Antigone Barton

TB, HIV treatment failures map potholes along American road to care

In a hospital serving an urban population, more than a third of patients with a confirmed TB diagnosis also had HIV. Of those, nearly three quarters had been diagnosed with the virus that greatly increased their risks of becoming sick from the world’s oldest airborne infection, with a median of six years between a test showing they had HIV, and a test showing they had become sick with tuberculosis. Among those 73 patients already diagnosed with HIV, only 10 were accessing the antiretroviral treatment that protected their immune systems and offered them a defense against TB. Even at the end of their treatment, when 74 patients had accessed antiretroviral medicine, the treatment had been effective enough to suppress the virus in only a little more than half the patients. Three years after they completed the treatment, fewer than a third had maintained continuous treatment for HIV, or suppressed viruses. The high rates HIV/TB co-infection, and low rates of treatment, as well as of viral suppression, compare unfavorably to those of some African countries confronting the highest burden of both diseases.

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App addresses nutrition needs of TB patients

It’s a measure of the time technology takes that now, finally, an app exists to address the wasting that gave tuberculosis its original name — consumption. Leading to malnutrition, serious side effects from drugs or failure to absorb medicines, the serious weight loss that can characterize the disease raises risks of death or recurrence of sickness after cure, and, diminishing patients’ ability to work, adds to the catastrophic personal and financial fallout from illness.

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Study indicates that acting on guidelines could avert half of TB cases among children

Tracing contacts of people confirmed to be sick with tuberculosis and making preventive treatment available to those at risk for the disease, could halve current numbers of TB cases among children in resource limited settings, according to researchers reporting a study of patients across a Kenya rural province.

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Comprehensive care and support significantly boosts MDR-TB successful treatment completion

A Taiwan program of comprehensive support and care centered on the needs of patients being treated for multidrug-resistant tuberculosis — at a cost of from $25,000 to $30,000 per patient, per year over the costs of medicines — substantially improved cure rates and drastically reduced rates of patients whose outcomes were unknown, according to a study reported in Clinical Infectious Diseases.

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48th Union World Conference: “While these drugs are new to the TB world, they’ve been around for a long time . . .”

At a conference focused on “Accelerating toward elimination” attention turns again to stalled rollouts of the most promising medicines and regimens.

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MAP-IT tool helps make decisions on childhood TB interventions investments

Childhood TB is a major issue, infecting up to one million children each year. The good news is that there are several effective diagnostic, treatment, and prevention strategies that can have a major impact on decreasing the burden of childhood TB and mortality. These include interventions like contact tracing, fixed-dose medication, and rapid testing. We must consider however, that not every strategy is going to be equally effective in every context. What works well in Kenya may not be as effective in India and vice-versa. With limited resources at our disposal, how do we decide which intervention approach to invest our efforts in? How do we make sure that the options we select will have the best evidence-based impact on child TB morbidity and mortality in the country we’re working in?

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TB killed an estimated 239,000 children in 2015, nearly all of them untreated, study finds

Analysis shows TB may be sixth highest cause of under-five deaths; toll could be prevented with improved case-finding, diagnosis

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Study: Screening malnourished children for TB in high-burden countries would boost detection

Fewer than half of countries with high rates of tuberculosis incidence surveyed in a recent study have guidelines recommending screening for the disease among children receiving services for malnutrition, even though having those guidelines, increasing case-finding among children, linking them to care, and tracking their contacts could lead to inroads against the leading infectious disease killer, according to authors of a report on the findings. The study gathered and analyzed malnutrition management guidelines from 17 countries with high rates of tuberculosis.

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Early intensified treatment boosted drug-resistant TB meningitis survival, but detection remains challenged

A randomized trial of clinical outcomes for patients with drug-resistant tuberculous meningitis underscores that new diagnostic tools and treatments for the disease are critically needed, authors of a report in the July Clinical Infectious Diseases write. Their study found early identification of drug-resistance and intensified treatment to be pivotal in improving survival chances of people with the disease, the most fatal form of TB, that also is among the most difficult to detect. Even with treatment, the disease kills about a third of patients who have it the authors note.

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Bedaquiline effective, safe, manageable across wide range of settings, five-continent data show

Data on patients treated with one of the two newest tuberculosis medicines in 15 countries across five continents show that the treatment, which represents a last resort for hundreds of thousands of people with drug-resistant strains of disease, can be administered safely in a wide range of settings, and bring greatly improved outcomes compared to patients without access to the medicine, according to a recent study.

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