagnosed, who default or fail treatment, and among patients with untreated recurrent TB or TB sequelae. In contrast, some deaths recorded during treatment are not due to TB. To ensure convergence between cohort monitoring and VR, definitions of causes of death--including TB as an associate cause in deaths from human immunodeficiency virus/acquired immune-deficiency syndrome--should be standardised, so that both systems adhere to the International Classification of Diseases.