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683 results on '"Dheda K"'

1. Frequency, kinetics and determinants of viable SARS-CoV-2 in bioaerosols from ambulatory COVID-19 patients infected with the Beta, Delta or Omicron variants.

Author

Jaumdally, S, Tomasicchio, M, Pooran, A, Esmail, A, Kotze, A, Meier, S, Wilson, L, Oelofse, S, van der Merwe, C, Roomaney, A, Davids, M, Suliman, T, Joseph, R, Perumal, T, Scott, A, Shaw, M, Preiser, W, Williamson, C, Goga, A, Mayne, E, Gray, G, Moore, P, Sigal, A, Metcalfe, J, Dheda, K, and Limberis, Jason

Subjects
Humans, SARS-CoV-2, COVID-19, Kinetics, Respiratory Aerosols and Droplets
Abstract

Airborne transmission of SARS-CoV-2 aerosol remains contentious. Importantly, whether cough or breath-generated bioaerosols can harbor viable and replicating virus remains largely unclarified. We performed size-fractionated aerosol sampling (Andersen cascade impactor) and evaluated viral culturability in human cell lines (infectiousness), viral genetics, and host immunity in ambulatory participants with COVID-19. Sixty-one percent (27/44) and 50% (22/44) of participants emitted variant-specific culture-positive aerosols  95%). There is considerable heterogeneity in potential infectiousness i.e., only 29% of participants were probably highly infectious (produced culture-positive aerosols

Published
2024

2. Standards for clinical trials for treating TB.

Author

du Cros, P, Greig, J, Alffenaar, J-W, Cross, G, Cousins, C, Berry, C, Khan, U, Phillips, P, Velásquez, G, Furin, J, Spigelman, M, Denholm, J, Thi, S, Tiberi, S, Huang, G, Marks, G, Turkova, A, Guglielmetti, L, Chew, K, Nguyen, H, Ong, C, Brigden, G, Singh, K, Motta, I, Lange, C, Seddon, J, Nyangwa, B-T, Maug, A, Gler, M, Dooley, K, Quelapio, M, Tsogt, B, Menzies, D, Cox, V, Upton, C, Skrahina, A, McKenna, L, Horsburgh, C, Dheda, K, and Marais, B

Subjects
Humans, Biological Specimen Banks, Tuberculosis, Clinical Trials as Topic
Abstract

BACKGROUND: The value, speed of completion and robustness of the evidence generated by TB treatment trials could be improved by implementing standards for best practice.METHODS: A global panel of experts participated in a Delphi process, using a 7-point Likert scale to score and revise draft standards until consensus was reached.RESULTS: Eleven standards were defined: Standard 1, high quality data on TB regimens are essential to inform clinical and programmatic management; Standard 2, the research questions addressed by TB trials should be relevant to affected communities, who should be included in all trial stages; Standard 3, trials should make every effort to be as inclusive as possible; Standard 4, the most efficient trial designs should be considered to improve the evidence base as quickly and cost effectively as possible, without compromising quality; Standard 5, trial governance should be in line with accepted good clinical practice; Standard 6, trials should investigate and report strategies that promote optimal engagement in care; Standard 7, where possible, TB trials should include pharmacokinetic and pharmacodynamic components; Standard 8, outcomes should include frequency of disease recurrence and post-treatment sequelae; Standard 9, TB trials should aim to harmonise key outcomes and data structures across studies; Standard 10, TB trials should include biobanking; Standard 11, treatment trials should invest in capacity strengthening of local trial and TB programme staff.CONCLUSION: These standards should improve the efficiency and effectiveness of evidence generation, as well as the translation of research into policy and practice.

Published
2023

3. Clinical standards for the dosing and management of TB drugs

Author

Alffenaar, JWC, Stocker, SL, Forsman, L Davies, Garcia-Prats, A, Heysell, SK, Aarnoutse, RE, Akkerman, OW, Aleksa, A, van Altena, R, de Oñata, W Arrazola, Bhavani, PK, Boveneind-Vrubleuskaya, N van T, Carvalho, ACC, Centis, R, Chakaya, JM, Cirillo, DM, Cho, JG, D’Ambrosio, L, Dalcolmo, MP, Denti, P, Dheda, K, Fox, GJ, Hesseling, AC, Kim, HY, Köser, CU, Marais, BJ, Margineanu, I, Märtson, AG, Torrico, M Munoz, Nataprawira, HM, Ong, CWM, Otto-Knapp, R, Peloquin, CA, Silva, DR, Ruslami, R, Santoso, P, Savic, RM, Singla, R, Svensson, EM, Skrahina, A, van Soolingen, D, Srivastava, S, Tadolini, M, Tiberi, S, Thomas, TA, Udwadia, ZF, Vu, DH, Zhang, W, Mpagama, SG, Schön, T, and Migliori, GB

Subjects
Rare Diseases, Orphan Drug, Clinical Research, Antimicrobial Resistance, Patient Safety, 7.3 Management and decision making, Management of diseases and conditions, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Development of treatments and therapeutic interventions, 5.1 Pharmaceuticals, Good Health and Well Being, Humans, Drug Monitoring, Patient Care, Reference Standards, Tuberculosis, Antitubercular Agents, tuberculosis, pharmacokinetics, pharmacodynamics, adverse drug reaction, management, dosing, Cardiorespiratory Medicine and Haematology, Microbiology
Abstract

BACKGROUND: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on 'best practice´ for dosing and management of TB drugs.METHODS: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.RESULTS: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.CONCLUSION: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

Published
2022

6. MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network

Author

Arkub, T. Abu, Akkerman, O.W., Aleksa, A., Belilovski, E., Bernal, E., Blanc, F-X., Boeree, M., Borisov, S., Bruchfeld, J., Cadiñanos Loidi, J., Caminero, J.A., Carvalho, A.C., Cebrian Gallardo, J.J., Charalampos, Danila, E., Davies Forsman, L., Denholm, J., Dheda, K., Diel, R., Diktanas, S., Dobler, C., Enwerem, M., Esposito, S., Escobar Salinas, N., Filippov, A., Formenti, B., García García, J.M., Goletti, D., Gomez Rosso, R., Gualano, G., Isaakidis, P., Kaluzhenina, A., Koirala, S., Kuksa, L., Kunst, H., Li, Y., Magis-Escurra, C., Manfrin, V., Manga, S., Manika, K., Marchese, V., Martínez Robles, E., Maryandyshev, A., Matteelli, A., Mariani, A., Mazza-Stalder, J., Mello, F., Mendoza, L., Mesi, A., Miliauskas, S., Mustafa Hamdan, H., Ndjeka, N., Nieto Marcos, M., Ottenhoff, T.H.M., Palmero, D.J., Palmieri, F., Papavasileiou, A., Payen, M.C., Pontarelli, A., Pretti Dalcolmo, M., Quirós Fernandez, S., Romero, R., Rossato Silva, D., Santos, A.P., Seaworth, B., Sinitsyn, M., Skrahina, A., Solovic, I., Spanevello, A., Tadolini, M., Torres, C., Udwadia, Z., van den Boom, M., Volchenkov, G.V., Yedilbayev, A., Zaleskis, R., Zellweger, J.P., Migliori, Giovanni Battista, Tiberi, Simon, Zumla, Alimuddin, Petersen, Eskild, Chakaya, Jeremiah Muhwa, Wejse, Christian, Muñoz Torrico, Marcela, Duarte, Raquel, Alffenaar, Jan Willem, Schaaf, H. Simon, Marais, Ben J., Cirillo, Daniela Maria, Alagna, Riccardo, Rendon, Adrian, Pontali, Emanuele, Piubello, Alberto, Figueroa, José, Ferlazzo, Gabriella, García-Basteiro, Alberto, Centis, Rosella, Visca, Dina, D’Ambrosio, Lia, and Sotgiu, Giovanni

Published
2020
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7. Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults

Author

Furin, J, Alirol, E, Allen, E, Fielding, K, Merle, C, Abubakar, I, Andersen, J, Davies, G, Dheda, K, Diacon, A, Dooley, KE, Dravnice, G, Eisenach, K, Everitt, D, Ferstenberg, D, Goolam-Mahomed, A, Grobusch, MP, Gupta, R, Harausz, E, Harrington, M, Horsburgh, CR, Lienhardt, C, McNeeley, D, Mitnick, CD, Nachman, S, Nahid, P, Nunn, AJ, Phillips, P, Rodriguez, C, Shah, S, Wells, C, Thomas-Nyang'wa, B, and du Cros, P

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Biodefense, Orphan Drug, Infectious Diseases, Patient Safety, Prevention, Clinical Trials and Supportive Activities, Vaccine Related, Rare Diseases, Tuberculosis, Antimicrobial Resistance, Clinical Research, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Infection, Good Health and Well Being, Adult, Antitubercular Agents, Clinical Trials as Topic, Humans, Mycobacterium tuberculosis, Research Design, Tuberculosis, Multidrug-Resistant, drug-resistant tuberculosis, research, definitions, Cardiorespiratory Medicine and Haematology, Microbiology, Cardiovascular medicine and haematology, Clinical sciences, Epidemiology
Abstract

Drug-resistant tuberculosis (DR-TB) is a growing public health problem, and for the first time in decades, new drugs for the treatment of this disease have been developed. These new drugs have prompted strengthened efforts in DR-TB clinical trials research, and there are now multiple ongoing and planned DR-TB clinical trials. To facilitate comparability and maximise policy impact, a common set of core research definitions is needed, and this paper presents a core set of efficacy and safety definitions as well as other important considerations in DR-TB clinical trials work. To elaborate these definitions, a search of clinical trials registries, published manuscripts and conference proceedings was undertaken to identify groups conducting trials of new regimens for the treatment of DR-TB. Individuals from these groups developed the core set of definitions presented here. Further work is needed to validate and assess the utility of these definitions but they represent an important first step to ensure there is comparability in clinical trials on multidrug-resistant TB.

Published
2016

11. Durability of ChAdOx1 nCoV-19 (AZD1222) vaccine and hybrid humoral immunity against variants including omicron BA.1 and BA.4 6 months after vaccination (COV005): a post-hoc analysis of a randomised, phase 1b–2a trial

Author

Madhi, SA, Kwatra, G, Richardson, SI, Koen, AL, Baillie, V, Cutland, CL, Fairlie, L, Padayachee, SD, Dheda, K, Barnabas, SL, Bhorat, QE, Briner, C, Ahmed, K, Aley, PK, Bhikha, S, Bhorat, AE, Esmail, A, Horne, E, Kaldine, H, Mukendi, CK, Madzorera, VS, Manamela, NP, Masilela, M, Hermanus, ST, Motlou, T, Mzindle, N, Oelofse, S, Patel, F, Rhead, S, Rossouw, L, Taoushanis, C, van Eck, S, Lambe, T, Gilbert, SC, Pollard, AJ, Moore, PL, and Izu, A

Subjects
Infectious Diseases
Abstract

Background COVID-19 vaccine rollout is lagging in Africa, where there has been a high rate of SARS-CoV-2 infection. We aimed to evaluate the effect of SARS-CoV-2 infection before vaccination with the ChAdOx-nCoV19 (AZD1222) vaccine on antibody responses through to 180 days. Methods We did an unmasked post-hoc immunogenicity analysis after the first and second doses of AZD1222 in a randomised, placebo-controlled, phase 1b–2a study done in seven locations in South Africa. AZD1222 recipients who were HIV-uninfected, were stratified into baseline seropositive or seronegative groups using the serum anti-nucleocapsid (anti-N) immunoglobulin G (IgG) electroluminescence immunoassay to establish SARS-CoV-2 infection before the first dose of AZD1222. Binding IgG to spike (anti-S) and receptor binding domain (anti-RBD) were measured before the first dose (day 0), second dose (day 28), day 42, and day 180. Neutralising antibody (NAb) against SARS-CoV-2 variants D614G, beta, delta, gamma, and A.VOI.V2, and omicron BA1 and BA.4 variants, were measured by pseudovirus assay (day 28, day 42, and day 180). This trial is registered with ClinicalTrials.gov, NCT04444674, and the Pan African Clinicals Trials Registry, PACTR202006922165132. Findings Of 185 individuals who were randomly assigned to AZD1222, we included 91 individuals who were baseline seropositive and 58 who were baseline seronegative, in the final analysis. In the seropositive group, there was little change of anti-S IgG (and anti-RBD IgG) or neutralising antibody (NAb) titres at day 42 compared with at day 28. Anti-S (and anti-RBD) IgG geometric mean concentrations (GMCs) were higher throughout in the seropositive compared with the seronegative group, including at day 180 (GMCs 517·8 [95% CI 411·3–651·9] vs 82·1 [55·2–122·3] BAU/mL). Also D614G NAb geometric mean titres (GMTs) were higher in the seropositive group than the seronegative group, as was the percentage with titres of at least 185 (80% putative risk reduction threshold [PRRT] against wild-type–alpha COVID-19), including at day 180 (92·0% [74·0–99·0] vs 18·2% [2·3–51·8). Similar findings were observed for beta, A.VOI.V2, and gamma. For delta, BA.1, and BA.4, NAb GMTs and the proportion with titres above the PRRT were substantially higher in the seropositive compared with seronegative group at day 28 and day 42, but no longer differed between the groups by day 180. Interpretation A single dose of AZD1222 in the general African population, where COVID-19 vaccine coverage is low and SARS-CoV-2 seropositivity is 90%, could enhance the magnitude and quality of antibody responses to SARS-CoV-2. Funding The Bill & Melinda Gates Foundation, the South African Medical Research Council, the UK Research and Innovation, the UK National Institute for Health Research, and the South African Medical Research Council. Translation For the Zulu translation of the abstract see Supplementary Materials section.

Published
2023
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12. Clinical standards for the management of adverse effects during treatment for TB

Author

Singh, K. P., primary, Carvalho, A. C. C., additional, Centis, R., additional, D´Ambrosio, L., additional, Migliori, G. B., additional, Mpagama, S. G., additional, Nguyen, B. C., additional, Aarnoutse, R. E., additional, Aleksa, A., additional, van Altena, R., additional, Bhavani, P. K., additional, Bolhuis, M. S., additional, Borisov, S., additional, van´t Boveneind-Vrubleuskaya, N., additional, Bruchfeld, J., additional, Caminero, J. A., additional, Carvalho, I., additional, Cho, J. G., additional, Davies Forsman, L., additional, Dedicoat, M., additional, Dheda, K., additional, Dooley, K., additional, Furin, J., additional, García-García, J. M., additional, Garcia-Prats, A., additional, Hesseling, A. C., additional, Heysell, S. K., additional, Hu, Y., additional, Kim, H. Y., additional, Manga, S., additional, Marais, B. J., additional, Margineanu, I., additional, Märtson, A-G., additional, Munoz Torrico, M., additional, Nataprawira, H. M., additional, Nunes, E., additional, Ong, C. W. M., additional, Otto-Knapp, R., additional, Palmero, D. J., additional, Peloquin, C. A., additional, Rendon, A., additional, Rossato Silva, D., additional, Ruslami, R., additional, Saktiawati, A. M. I., additional, Santoso, P., additional, Schaaf, H. S., additional, Seaworth, B., additional, Simonsson, U. S. H., additional, Singla, R., additional, Skrahina, A., additional, Solovic, I., additional, Srivastava, S., additional, Stocker, S. L., additional, Sturkenboom, M. G. G., additional, Svensson, E. M., additional, Tadolini, M., additional, Thomas, T. A., additional, Tiberi, S., additional, Trubiano, J., additional, Udwadia, Z. F., additional, Verhage, A. R., additional, Vu, D. H., additional, Akkerman, O. W., additional, Alffenaar, J. W. C., additional, and Denholm, J. T., additional

Published
2023
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14. SARS-CoV-2 viral replication persists in the human lung for several weeks after onset of symptomatic severe COVID-19 and is associated with attenuated pulmonary immunity and variant-specific clinical sequalae

Author

Tomasicchio, M, primary, Jaumdally, S, additional, Pooran, A, additional, Esmail, A, additional, Wilson, L, additional, Kotze, A, additional, Semple, L, additional, Meier, S, additional, Pillay, K, additional, Roberts, R, additional, Kriel, R, additional, Meldau, R, additional, Oelofse, S, additional, Mandviwala, C, additional, Burns, J, additional, Londt, R, additional, Davids, M, additional, van der Merwe, C, additional, Roomaney, A, additional, Kühn, L, additional, Perumal, T, additional, Scott, A.J, additional, Hale, M.J, additional, Baillie, V, additional, Mahtab, S, additional, Williamson, C, additional, Joseph, R, additional, Sigal, A, additional, Joubert, I, additional, Piercy, J, additional, Thomson, D, additional, Fredericks, DL, additional, Miller, MGA, additional, Nunes, M, additional, Madhi, S.A, additional, and Dheda, K, additional

Published
2023
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15. Clinical standards for the management of adverse effects during treatment for TB.

Author

Singh, K.P., Carvalho, A.C.C., Centis, R., Ambrosio, L.D., Migliori, G.B., Mpagama, S.G., Nguyen, B.C., Aarnoutse, R.E., Aleksa, A., Altena, R. van, Bhavani, P.K., Bolhuis, M.S., Borisov, S., Boveneind-Vrubleuskaya, N. Van't, Bruchfeld, J., Caminero, J.A., Carvalho, I., Cho, J.G., Davies Forsman, L., Dedicoat, M., Dheda, K., Dooley, K., Furin, J., García-García, J.M., Garcia-Prats, A., Hesseling, A.C., Heysell, S.K., Hu, Y., Kim, H.Y., Manga, S., Marais, B.J., Margineanu, I., Märtson, A.G., Munoz Torrico, M., Nataprawira, H.M., Nunes, E., Ong, C.W.M., Otto-Knapp, R., Palmero, D.J., Peloquin, C.A., Rendon, A., Rossato Silva, D., Ruslami, R., Saktiawati, A.M.I., Santoso, P., Schaaf, H.S., Seaworth, B., Simonsson, U.S.H., Singla, R., Skrahina, A., Solovic, I., Srivastava, S., Stocker, S.L., Sturkenboom, M.G.G., Svensson, E.M., Tadolini, M., Thomas, T.A., Tiberi, S., Trubiano, J., Udwadia, Z.F., Verhage, A.R., Vu, D.H., Akkerman, O.W., Alffenaar, J.W.C., Denholm, J.T., Singh, K.P., Carvalho, A.C.C., Centis, R., Ambrosio, L.D., Migliori, G.B., Mpagama, S.G., Nguyen, B.C., Aarnoutse, R.E., Aleksa, A., Altena, R. van, Bhavani, P.K., Bolhuis, M.S., Borisov, S., Boveneind-Vrubleuskaya, N. Van't, Bruchfeld, J., Caminero, J.A., Carvalho, I., Cho, J.G., Davies Forsman, L., Dedicoat, M., Dheda, K., Dooley, K., Furin, J., García-García, J.M., Garcia-Prats, A., Hesseling, A.C., Heysell, S.K., Hu, Y., Kim, H.Y., Manga, S., Marais, B.J., Margineanu, I., Märtson, A.G., Munoz Torrico, M., Nataprawira, H.M., Nunes, E., Ong, C.W.M., Otto-Knapp, R., Palmero, D.J., Peloquin, C.A., Rendon, A., Rossato Silva, D., Ruslami, R., Saktiawati, A.M.I., Santoso, P., Schaaf, H.S., Seaworth, B., Simonsson, U.S.H., Singla, R., Skrahina, A., Solovic, I., Srivastava, S., Stocker, S.L., Sturkenboom, M.G.G., Svensson, E.M., Tadolini, M., Thomas, T.A., Tiberi, S., Trubiano, J., Udwadia, Z.F., Verhage, A.R., Vu, D.H., Akkerman, O.W., Alffenaar, J.W.C., and Denholm, J.T.

Abstract

Item does not contain fulltext, BACKGROUND: Adverse effects (AE) to TB treatment cause morbidity, mortality and treatment interruption. The aim of these clinical standards is to encourage best practise for the diagnosis and management of AE.METHODS: 65/81 invited experts participated in a Delphi process using a 5-point Likert scale to score draft standards.RESULTS: We identified eight clinical standards. Each person commencing treatment for TB should: Standard 1, be counselled regarding AE before and during treatment; Standard 2, be evaluated for factors that might increase AE risk with regular review to actively identify and manage these; Standard 3, when AE occur, carefully assessed and possible allergic or hypersensitivity reactions considered; Standard 4, receive appropriate care to minimise morbidity and mortality associated with AE; Standard 5, be restarted on TB drugs after a serious AE according to a standardised protocol that includes active drug safety monitoring. In addition: Standard 6, healthcare workers should be trained on AE including how to counsel people undertaking TB treatment, as well as active AE monitoring and management; Standard 7, there should be active AE monitoring and reporting for all new TB drugs and regimens; and Standard 8, knowledge gaps identified from active AE monitoring should be systematically addressed through clinical research.CONCLUSION: These standards provide a person-centred, consensus-based approach to minimise the impact of AE during TB treatment.

Published
2023

16. Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a 2023 TBnet/RESIST-TB consensus statement.

Author

Domínguez, J., Boeree, M.J., Cambau, E., Chesov, D., Conradie, F., Cox, V., Dheda, K., Dudnyk, A., Farhat, M.R., Gagneux, S., Grobusch, M.P., Gröschel, M.I., Guglielmetti, L., Kontsevaya, I., Lange, B., Leth, F. van, Lienhardt, C., Mandalakas, A.M., Maurer, F.P., Merker, M., Miotto, P., Molina-Moya, B., Morel, F., Niemann, S., Veziris, N., Whitelaw, A., Horsburgh CR, J.r., Lange, C de, Domínguez, J., Boeree, M.J., Cambau, E., Chesov, D., Conradie, F., Cox, V., Dheda, K., Dudnyk, A., Farhat, M.R., Gagneux, S., Grobusch, M.P., Gröschel, M.I., Guglielmetti, L., Kontsevaya, I., Lange, B., Leth, F. van, Lienhardt, C., Mandalakas, A.M., Maurer, F.P., Merker, M., Miotto, P., Molina-Moya, B., Morel, F., Niemann, S., Veziris, N., Whitelaw, A., Horsburgh CR, J.r., and Lange, C de

Abstract

01 april 2023, Item does not contain fulltext, Drug-resistant tuberculosis is a substantial health-care concern worldwide. Despite culture-based methods being considered the gold standard for drug susceptibility testing, molecular methods provide rapid information about the Mycobacterium tuberculosis mutations associated with resistance to anti-tuberculosis drugs. This consensus document was developed on the basis of a comprehensive literature search, by the TBnet and RESIST-TB networks, about reporting standards for the clinical use of molecular drug susceptibility testing. Review and the search for evidence included hand-searching journals and searching electronic databases. The panel identified studies that linked mutations in genomic regions of M tuberculosis with treatment outcome data. Implementation of molecular testing for the prediction of drug resistance in M tuberculosis is key. Detection of mutations in clinical isolates has implications for the clinical management of patients with multidrug-resistant or rifampicin-resistant tuberculosis, especially in situations when phenotypic drug susceptibility testing is not available. A multidisciplinary team including clinicians, microbiologists, and laboratory scientists reached a consensus on key questions relevant to molecular prediction of drug susceptibility or resistance to M tuberculosis, and their implications for clinical practice. This consensus document should help clinicians in the management of patients with tuberculosis, providing guidance for the design of treatment regimens and optimising outcomes.

Published
2023

17. Clinical standards for the management of adverse effects during treatment for TB

Author

Singh, K. P., Carvalho, A. C. C., Centis, R., D'Ambrosio, L., Migliori, G. B., Mpagama, S. G., Nguyen, B. C., Aarnoutse, R. E., Aleksa, A., van Altena, R., Bhavani, P. K., Bolhuis, M. S., Borisov, S., van't Boveneind-Vrubleuskaya, N., Bruchfeld, J., Caminero, J. A., Carvalho, I., Cho, J. G., Forsman, L. Davies, Dedicoat, M., Dheda, K., Dooley, K., Furin, J., Garcia-Garcia, J. M., Garcia-Prats, A., Hesseling, A. C., Heysell, S. K., Hu, Y., Kim, H. Y., Manga, S., Marais, B. J., Margineanu, I., Martson, A-G, Torrico, M. Munoz, Nataprawira, H. M., Nunes, E., Ong, C. W. M., Otto-Knapp, R., Palmero, D. J., Peloquin, C. A., Rendon, A., Silva, D. Rossato, Ruslami, R., Saktiawati, A. M. I., Santoso, P., Schaaf, H. S., Seaworth, B., Simonsson, Ulrika S. H., Singla, R., Skrahina, A., Solovic, I., Srivastava, S., Stocker, S. L., Stukenboom, M. G. G., Svensson, Elin, Tadolini, M., Thomas, T. A., Tiberi, S., Trubiano, J., Udwadia, Z. F., Verhage, A. R., Vu, D. H., Akkerman, O. W., Alffenaar, J. W. C., Denholm, J. T., Singh, K. P., Carvalho, A. C. C., Centis, R., D'Ambrosio, L., Migliori, G. B., Mpagama, S. G., Nguyen, B. C., Aarnoutse, R. E., Aleksa, A., van Altena, R., Bhavani, P. K., Bolhuis, M. S., Borisov, S., van't Boveneind-Vrubleuskaya, N., Bruchfeld, J., Caminero, J. A., Carvalho, I., Cho, J. G., Forsman, L. Davies, Dedicoat, M., Dheda, K., Dooley, K., Furin, J., Garcia-Garcia, J. M., Garcia-Prats, A., Hesseling, A. C., Heysell, S. K., Hu, Y., Kim, H. Y., Manga, S., Marais, B. J., Margineanu, I., Martson, A-G, Torrico, M. Munoz, Nataprawira, H. M., Nunes, E., Ong, C. W. M., Otto-Knapp, R., Palmero, D. J., Peloquin, C. A., Rendon, A., Silva, D. Rossato, Ruslami, R., Saktiawati, A. M. I., Santoso, P., Schaaf, H. S., Seaworth, B., Simonsson, Ulrika S. H., Singla, R., Skrahina, A., Solovic, I., Srivastava, S., Stocker, S. L., Stukenboom, M. G. G., Svensson, Elin, Tadolini, M., Thomas, T. A., Tiberi, S., Trubiano, J., Udwadia, Z. F., Verhage, A. R., Vu, D. H., Akkerman, O. W., Alffenaar, J. W. C., and Denholm, J. T.

Abstract

BACKGROUND: Adverse effects (AE) to TB treatment cause morbidity, mortality and treatment interruption. The aim of these clinical standards is to encourage best practise for the diagnosis and management of AE. METHODS: 65/81 invited experts participated in a Delphi process using a 5-point Likert scale to score draft standards. RESULTS: We identified eight clinical standards. Each person commencing treatment for TB should: Standard 1, be counselled regarding AE before and during treatment; Standard 2, be evaluated for factors that might increase AE risk with regular review to actively identify and manage these; Standard 3, when AE occur, carefully assessed and possible allergic or hypersensitiv-ity reactions considered; Standard 4, receive appropriate care to minimise morbidity and mortality associated with AE; Standard 5, be restarted on TB drugs after a serious AE according to a standardised protocol that includes active drug safety monitoring. In addition: Standard 6, healthcare workers should be trained on AE including how to counsel people undertaking TB treatment, as well as active AE monitoring and management; Standard 7, there should be active AE monitoring and reporting for all new TB drugs and regimens; and Standard 8, knowledge gaps identified from active AE monitoring should be systematically addressed through clinical research. CONCLUSION: These standards provide a person -centred, consensus-based approach to minimise the impact of AE TB treatment.

Published
2023
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18. Clinical standards for the dosing and management of TB drugs

Author

Alffenaar, J W C, Stocker, S L, Forsman, L Davies, Garcia-Prats, A, Heysell, S K, Aarnoutse, R E, Akkerman, O W, Aleksa, A, van Altena, R, de Oñata, W Arrazola, Bhavani, P K, Van't Boveneind-Vrubleuskaya, N, Carvalho, A C C, Centis, R, Chakaya, J M, Cirillo, D M, Cho, J G, D Ambrosio, L, Dalcolmo, M P, Denti, P, Dheda, K, Fox, G J, Hesseling, A C, Kim, H Y, Köser, C U, Marais, B J, Margineanu, I, Märtson, A G, Torrico, M Munoz, Nataprawira, H M, Ong, C W M, Otto-Knapp, R, Peloquin, C A, Silva, D R, Ruslami, R, Santoso, P, Savic, R M, Singla, R, Svensson, E M, Skrahina, A, van Soolingen, D, Srivastava, S, Tadolini, M, Tiberi, S, Thomas, T A, Udwadia, Z F, Vu, D H, Zhang, W, Mpagama, S G, Schön, T, Migliori, G B, Alffenaar, J W C, Stocker, S L, Forsman, L Davie, Garcia-Prats, A, Heysell, S K, Aarnoutse, R E, Akkerman, O W, Aleksa, A, van Altena, R, de Oñata, W Arrazola, Bhavani, P K, Van't Boveneind-Vrubleuskaya, N, Carvalho, A C C, Centis, R, Chakaya, J M, Cirillo, D M, Cho, J G, D Ambrosio, L, Dalcolmo, M P, Denti, P, Dheda, K, Fox, G J, Hesseling, A C, Kim, H Y, Köser, C U, Marais, B J, Margineanu, I, Märtson, A G, Torrico, M Munoz, Nataprawira, H M, Ong, C W M, Otto-Knapp, R, Peloquin, C A, Silva, D R, Ruslami, R, Santoso, P, Savic, R M, Singla, R, Svensson, E M, Skrahina, A, van Soolingen, D, Srivastava, S, Tadolini, M, Tiberi, S, Thomas, T A, Udwadia, Z F, Vu, D H, Zhang, W, Mpagama, S G, Schön, T, Migliori, G B, and Microbes in Health and Disease (MHD)

Subjects
Pulmonary and Respiratory Medicine, Health Personnel, adverse drug reaction, Cardiorespiratory Medicine and Haematology, Microbiology, 7.3 Management and decision making, Rare Diseases, Clinical Research, qv_771, pharmacodynamics, Humans, tuberculosi, pharmacokinetic, Evaluation of treatments and therapeutic interventions, Reference Standards, dosing, pharmacodynamic, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Infectious Diseases, Orphan Drug, tuberculosis, 5.1 Pharmaceuticals, 6.1 Pharmaceuticals, wf_360, Reference Standard, wf_200, Patient Care, Patient Safety, Antimicrobial Resistance, Management of diseases and conditions, Drug Monitoring, Development of treatments and therapeutic interventions, pharmacokinetics, management, Human
Abstract

BACKGROUND: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on ‘best practice´ for dosing and management of TB drugs.METHODS: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.RESULTS: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.CONCLUSION: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

Published
2022

19. High frequency of bedaquiline resistance in programmatically treated drug-resistant TB patients with sustained culture-positivity in Cape Town, South Africa

Author

Derendinger, B., primary, Dippenaar, A., additional, de Vos, M., additional, Huo, S., additional, Alberts, R., additional, Tadokera, R., additional, Limberis, J., additional, Sirgel, F., additional, Dolby, T., additional, Spies, C., additional, Reuter, A., additional, Folkerts, M., additional, Allender, C., additional, Van Rie, A., additional, Gagneux, S., additional, Rigouts, L., additional, te Riele, J., additional, Dheda, K., additional, Engelthaler, D., additional, Warren, R., additional, Metcalfe, J., additional, Cox, H., additional, and Theron, G., additional

Published
2022
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20. Clinical standards for drug-susceptible pulmonary TB

Author

Akkerman, O. W., primary, Duarte, R., additional, Tiberi, S., additional, Schaaf, H. S., additional, Lange, C., additional, Alffenaar, J. W. C., additional, Denholm, J., additional, Carvalho, A. C. C., additional, Bolhuis, M. S., additional, Borisov, S., additional, Bruchfeld, J., additional, Cabibbe, A. M., additional, Caminero, J. A., additional, Carvalho, I., additional, Chakaya, J., additional, Centis, R., additional, Dalcomo, M. P., additional, D´Ambrosio, L., additional, Dedicoat, M., additional, Dheda, K., additional, Dooley, K. E., additional, Furin, J., additional, García-García, J-M., additional, van Hest, N. A. H., additional, de Jong, B. C., additional, Kurhasani, X., additional, Märtson, A. G., additional, Mpagama, S., additional, Torrico, M. Munoz, additional, Nunes, E., additional, Ong, C. W. M., additional, Palmero, D. J., additional, Ruslami, R., additional, Saktiawati, A. M. I., additional, Semuto, C., additional, Silva, D. R., additional, Singla, R., additional, Solovic, I., additional, Srivastava, S., additional, de Steenwinkel, J. E. M., additional, Story, A., additional, Sturkenboom, M. G. G., additional, Tadolini, M., additional, Udwadia, Z. F., additional, Verhage, A. R., additional, Zellweger, J. P., additional, and Migliori, G. B., additional

Published
2022
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22. Clinical standards for the dosing and management of TB drugs

Author

Alffenaar, J. W. C., Stocker, S. L., Forsman, L. Davies, Garcia-Prats, A., Heysell, S. K., Aarnoutse, R. E., Akkerman, O. W., Aleksa, A., van Altena, R., de Onata, W. Arrazola, Bhavani, P. K., Van't Boveneind-Vrubleuskaya, N., Carvalho, A. C. C., Centis, R., Chakaya, J. M., Cirillo, D. M., Cho, J. G., Ambrosio, L. D., Dalcolmo, M. P., Denti, P., Dheda, K., Fox, G. J., Hesseling, A. C., Kim, H. Y., Koser, C. U., Marais, B. J., Margineanu, I, Martson, A. G., Torrico, M. Munoz, Nataprawira, H. M., Ong, C. W. M., Otto-Knapp, R., Peloquin, C. A., Silva, D. R., Ruslami, R., Santoso, P., Savic, R. M., Singla, R., Svensson, Elin, Skrahina, A., van Soolingen, D., Srivastava, S., Tadolini, M., Tiberi, S., Thomas, T. A., Udwadia, Z. F., Vu, D. H., Zhang, W., Mpagama, S. G., Schon, T., Migliori, G. B., Alffenaar, J. W. C., Stocker, S. L., Forsman, L. Davies, Garcia-Prats, A., Heysell, S. K., Aarnoutse, R. E., Akkerman, O. W., Aleksa, A., van Altena, R., de Onata, W. Arrazola, Bhavani, P. K., Van't Boveneind-Vrubleuskaya, N., Carvalho, A. C. C., Centis, R., Chakaya, J. M., Cirillo, D. M., Cho, J. G., Ambrosio, L. D., Dalcolmo, M. P., Denti, P., Dheda, K., Fox, G. J., Hesseling, A. C., Kim, H. Y., Koser, C. U., Marais, B. J., Margineanu, I, Martson, A. G., Torrico, M. Munoz, Nataprawira, H. M., Ong, C. W. M., Otto-Knapp, R., Peloquin, C. A., Silva, D. R., Ruslami, R., Santoso, P., Savic, R. M., Singla, R., Svensson, Elin, Skrahina, A., van Soolingen, D., Srivastava, S., Tadolini, M., Tiberi, S., Thomas, T. A., Udwadia, Z. F., Vu, D. H., Zhang, W., Mpagama, S. G., Schon, T., and Migliori, G. B.

Abstract

Background: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on 'best practice' for dosing and management of TB drugs. Methods: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants. Results: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified. Conclusion: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

Published
2022
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23. Tuberculosis and COVID-19 co-infection: description of the global cohort

Author

Casco, N, Jorge, AL, Palmero, DJ, Alffenaar, J-W, Denholm, J, Fox, GJ, Ezz, W, Cho, J-G, Skrahina, A, Solodovnikova, V, Bachez, P, Piubello, A, Arbex, MA, Alves, T, Rabahi, MF, Pereira, GR, Sales, R, Silva, DR, Saffie, MM, Miranda, RC, Cancino, V, Carbonell, M, Cisterna, C, Concha, C, Cruz, A, Salinas, NE, Revillot, ME, Valdes, JF, Fernandez, I, Flores, X, Tapia, PG, Garavagno, A, Vera, CG, Bahamondes, MH, Merino, LM, Munoz, E, Munoz, C, Navarro, I, Subiabre, JN, Ortega, C, Palma, S, Pradenas, AM, Pereira, G, Castillo, PP, Pinto, M, Pizarro, R, Bidegain, FR, Rodriguez, P, Sanchez, C, Salinas, AS, Soto, A, Taiba, C, Venegas, M, Riquelme, MSV, Vilca, E, Villalon, C, Yucra, E, Li, Y, Guelvez, B, Plaza, RV, Hoyos, KYT, Andrejak, C, Blanc, F-X, Dourmane, S, Froissart, A, Izadifar, A, Riviere, F, Schlemmer, F, Manika, K, Diallo, BD, Hassane-Harouna, S, Artiles, N, Mejia, LA, Gupta, N, Ish, P, Mishra, G, Sharma, S, Singla, R, Udwadia, ZF, Alladio, F, Angeli, F, Calcagno, A, Centis, R, Codecasa, LR, D'Ambrosio, L, Lauretis, AD, Esposito, S, Formenti, B, Gaviraghi, A, Giacomet, V, Goletti, D, Gualano, G, Matteelli, A, Migliori, GB, Motta, I, Palmieri, F, Pontali, E, Prestileo, T, Riccardi, N, Saderi, L, Saporiti, M, Sotgiu, G, Stochino, C, Tadolini, M, Torre, A, Villa, S, Visca, D, Danila, E, Diktanas, S, Ridaura, RL, Lopez, FLL, Torrico, MM, Rendon, A, Akkerman, OW, Souleymane, MB, Al-Abri, S, Alyaquobi, F, Althohli, K, Aizpurua, E, Gonzales, R, Jurado, J, Loban, A, Aguirre, S, Teixeira, RC, De Egea, V, Irala, S, Medina, A, Sequera, G, Sosa, N, Vazquez, F, Llanos-Tejada, FK, Manga, S, Villanueva-Villegas, R, Araujo, D, Duarte, R, Marques, TS, Grecu, VI, Socaci, A, Barkanova, O, Bogorodskaya, M, Borisov, S, Mariandyshev, A, Kaluzhenina, A, Vukicevic, TA, Stosic, M, Beh, D, Ng, D, Ong, CWM, Solovic, I, Dheda, K, Gina, P, Caminero, JA, Cardoso-Landivar, J, Galvao, MLDS, Dominguez-Castellano, A, Garcia-Garcia, J-M, Pinargote, IM, Fernandez, SQ, Sanchez-Montalva, A, Huguet, ET, Murguiondo, MZ, Bart, P-A, Mazza-Stalder, J, Bakko, F, Barnacle, J, Brown, A, Chandran, S, Killington, K, Man, K, Papineni, P, Tiberi, S, Utjesanovic, N, Zenner, D, Hearn, JL, Heysell, S, Young, L, Casco, N, Jorge, AL, Palmero, DJ, Alffenaar, J-W, Denholm, J, Fox, GJ, Ezz, W, Cho, J-G, Skrahina, A, Solodovnikova, V, Bachez, P, Piubello, A, Arbex, MA, Alves, T, Rabahi, MF, Pereira, GR, Sales, R, Silva, DR, Saffie, MM, Miranda, RC, Cancino, V, Carbonell, M, Cisterna, C, Concha, C, Cruz, A, Salinas, NE, Revillot, ME, Valdes, JF, Fernandez, I, Flores, X, Tapia, PG, Garavagno, A, Vera, CG, Bahamondes, MH, Merino, LM, Munoz, E, Munoz, C, Navarro, I, Subiabre, JN, Ortega, C, Palma, S, Pradenas, AM, Pereira, G, Castillo, PP, Pinto, M, Pizarro, R, Bidegain, FR, Rodriguez, P, Sanchez, C, Salinas, AS, Soto, A, Taiba, C, Venegas, M, Riquelme, MSV, Vilca, E, Villalon, C, Yucra, E, Li, Y, Guelvez, B, Plaza, RV, Hoyos, KYT, Andrejak, C, Blanc, F-X, Dourmane, S, Froissart, A, Izadifar, A, Riviere, F, Schlemmer, F, Manika, K, Diallo, BD, Hassane-Harouna, S, Artiles, N, Mejia, LA, Gupta, N, Ish, P, Mishra, G, Sharma, S, Singla, R, Udwadia, ZF, Alladio, F, Angeli, F, Calcagno, A, Centis, R, Codecasa, LR, D'Ambrosio, L, Lauretis, AD, Esposito, S, Formenti, B, Gaviraghi, A, Giacomet, V, Goletti, D, Gualano, G, Matteelli, A, Migliori, GB, Motta, I, Palmieri, F, Pontali, E, Prestileo, T, Riccardi, N, Saderi, L, Saporiti, M, Sotgiu, G, Stochino, C, Tadolini, M, Torre, A, Villa, S, Visca, D, Danila, E, Diktanas, S, Ridaura, RL, Lopez, FLL, Torrico, MM, Rendon, A, Akkerman, OW, Souleymane, MB, Al-Abri, S, Alyaquobi, F, Althohli, K, Aizpurua, E, Gonzales, R, Jurado, J, Loban, A, Aguirre, S, Teixeira, RC, De Egea, V, Irala, S, Medina, A, Sequera, G, Sosa, N, Vazquez, F, Llanos-Tejada, FK, Manga, S, Villanueva-Villegas, R, Araujo, D, Duarte, R, Marques, TS, Grecu, VI, Socaci, A, Barkanova, O, Bogorodskaya, M, Borisov, S, Mariandyshev, A, Kaluzhenina, A, Vukicevic, TA, Stosic, M, Beh, D, Ng, D, Ong, CWM, Solovic, I, Dheda, K, Gina, P, Caminero, JA, Cardoso-Landivar, J, Galvao, MLDS, Dominguez-Castellano, A, Garcia-Garcia, J-M, Pinargote, IM, Fernandez, SQ, Sanchez-Montalva, A, Huguet, ET, Murguiondo, MZ, Bart, P-A, Mazza-Stalder, J, Bakko, F, Barnacle, J, Brown, A, Chandran, S, Killington, K, Man, K, Papineni, P, Tiberi, S, Utjesanovic, N, Zenner, D, Hearn, JL, Heysell, S, and Young, L

Abstract

BACKGROUND: Information on tuberculosis (TB) and coronavirus disease 2019 (COVID-19) is still limited. The aim of this study was to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multicountry register-based cohort with special focus on the determinants of mortality and other outcomes. METHODS: We enrolled all patients of any age with either active TB or previous TB and COVID-19. 172 centres from 34 countries provided individual data on 767 TB-COVID-19 co-infected patients, (>50% population-based). RESULTS: Of 767 patients, 553 (74.0%) out of 747 had TB before COVID-19 (including 234 out of 747 with previous TB), 71 (9.5%) out of 747 had COVID-19 first and 123 (16.5%) out of 747 had both diseases diagnosed within the same week (n=35 (4.6%) on the same day). 85 (11.08%) out of 767 patients died (41 (14.2%) out of 289 in Europe and 44 (9.2%) out of 478 outside Europe; p=0.03): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, one (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, male gender, having more than one comorbidity, diabetes mellitus, cardiovascular disease, chronic respiratory disease, chronic renal disease, presence of key symptoms, invasive ventilation and hospitalisation due to COVID-19. The final multivariable logistic regression model included age, male gender and invasive ventilation as independent contributors to mortality. CONCLUSION: The data suggest that TB and COVID-19 are a "cursed duet" and need immediate attention. TB should be considered a risk factor for severe COVID disease and patients with TB should be prioritised for COVID-19 preventative efforts, including vaccination.

Published
2022

24. Clinical standards for the dosing and management of TB drugs

Author

Alffenaar, J.W.C., Stocker, S.L., Forsman, L.D., Garcia-Prats, A., Heysell, S.K., Aarnoutse, R.E., Akkerman, O.W., Aleksa, A., Altena, R. van, Oñata, W.A. de, Bhavani, P.K., Boveneind-Vrubleuskaya, N. Van't, Carvalho, A.C.C., Centis, R., Chakaya, J.M., Cirillo, D.M., Cho, J.G., Ambrosio, L.D., Dalcolmo, M.P., Denti, P., Dheda, K., Fox, G.J., Hesseling, A.C., Kim, H.Y., Köser, C.U., Marais, B.J., Margineanu, I., Märtson, A.G., Torrico, M.M., Nataprawira, H.M., Ong, C.W.M., Otto-Knapp, R., Peloquin, C.A., Silva, D.R., Ruslami, R., Santoso, P., Savic, R.M., Singla, R., Svensson, E.M., Skrahina, A., Soolingen, D. van, Srivastava, S., Tadolini, M., Tiberi, S., Thomas, T.A., Udwadia, Z.F., Vu, D.H., Zhang, W., Mpagama, S.G., Schön, T., Migliori, G.B., Alffenaar, J.W.C., Stocker, S.L., Forsman, L.D., Garcia-Prats, A., Heysell, S.K., Aarnoutse, R.E., Akkerman, O.W., Aleksa, A., Altena, R. van, Oñata, W.A. de, Bhavani, P.K., Boveneind-Vrubleuskaya, N. Van't, Carvalho, A.C.C., Centis, R., Chakaya, J.M., Cirillo, D.M., Cho, J.G., Ambrosio, L.D., Dalcolmo, M.P., Denti, P., Dheda, K., Fox, G.J., Hesseling, A.C., Kim, H.Y., Köser, C.U., Marais, B.J., Margineanu, I., Märtson, A.G., Torrico, M.M., Nataprawira, H.M., Ong, C.W.M., Otto-Knapp, R., Peloquin, C.A., Silva, D.R., Ruslami, R., Santoso, P., Savic, R.M., Singla, R., Svensson, E.M., Skrahina, A., Soolingen, D. van, Srivastava, S., Tadolini, M., Tiberi, S., Thomas, T.A., Udwadia, Z.F., Vu, D.H., Zhang, W., Mpagama, S.G., Schön, T., and Migliori, G.B.

Abstract

Item does not contain fulltext, BACKGROUND: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on 'best practice´ for dosing and management of TB drugs.METHODS: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.RESULTS: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.CONCLUSION: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.

Published
2022

25. Clinical standards for drug-susceptible pulmonary TB

Author

Akkerman, OW, Duarte, R, Tiberi, S, Schaaf, HS, Lange, C, Alffenaar, JWC, Denholm, J, Carvalho, ACC, Bolhuis, MS, Borisov, S, Bruchfeld, J, Cabibbe, AM, Caminero, JA, Carvalho, I, Chakaya, J, Centis, R, Dalcomo, MP, Ambrosio, LD, Dedicoat, M, Dheda, K, Dooley, KE, Furin, J, Garcia-Garcia, J-M, van Hest, NAH, de Jong, BC, Kurhasani, X, Martson, AG, Mpagama, S, Torrico, MM, Nunes, E, Ong, CWM, Palmero, DJ, Ruslami, R, Saktiawati, AM, Semuto, C, Silva, DR, Singla, R, Solovic, I, Srivastava, S, de Steenwinkel, JEM, Story, A, Sturkenboom, MGG, Tadolini, M, Udwadia, ZF, Verhage, AR, Zellweger, JP, Migliori, GB, Akkerman, OW, Duarte, R, Tiberi, S, Schaaf, HS, Lange, C, Alffenaar, JWC, Denholm, J, Carvalho, ACC, Bolhuis, MS, Borisov, S, Bruchfeld, J, Cabibbe, AM, Caminero, JA, Carvalho, I, Chakaya, J, Centis, R, Dalcomo, MP, Ambrosio, LD, Dedicoat, M, Dheda, K, Dooley, KE, Furin, J, Garcia-Garcia, J-M, van Hest, NAH, de Jong, BC, Kurhasani, X, Martson, AG, Mpagama, S, Torrico, MM, Nunes, E, Ong, CWM, Palmero, DJ, Ruslami, R, Saktiawati, AM, Semuto, C, Silva, DR, Singla, R, Solovic, I, Srivastava, S, de Steenwinkel, JEM, Story, A, Sturkenboom, MGG, Tadolini, M, Udwadia, ZF, Verhage, AR, Zellweger, JP, and Migliori, GB

Abstract

BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice´ for diagnosis, treatment and management of drug-susceptible pulmonary TB (PTB).METHODS: A panel of 54 global experts in the field of TB care, public health, microbiology, and pharmacology were identified; 46 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all 46 participants.RESULTS: Seven clinical standards were defined: Standard 1, all patients (adult or child) who have symptoms and signs compatible with PTB should undergo investigations to reach a diagnosis; Standard 2, adequate bacteriological tests should be conducted to exclude drug-resistant TB; Standard 3, an appropriate regimen recommended by WHO and national guidelines for the treatment of PTB should be identified; Standard 4, health education and counselling should be provided for each patient starting treatment; Standard 5, treatment monitoring should be conducted to assess adherence, follow patient progress, identify and manage adverse events, and detect development of resistance; Standard 6, a recommended series of patient examinations should be performed at the end of treatment; Standard 7, necessary public health actions should be conducted for each patient. We also identified priorities for future research into PTB.CONCLUSION: These consensus-based clinical standards will help to improve patient care by guiding clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment for PTB.

Published
2022

26. Clinical standards for drug-susceptible pulmonary TB

Author

Akkerman, O. W., Duarte, R., Tiberi, S., Schaaf, H. S., Lange, C., Alffenaar, J. W.C., Denholm, J., Carvalho, A. C.C., Bolhuis, M. S., Borisov, S., Bruchfeld, J., Cabibbe, A. M., Caminero, J. A., Carvalho, I., Chakaya, J., Centis, R., Dalcomo, M. P., D'Ambrosio, L., Dedicoat, M., Dheda, K., Dooley, K. E., Furin, J., Garcia-Garcia, J. M., van Hest, N. A.H., de Jong, B. C., Kurhasani, X., Martson, A. G., Mpagama, S., Munoz Torrico, M., Nunes, E., Ong, C. W.M., Palmero, D. J., Ruslami, R., Saktiawati, A. M.I., Semuto, C., Silva, D. R., Singla, R., Solovic, I., Srivastava, S., de Steenwinkel, J. E.M., Story, A., Sturkenboom, M. G.G., Tadolini, M., Udwadia, Z. F., Verhage, A. R., Zellweger, J. P., Migliori, G. B., Akkerman, O. W., Duarte, R., Tiberi, S., Schaaf, H. S., Lange, C., Alffenaar, J. W.C., Denholm, J., Carvalho, A. C.C., Bolhuis, M. S., Borisov, S., Bruchfeld, J., Cabibbe, A. M., Caminero, J. A., Carvalho, I., Chakaya, J., Centis, R., Dalcomo, M. P., D'Ambrosio, L., Dedicoat, M., Dheda, K., Dooley, K. E., Furin, J., Garcia-Garcia, J. M., van Hest, N. A.H., de Jong, B. C., Kurhasani, X., Martson, A. G., Mpagama, S., Munoz Torrico, M., Nunes, E., Ong, C. W.M., Palmero, D. J., Ruslami, R., Saktiawati, A. M.I., Semuto, C., Silva, D. R., Singla, R., Solovic, I., Srivastava, S., de Steenwinkel, J. E.M., Story, A., Sturkenboom, M. G.G., Tadolini, M., Udwadia, Z. F., Verhage, A. R., Zellweger, J. P., and Migliori, G. B.

Abstract

BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice' for diagnosis, treatment and management of drug-susceptible pulmonary TB (PTB). METHODS : A panel of 54 global experts in the field of TB care, public health, microbiology, and pharmacology were identified; 46 participated in a Delphi process. A 5- point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all 46 participants. RESULTS : Seven clinical standards were defined: Standard 1, all patients (adult or child) who have symptoms and signs compatible with PTB should undergo investigations to reach a diagnosis; Standard 2, adequate bacteriological tests should be conducted to exclude drug-resistant TB; Standard 3, an appropriate regimen recommended by WHO and national guidelines for the treatment of PTB should be identified; Standard 4, health education and counselling should be provided for each patient starting treatment; Standard 5, treatment monitoring should be conducted to assess adherence, follow patient progress, identify and manage adverse events, and detect development of resistance; Standard 6, a recommended series of patient examinations should be performed at the end of treatment; Standard 7, necessary public health actions should be conducted for each patient. We also identified priorities for future research into PTB. CONCLUSION: These consensus-based clinical standards will help to improve patient care by guiding clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment for PTB.

Published
2022

28. Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society - 2021 update

Author

Lalloo, U G, Kalla, I S, Abdool-Gaffar, S, Dheda, K, Koegelenberg, C F N, Greenblatt, M, Feldman, C, Wong, M L, and van Zyl-Smit, R N

Subjects
Applied Mathematics, Guidelines, asthma, management
Abstract

Asthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times. The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care: • continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment • to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms • to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA) • to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma • to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and • to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma

Published
2022

29. Position statement on endoscopic lung volume reduction in South Africa: 2022 update

Author

Koegelenberg, CFN, van Zyl-Smit, RN, Dheda, K, Allwood, BW, Vorster, MJ, Plekker, D, Slebos, D-J, Klooster, K, Shah, PL, Herth, FJF, and Assembly on Interventional Pulmonology of the South African Thor

Abstract

Chronic obstructive pulmonary disease (COPD) remains one of the most common causes of morbidity and mortality in South Africa. Endoscopic lung volume reduction (ELVR) was first proposed by the South African Thoracic Society (SATS) for the treatment of advanced emphysema in 2015. Since the original statement was published, there has been a growing body of evidence that a certain well-defined sub-group of patients with advanced emphysema may benefit from ELVR, to the point where the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines and the United Kingdom National Institute for Health and Care Excellence (NICE) advocate the use of endoscopic valves based on level A evidence. Patients aged 40 - 75 years with severe dyspnoea (COPD Assessment Test score ≥10) despite maximal medical therapy and pulmonary rehabilitation, with forced expiratory volume in one second (FEV1) 20 - 50%, hyperinflation with residual volume (RV) >175% or RV/total lung capacity (TLC) >55% and a six-minute walking distance (6MWD) of 100 - 450 m (post-rehabilitation) should be referred for evaluation for ELVR, provided no contraindications (e.g. severe pulmonary hypertension) are present. Further evaluation should focus on the extent of parenchymal tissue destruction on high-resolution computed tomography (HRCT) of the lungs and interlobar collateral ventilation (CV) to identify a potential target lobe. Commercially available radiology software packages and/or an endobronchial catheter system can aid in this assessment. The aim of this statement is to provide the South African medical practitioner and healthcare funders with an overview of the practical aspects and current evidence for the judicious use of the valves and other ELVR modalities which may become available in the country.

Published
2022

30. A position statement and practical guide to the use of particulate filtering facepiece respirators (N95, FFP2, or equivalent) for South African health workers exposed to respiratory pathogens including Mycobacterium tuberculosis and SARS-CoV-2

Author

Dheda, K, Charalambous, S, Kharat, AS, von Delft, A, van Zyl-SMit, RN, Perumal, R, Allwood, BW, Esmail, A, Wong, ML, Duse, AG, Richards, G, Feldman, C, Mer, M, Nyamande, K, Lalla, U, Koegelenberg, CFN, Venter, F, Dawood, H, Adams, S, Ntusi, NAB, van der Westhuizen, H-M, Moosa, M-YS, van der Westhuizen, NA, Moultrie, H, Nel, J, Hausler, H, Preiser, W, Lasersohn, L, Zar, HJ, and Churchyard, GJ

Abstract

Summary\ud Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is transmitted mainly by aerosol in particles

Published
2021

31. Bronchial Thermoplasty Global Registry (BTGR): 2-year results

Author

Torrego, Alfons, Herth, F. J., Munoz-Fernandez, A. M., Puente, L., Facciolongo, N., Bicknell, S., Novali, M., Gasparini, S., Bonifazi, M., Dheda, K., Andreo García, Felipe, Votruba, P., Langton, D., Flandes, Javier, Fielding, D., Bonta, P. I., Skowasch, D., Schulz, C., Darwiche, K., McMullen, E., Grubb, G. M., Niven, R., Universitat Autònoma de Barcelona, Pulmonology, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, Pulmonary medicine, Institut Català de la Salut, [Torrego A] Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Herth FJ] Thoraxklinik, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany. [Munoz-Fernandez AM] Departament de Pneumologia, Hospital Universitari de Girona Doctor Josep Trueta, Institut Català de la Salut (ICS), Girona, Spain. [Puente L] Respiratory Department, Hospital General Universitario Gregorio Marañon-Facultad de Medicina, Universidad Complutense, Madrid, Spain. [Facciolongo N] AUSL-IRCCS Reggio Emilia Pulmonology Unit, IRCCS Reggio Emilia Pulmonology Unit, Santa Maria Nuova, Italy. [Bicknell S] Respiratory Department, Gartnavel General Hospital, Glasgow, UK, and Hospital Universitari de Girona Dr Josep Trueta

Subjects
Adult, bronchoscopy, Adolescent, Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Respiratory System::Bronchoscopy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Therapeutics::Radiofrequency Therapy::Radiofrequency Ablation::Catheter Ablation::Bronchial Thermoplasty [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Medizin, Asma - Tractament, terapéutica::tratamiento de radiofrecuencia::ablación por radiofrecuencia::ablación por catéter::termoplastia bronquial [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Broncoscòpia, Bronchoscopy, diagnóstico::técnicas y procedimientos diagnósticos::técnicas diagnósticas respiratorias::broncoscopia [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Humans, Chronic airways disease, respiratory medicine (see thoracic medicine), Prospective Studies, Registries, Respiratory Medicine, Bronchial Thermoplasty, General Medicine, Respiratory Tract Diseases::Bronchial Diseases::Asthma [DISEASES], asthma, Asthma, Treatment Outcome, chronic airways disease, Quality of Life, enfermedades respiratorias::enfermedades bronquiales::asma [ENFERMEDADES]
Abstract

ObjectivesBronchial thermoplasty (BT) is a device-based treatment for subjects ≥18 years with severe asthma not well controlled with inhaled corticosteroids and long-acting beta-agonists. The Bronchial Thermoplasty Global Registry (BTGR) collected real-world data on subjects undergoing this procedure.DesignThe BTGR is an all-comer, prospective, open-label, multicentre study enrolling adult subjects indicated for and treated with BT.SettingEighteen centres in Spain, Italy, Germany, the UK, the Netherlands, the Czech Republic, South Africa and AustraliaParticipantsOne hundred fifty-seven subjects aged 18 years and older who were scheduled to undergo BT treatment for asthma. Subjects diagnosed with other medical conditions which, in the investigator’s opinion, made them inappropriate for BT treatment were excluded.Primary and secondary outcome measuresBaseline characteristics collected included demographics, Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Test (ACT), medication usage, forced expiratory volume in one second and forced vital capacity, medical history, comorbidities and 12-month baseline recall data (severe exacerbations (SE) and healthcare utilisation). SE incidence and healthcare utilisation were summarised at 1 and 2 years post-BT.ResultsSubjects’ baseline characteristics were representative of persons with severe asthma. A comparison of the proportion of subjects experiencing events during the 12 months prior to BT to the 2-year follow-up showed a reduction in SE (90.3% vs 56.1%, pConclusionsThe BTGR demonstrates sustained improvement in clinical outcomes and reduction in asthma medication usage 2 years after BT in a real-world population. This is consistent with results from other BT randomised controlled trials and registries and further supports improvement in asthma control after BT.Trial registration numberNCT02104856.

Published
2021
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33. Tuberculosis and COVID-19 co-infection: description of the global cohort

Author

Migliori, G. B., Casco, N., Jorge, A. L., Palmero, D. J., Alffenaar, J. -W., Denholm, J., Fox, G. J., Ezz, W., Cho, J. -G., Skrahina, A., Solodovnikova, V., Bachez, P., Piubello, A., Arbex, M. A., Alves, T., Rabahi, M. F., Pereira, G. R., Sales, R., Silva, D. R., Saffie, M. M., Miranda, R. C., Cancino, V., Carbonell, M., Cisterna, C., Concha, C., Cruz, A., Salinas, N. E., Revillot, M. E., Valdes, J. F., Fernandez, I., Flores, X., Tapia, P. G., Garavagno, A., Vera, C. G., Bahamondes, M. H., Merino, L. M., Munoz, E., Munoz, C., Navarro, I., Subiabre, J. N., Ortega, C., Palma, S., Pradenas, A. M., Pereira, G., Castillo, P. P., Pinto, M., Pizarro, R., Bidegain, F. R., Rodriguez, P., Sanchez, C., Salinas, A. S., Soto, A., Taiba, C., Venegas, M., Riquelme, M. S. V., Vilca, E., Villalon, C., Yucra, E., Li, Y., Guelvez, B., Plaza, R. V., Hoyos, K. Y. T., Andrejak, C., Blanc, F. -X., Dourmane, S., Froissart, A., Izadifar, A., Riviere, F., Schlemmer, F., Manika, K., Diallo, B. D., Hassane-Harouna, S., Artiles, N., Mejia, L. A., Gupta, N., Ish, P., Mishra, G., Sharma, S., Singla, R., Udwadia, Z. F., Alladio, F., Angeli, F., Calcagno, A., Centis, R., Codecasa, L. R., D'Ambrosio, L., De Lauretis, A., Esposito, S., Formenti, B., Gaviraghi, A., Giacomet, V., Goletti, D., Gualano, G., Matteelli, A., Motta, I., Palmieri, F., Pontali, E., Prestileo, T., Riccardi, N., Saderi, L., Saporiti, M., Sotgiu, G., Stochino, C., Tadolini, M., Torre, A., Villa, S., Visca, D., Danila, E., Diktanas, S., Ridaura, R. L., Lopez, F. L. L., Torrico, M. M., Rendon, A., Akkerman, O. W., Souleymane, M. B., Al-Abri, S., Alyaquobi, F., Althohli, K., Aizpurua, E., Gonzales, R., Jurado, J., Loban, A., Aguirre, S., Teixeira, R. C., De Egea, V., Irala, S., Medina, A., Sequera, G., Sosa, N., Vazquez, F., Llanos-Tejada, F. K., Manga, S., Villanueva-Villegas, R., Araujo, D., Duarte, R., Marques, T. S., Grecu, V. I., Socaci, A., Barkanova, O., Bogorodskaya, M., Borisov, S., Mariandyshev, A., Kaluzhenina, A., Vukicevic, T. A., Stosic, M., Beh, D., Ng, D., Ong, C. W. M., Solovic, I., Dheda, K., Gina, P., Caminero, J. A., Cardoso-Landivar, J., De Souza Galvao, M. L., Dominguez-Castellano, A., Garcia-Garcia, J. -M., Pinargote, I. M., Fernandez, S. Q., Sanchez-Montalva, A., Huguet, E. T., Murguiondo, M. Z., Bart, P. -A., Mazza-Stalder, J., Bakko, F., Barnacle, J., Brown, A., Chandran, S., Killington, K., Man, K., Papineni, P., Tiberi, S., Utjesanovic, N., Zenner, D., Hearn, J. L., Heysell, S., and Young, L.

Subjects
Pulmonary and Respiratory Medicine, Cohort Studies, Male, Coinfection, Humans, Prospective Studies, COVID-19, Tuberculosis, Original Research Article
Abstract

BackgroundInformation on tuberculosis (TB) and coronavirus disease 2019 (COVID-19) is still limited. The aim of this study was to describe the features of the TB/COVID-19 co-infected individuals from a prospective, anonymised, multicountry register-based cohort with special focus on the determinants of mortality and other outcomes.MethodsWe enrolled all patients of any age with either active TB or previous TB and COVID-19. 172 centres from 34 countries provided individual data on 767 TB-COVID-19 co-infected patients, (>50% population-based).ResultsOf 767 patients, 553 (74.0%) out of 747 had TB before COVID-19 (including 234 out of 747 with previous TB), 71 (9.5%) out of 747 had COVID-19 first and 123 (16.5%) out of 747 had both diseases diagnosed within the same week (n=35 (4.6%) on the same day). 85 (11.08%) out of 767 patients died (41 (14.2%) out of 289 in Europe and 44 (9.2%) out of 478 outside Europe; p=0.03): 42 (49.4%) from COVID-19, 31 (36.5%) from COVID-19 and TB, one (1.2%) from TB and 11 from other causes. In the univariate analysis on mortality the following variables reached statistical significance: age, male gender, having more than one comorbidity, diabetes mellitus, cardiovascular disease, chronic respiratory disease, chronic renal disease, presence of key symptoms, invasive ventilation and hospitalisation due to COVID-19. The final multivariable logistic regression model included age, male gender and invasive ventilation as independent contributors to mortality.ConclusionThe data suggest that TB and COVID-19 are a “cursed duet” and need immediate attention. TB should be considered a risk factor for severe COVID disease and patients with TB should be prioritised for COVID-19 preventative efforts, including vaccination.

Published
2021

34. A position statement and practical guide to the use of particulate filtering facepiece respirators (N95, FFP2, or equivalent) for South African health workers exposed to respiratory pathogens including Mycobacterium tuberculosis and SARS-CoV-2

Author

Dheda, K, primary, Charalambous, S, additional, Karat, A S, additional, Von Delf, A, additional, Lalloo, U G, additional, Van Zyl Smit, R, additional, Perumal, R, additional, Allwood, B W, additional, Esmail, A, additional, Wong, M L, additional, Duse, A G, additional, Richards, G, additional, Feldman, C, additional, Mer, M, additional, Nyamande, K, additional, Lalla, U, additional, Koegelenberg, C F N, additional, Venter, F, additional, Dawood, H, additional, Adams, S, additional, Ntusi, N A B, additional, Van der Westhuizen, H-M, additional, Moosa, M-Y S, additional, Martinson, N A, additional, Moultrie, H, additional, Nel, J, additional, Hausler, H, additional, Preiser, W, additional, Lasersohn, L, additional, Zar, H J, additional, and Churchyard, G J, additional

Published
2021
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35. The organisational response of a hospital critical care service to the COVID-19 pandemic: The Groote Schuur Hospital experience

Author

Michell, W, primary, Joubert, I, additional, Peters, S, additional, Fredericks, D, additional, Miller, M, additional, Piercy, J, additional, Arnold-Day, C, additional, Thomson, D, additional, VanZyl-Smit, R, additional, Calligaro, G, additional, Strathie, G, additional, Semple, P, additional, Hofmeyr, R, additional, Peters, D, additional, and Dheda, K, additional

Published
2021
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36. Pretomanid with bedaquiline and linezolid for drug-resistant TB: a comparison of prospective cohorts

Author

Oelofse, S., primary, Esmail, A., additional, Diacon, A. H., additional, Conradie, F., additional, Olayanju, O., additional, Ngubane, N., additional, Howell, P., additional, Everitt, D., additional, Crook, A. M., additional, Mendel, C. M., additional, Wills, G. H., additional, Olugbosi, M., additional, del Parigi, A., additional, Sun, E., additional, Calatroni, A., additional, Spigelman, M., additional, and Dheda, K., additional

Published
2021
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37. Screening for Tuberculosis in Migrants: A Survey by the Global Tuberculosis Network

Author

D'Ambrosio, L, Centis, R, Dobler, CC, Tiberi, S, Matteelli, A, Denholm, J, Zenner, D, Al-Abri, S, Alyaquobi, F, Arbex, MA, Belilovskiy, E, Blanc, F-X, Borisov, S, Carvalho, ACC, Chakaya, JM, Cocco, N, Codecasa, LR, Dalcolmo, MP, Dheda, K, Dinh-Xuan, AT, Esposito, SR, Garcia-Garcia, J-M, Li, Y, Manga, S, Marchese, V, Munoz Torrico, M, Pontali, E, Rendon, A, Rossato Silva, D, Singla, R, Solovic, I, Sotgiu, G, van den Boom, M, Nhung, NV, Zellweger, J-P, Migliori, GB, D'Ambrosio, L, Centis, R, Dobler, CC, Tiberi, S, Matteelli, A, Denholm, J, Zenner, D, Al-Abri, S, Alyaquobi, F, Arbex, MA, Belilovskiy, E, Blanc, F-X, Borisov, S, Carvalho, ACC, Chakaya, JM, Cocco, N, Codecasa, LR, Dalcolmo, MP, Dheda, K, Dinh-Xuan, AT, Esposito, SR, Garcia-Garcia, J-M, Li, Y, Manga, S, Marchese, V, Munoz Torrico, M, Pontali, E, Rendon, A, Rossato Silva, D, Singla, R, Solovic, I, Sotgiu, G, van den Boom, M, Nhung, NV, Zellweger, J-P, and Migliori, GB

Abstract

Tuberculosis (TB) does not respect borders, and migration confounds global TB control and elimination. Systematic screening of immigrants from TB high burden settings and-to a lesser degree TB infection (TBI)-is recommended in most countries with a low incidence of TB. The aim of the study was to evaluate the views of a diverse group of international health professionals on TB management among migrants. Participants expressed their level of agreement using a six-point Likert scale with different statements in an online survey available in English, French, Mandarin, Spanish, Portuguese and Russian. The survey consisted of eight sections, covering TB and TBI screening and treatment in migrants. A total of 1055 respondents from 80 countries and territories participated between November 2019 and April 2020. The largest professional groups were pulmonologists (16.8%), other clinicians (30.4%), and nurses (11.8%). Participants generally supported infection control and TB surveillance established practices (administrative interventions, personal protection, etc.), while they disagreed on how to diagnose and manage both TB and TBI, particularly on which TBI regimens to use and when patients should be hospitalised. The results of this first knowledge, attitude and practice study on TB screening and treatment in migrants will inform public health policy and educational resources.

Published
2021

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