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'Every day, more than 200 children under the age of 15 die needlessly from tuberculosis (TB) - a disease that is preventable and curable. The World Health Organization estimates that as many as 1 in 10 TB cases globally (6-10% of all TB cases) are among this age group, but the number could be even higher because many children are simply undiagnosed.' Childhood TB is emerging from the shadows. This quote comes from the recently launched international roadmap towards zero TB deaths in children. We provide a brief update of new developments and remaining challenges related to childhood TB, with particular emphasis on the new roadmap. [ABSTRACT FROM AUTHOR]

Objective: To describe the burden of and trends in paediatric tuberculosis (TB) in Australia between 2003 and 2012. Design: A retrospective analysis of TB data from the National Notifiable Diseases Surveillance System (NNDSS) on TB in children (under 15 years of age) during the 10-year period, 2003–2012. Results: TB notifications in Australia during the study period included 538 children (range, 37–66 cases per year), representing 4.6% of the total TB case load during the period (range, 3.8%e5.8% each year). Place of birth was recorded for 524 patients (97.4%); of these, 230 (43.9%) were born in Australia, 294 (56.1%) overseas. The average annual notification rate was 1.31 (95% CI, 1.20e1.43) cases per 100000 child population. The rate was higher for overseas-born than for Australian-born children (9.57 [95% CI, 8.51–10.73] v 0.61 [95% CI, 0.53–0.69] cases per 100000 children. The overall rate was highest among those aged 0–4 years. The annual notification rate was three times higher for Indigenous children than for non- Indigenous Australian-born children. Of 427 patients (79.4% of total) for whom the method of case detection was recorded, 37.0% were detected by contact screening, 8.7% by post-arrival immigration screening, and 54.3% by passive case detection. Pulmonary TB was the most common diagnostic classification (64.7% of patients). The most common risk factors were close contact with a TB case and recent residence in a country with a high incidence of TB. Treatment outcomes were satisfactory; 89.4% of children had completed treatment or were cured. Conclusions: The burden of paediatric TB in Australia is low but has not changed over the past decade. The highest rates are among children born overseas, emphasising the important role of immigration screening as Australia aspires to eliminate TB. [ABSTRACT FROM AUTHOR]

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Aim: This study explored neonatal morbidity and mortality in hospitalised patients in central Vietnam and risk factors associated with mortality. Methods: We conducted a prospective cohort study of all newborn infants (<28 days) hospitalised in a neonatal unit over a 1-year period and followed until discharge. The main outcome measures were case fatality rate and the rate of different clinical diagnoses. Results: There were 2555 admissions during the study period. The leading primary causes of admissions were infections (41%), haematological problems such as jaundice (23%) and prematurity and its complications (18%). The overall case fatality rate was 8.6%, and it was 59% among very low-birthweight (<1500 g) neonates. Mortality was inversely associated with birthweight and gestational age. Of the 220 deaths, 57% occurred within the first 7 days of life. Although the causes of death were often multifactorial, the leading primary causes were infections (32%), prematurity and its complications (25%), birth defects (24%) and birth asphyxia (6%). Risk factors associated with death were being outborn, early gestational age, small for gestational age, confirmed sepsis and birth defects. Conclusion: Mortality rates were high among hospitalised neonates in central Vietnam, and this paper suggests interventions that might improve outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Background: This study was designed to assess changes in brain volume and cognitive abilities in memantine-treated patients with Alzheimer’s disease (AD) by using an exploratory, single-arm, delayed-start design. Methods: Cholinesterase inhibitor-treated patients with AD (N = 47; Mini-Mental State Examination score range: 15–23) were enrolled in an observational lead-in period (weeks: 1–24), followed by an open-label period of add-on memantine treatment (weeks: 25–48). The patients underwent magnetic resonance imaging at weeks 0 (baseline), 24 (immediately before memantine initiation), and 48 (endpoint), and a battery of neuropsychological tests at weeks 0, 24, 28, 36, and 48. The primary outcome measure was the annualized rate of change (%) in total brain volume (TBV) between the two study periods. Data were analyzed using paired t-tests. Results: There were no statistically significant differences in the rates of change in TBV, ventricular volume, or left hippocampal volume between the study periods; however, the memantine treatment period was associated with a significantly slower right hippocampal atrophy (−5.5% ± 12.0% vs −10.8% ± 7.2%; P = .038). Memantine treatment was also associated with superior performances on the Boston Naming Test (P = .034) and the Trail Making Test, Part B (P = .001), but also with a higher number of errors (i.e., repetitions and intrusions) on the California Verbal Learning Test. Memantine was found to be safe and well tolerated. Conclusions: In this study, no difference in the rates of TBV change between the two periods was observed; however, memantine treatment was found to be associated with slowing of right hippocampal atrophy, and with improvement on one test of executive functioning as well as a test of confrontation naming ability. Trials using structural magnetic resonance imaging and a delayed-start design may be a feasible option for the assessment of treatments for AD. [Copyright &y& Elsevier]

Objective To determine the frequency and manifestations of adverse events associated with recommended first-line anti-TB drugs in children. Method Literature review. Results Overall, children tolerate anti-TB drugs very well when using currently recommended dosages. Serious adverse events are rare and even mild symptoms such as nausea or vomiting are uncommon. There are occasional case reports of severe hepatotoxicity. Conclusions Surveillance and reporting of adverse events will need to be improved when recommended dosages of the main first-line anti-TB therapy for children are increased. Co-morbidities such as HIV infection and severe malnutrition may affect the incidence and complicate the management of possible adverse events to anti-TB therapy. [ABSTRACT FROM AUTHOR]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Background: Clinical trials have suggested benefits of memantine for all stages of Alzheimer’s disease (AD). A meta-analysis of memantine trials in outpatients with probable AD was conducted. Methods: Six randomized, placebo-controlled trials fulfilled inclusion criteria. Cognitive, global, functional, behavioral, and safety measures were evaluated by using fixed or random effects models. Sensitivity analysis was performed to determine potential effects of disease severity and concomitant cholinesterase inhibitor use. Results: Overall, memantine showed statistically significant, homogenous benefits on global and functional outcomes and statistically significant but heterogeneous benefit on cognition. In pooled moderate to severe AD studies, effects were significant and homogeneous on global, functional, and behavioral measures; in pooled mild to moderate studies, significant and homogeneous effects were found on global rating and cognition. Safety profiles suggested excellent safety and tolerability, with no differences between the severity groups. Conclusions: Memantine consistently benefited patients in all stages of AD and was well-tolerated. [Copyright &y& Elsevier]