The overall objective of this implementation plan is to define the strategy for implementation of the Xpert MTB/RIF test for rapid detection of TB and rifampicin (RIF) resistance in Tanzania, within the context of the National Tuberculosis and Leprosy Programme (NTLP) strategic plan and other nation...al health guidelines. It is intended to serve as the main guiding document for national, regional and local programme managers, clinicians, coordinators, laboratory staff and other health workers; national and regional reference laboratories; local and international implementing partners; and donors involved in TB control.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Buruli ulcer is caused by infection with Mycobacterium ulcerans. The disease is reported in more than 33 countries worldwide, but only about half of these countries regularly report data to WHO; most cases are reported from subregions of West and Central Africa. The mode of transmission is not known....
About half of those affected are children aged under 15 years; there is no gender difference. Diagnosis is based mainly on clinical and epidemiological characteristics. Of the four methods used for laboratory confirmation (microscopy, polymerase chain reaction (PCR), histopathology and culture), PCR is the most rapid and widely used. Other rapid methods for detection of mycolactone in lesions from suspected cases, such as fluorescent thin-layer chromatography, are under evaluation in four countries in Africa.
Research to develop point-of-care tests is in progress. Treatment of Buruli ulcer comprises 8 weeks of combined antibiotics (rifampicin and clarithromycin). Complementary therapies such as wound care, skin graft and prevention of disability are needed in some cases to ensure full recovery.
The target set by the World Health Organization (WHO) for control of Buruli ulcer is for countries to achieve a rate of case confirmation by PCR of at least 70%. All endemic countries have at least one PCR facility to support confirmation of cases. However, most countries in the WHO African Region have not been able to reach the target, and the rate of case confirmation has been declining
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Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv...e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delama...nid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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L’ulcère de Buruli, une infection causée par Mycobacterium ulcerans, touche plus de 33 pays dans le monde, mais un peu moins de la moitié seulement de ces pays communiquent régulièrement des données sur la maladie à l’OMS. La plupart des cas notifiés se trouvent dans les sous-régions d...Afrique occi-
dentale et centrale. Le mode de transmission de l’ulcère de Buruli n’est pas connu. Environ la moitié des personnes touchées sont des enfants de moins de 15 ans et les deux sexes sont concernés à parts égales.
Le diagnostic repose principalement sur l’observation des caractéristiques cliniques et épidémiologiques.
Parmi les quatre méthodes de confirmation utilisées (examen microscopique, amplification en chaîne par polymérase (PCR), histopathologie et mise en culture), la PCR est la plus rapide et la plus courament employée. D’autres méthodes rapides, comme l’utilisation de la chromatographie sur couche mince par fluorescence pour détecter la mycolactone dans les lésions des cas suspects d’ulcère de Buruli, sont actuellement à l’étude dans quatre pays d’Afrique. Des travaux de recherche sont en cours pour mettre au
point des tests utilisables sur le lieu des soins. Le traitement de l’ulcère de Buruli consiste à administrer une association d’antibiotiques (rifampicine et clarithromycine) pendant 8 semaines. Des traitements complémentaires, comme le soin des plaies, les greffes cutanées et la prévention des incapacités, sont nécessaires dans certains cas pour parvenir à une guérison complète.
La cible fixée par l’Organisation mondiale de la Santé (OMS) exigée des pays pour assurer la lutte contre l’ulcère de Buruli est la confirmation d’au moins 70 % des cas par PCR pour chaque pays. Tous les pays d’endémie disposent d’au moins un établissement doté des moyens nécessaires pour effectuer les tests de PCR pour la confirmation des cas. Cependant, la plupart des pays de la Région africaine n’ont pas réussi à atteindre la cible fixée. Un déclin du taux de confirmation a même été observé.
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There is an urgent need for safer, simpler, more efficacious and accessible treatment regimens for all forms of TB. The development of Target Product Profiles for TB treatment regimens (referred to as Target Regimen Profiles or TRPs) seeks to guide the drug development process towards important regi...men characteristics corresponding to the needs of end-users.
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Глобальными приоритетами для лечения туберкулеза (ТБ) и борьбы с ним являются улучшенное и ранее выявление случаев туберкулеза, в том числе случаев заболевания с о...трицательным мазком мокроты, которые часто ассоциируются с вирусом иммунодефицита человека (ВИЧ) и ранним возрастом, а также расширенные возможности для диагностики туберкулеза с множественной лекарственной устойчивостью (МЛУ-ТБ)
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Technical and operational ‘how-to’: practical considerations
Consenso de los Laboratorios Supranacionales (LSN), Centros Colaboradores (CC) y Laboratorios Nacionales de Referencia (LNR) de “países priorizados” para la aplicación del Xpert-MTB/Rif en Las Américas.
Guatemala, 11-12 abril de 2011
Accessed December 2017
OBJETIVO DE LA GUÍA
Describir los lineamientos técnicos de la vigilancia de tuberculosis por el laboratorio, así como los
procesos de obtención, recolección, procesamiento, transporte y conservación de muestras, y las
funciones que se realizan y articulan por todos los integra...ntes de la Red Nacional de Laboratorios.
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Death investigation form tuberculosis: Hospital Unit, Urgency and Emergency Unit
Acta Med Peru. 2017;34(3):182-7; El objetivo del presente trabajo es conocer la magnitud del problema de la TB y sus principales características epidemiológicas en la población del penal de varones de penal de varones de Trujillo, que sirva de base para plantear las mejores soluciones terapéutic...as.
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12 countries have a high TB estimated burden with an incidence rate more than 45 per 100 000 population They represent 88 of the cases in the Region
In 2019 the TB case detection gap in the Region was 52 500 cases