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Journal of the Pediatric Infectious... Oct 2022Tuberculosis (TB) preventive therapy (TPT) is increasingly recognized as the key to eliminating tuberculosis globally and is particularly critical for children with TB... (Review)
Review
Tuberculosis (TB) preventive therapy (TPT) is increasingly recognized as the key to eliminating tuberculosis globally and is particularly critical for children with TB infection or who are in close contact with individuals with infectious TB. But many barriers currently impede successful scale-up to provide TPT to those at high risk of TB disease. The cascade of care in TB infection (and the related contact management cascade) is a conceptual framework to evaluate and improve the care of persons who are potential candidates for TPT. This review summarizes recent literature on barriers and solutions in the TB infection care cascade, focusing on children in both high- and low-burden settings, and drawing from studies on children and adults. Identifying and closing gaps in the care cascade will require the implementation of tools that are new (e.g. computer-assisted radiography) and old (e.g. efficient contact tracing), and will be aided by innovative implementation study designs, quality improvement methods, and shared clinical practice with primary care providers.
Topics: Child; Adult; Humans; Tuberculosis; Latent Tuberculosis; Quality Improvement
PubMed: 36314552
DOI: 10.1093/jpids/piac070 -
Frontiers in Immunology 2024
Topics: Humans; Tuberculosis; Adaptive Immunity; Latent Tuberculosis; Vaccines
PubMed: 38322257
DOI: 10.3389/fimmu.2024.1366976 -
The Indian Journal of Tuberculosis 2023Tuberculosis and malignancy are major public health problems in developing countries like India and causes significant morbidity and mortality. Mycobacterium... (Review)
Review
Tuberculosis and malignancy are major public health problems in developing countries like India and causes significant morbidity and mortality. Mycobacterium tuberculosis is an aerobic acid-fast bacilli which is an important pathogen especially complicating clinical status of paediatric oncology patients and treatment of infection with this bacilli is challenging in this subpopulation of patients because of ongoing immunosuppression and relative lack of published guidelines. Atypical presentations of tuberculosis in children also complicate the diagnosis and management. All the more, in tuberculosis endemic area lung cancer may be mistakenly diagnosed as tuberculosis or vice versa and this wrong diagnosis increases the burden on country's health status. It is noted that tuberculosis prevalence is high in children with haematological malignancy and head and neck tumours compared to other solid organ tumours. Moreover, it is found that morbidity and mortality from tuberculosis is more in children from WHO listed high TB burden countries who undergo hematopoietic stem cell and solid organ transplantation. Use of immune checkpoint inhibitors as novel therapy in treatment of childhood malignancies has led to modification of the body's immunological response and has resulted in increased latent tuberculosis infection reactivation as one immune-related infectious consequence. Latent TB infection screening is important concept in management of paediatric oncology patients. Currently, the tests employed as screening diagnostics for LTBI are interferon-gamma release assay (IGRA) blood test and the tuberculin skin test (TST). Various regimens have been suggested for the treatment of LTBI. But, after a positive IGRA or TST and prior to latent TB treatment, active tuberculosis should be ruled out by detailed history taking, examination and appropriate investigations so as to minimize the risk of drug resistance with anti-tuberculosis monotherapy used in LTBI treatment. To add on to literature, Non tuberculous mycobacteria are universally present environmental organisms. However, in immunocompromised children especially in subpopulation of malignancy, NTM is known to cause infections which needs protocol based management. Also importance has to given to implementation of adequate preventive and corrective measures to prevent such opportunistic infection in paediatric oncology subpopulation. In this review, we provide an overview of tuberculosis in paediatric oncology patients and summarize the expansive body of literature on the tuberculosis mimicking carcinoma, tuberculosis burden in transplantation patients and those receiving immune check point inhibitors, latent TB infection screening and management, and NTM infection in children with malignancy.
Topics: Humans; Child; Latent Tuberculosis; Neoplasms; Tuberculosis; Interferon-gamma Release Tests; Tuberculin Test
PubMed: 38110259
DOI: 10.1016/j.ijtb.2023.09.006 -
The International Journal of... May 2020Latent tuberculosis infection (LTBI) is increasingly recognised as central to programmatic TB activity, and a critical element in global progress towards TB elimination.... (Review)
Review
Latent tuberculosis infection (LTBI) is increasingly recognised as central to programmatic TB activity, and a critical element in global progress towards TB elimination. LTBI affects a much larger group of people than active disease, who by definition are asymptomatic. Furthermore, while LTBI represents a state of risk, there remains significant uncertainty regarding which individuals will progress to active disease. Therefore, the development and implementation of LTBI management policies within the End TB Strategy requires careful ethical consideration. This article reviews ethical issues related to developments in LTBI diagnosis and management, including new tools and emerging policies and practice. Implications of LTBI management practices in specific settings are discussed, including healthcare worker infection and management of likely multidrug-resistant (MDR) LTBI. Better prediction of progression to active disease and less burdensome treatments would allow ethically appropriate expansion of testing programmes in future. However, even with existing tools there is a strong ethical imperative to provide the most effective and least burdensome therapy possible to those with LTBI, particularly those at highest risk of progression and/or poor outcomes from active disease. Greater community engagement is required in designing optimal LTBI management programmes, and ensure harms and benefits are appropriately balanced in specific settings.
Topics: Humans; Latent Tuberculosis; Tuberculosis, Multidrug-Resistant
PubMed: 32553039
DOI: 10.5588/ijtld.17.0756 -
Clinical Infectious Diseases : An... Jul 2020
Topics: Hematopoietic Stem Cell Transplantation; Humans; Latent Tuberculosis; Tuberculosis
PubMed: 31584622
DOI: 10.1093/cid/ciz981 -
The Veterinary Record Sep 2019
Topics: Animals; Cat Diseases; Cats; Mycobacterium Infections; Scotland
PubMed: 31541054
DOI: 10.1136/vr.l5594 -
International Journal of Infectious... May 2023Viruses, including SARS-CoV-2, which causes COVID-19, are constantly changing. These genetic changes (aka mutations) occur over time and can lead to the emergence of new...
INTRO
Viruses, including SARS-CoV-2, which causes COVID-19, are constantly changing. These genetic changes (aka mutations) occur over time and can lead to the emergence of new variants that may have different characteristics. After the first SARS-CoV-2 genome was published in early 2020, scientists all over the world soon realized the immediate need to obtain as much genetic information from as many strains as possible. However, understanding the functional significance of the mutations harbored by a variant is important to assess its impact on transmissibility, disease severity, immune escape, and the effectiveness of vaccines and therapeutics.
METHODS
Here in Canada, we have developed an interactive framework for visualizing and reporting mutations in SARS-CoV-2 variants. This framework is composed of three stand-alone yet connected components; an interactive visualization (COVID-MVP), a manually curated functional annotation database (pokay), and a genomic analysis workflow (nf-ncov-voc). Findings: COVID-MVP provides (i) an interactive heatmap to visualize and compare mutations in SARS-CoV-2 lineages classified across different VOCs, VOIs, and VUMs; (ii) mutation profiles including the type, impact, and contextual information; (iii) annotation of biological impacts for mutations where functional data is available in the literature; (iv) summarized information for each variant and/or lineage in the form of a surveillance report; and (v) the ability to upload raw genomic sequence(s) for rapid processing and annotating for real-time classification.
DISCUSSION
This comprehensive comparison allows microbiologists and public health practitioners to better predict how the mutations in emerging variants will impact factors such as infection severity, vaccine resistance, hospitalization rates, etc.
CONCLUSION
This framework is cloud-compatible & standalone, which makes it easier to integrate into other genomic surveillance tools as well. COVID-MVP is integrated into the Canadian VirusSeq data portal (https://virusseqdataportal.ca) - a national data hub for SARS-COV-2 genomic data. COVID-MVP is also used by the CanCOGeN and CoVaRR networks in national COVID-19 genomic surveillance.
Topics: Humans; Tuberculosis; Mycobacterium tuberculosis; World Health Organization
PubMed: 38039194
DOI: 10.1016/j.ijid.2023.04.006 -
The Veterinary Clinics of North... Apr 2023Foals become infected shortly after birth; most develop subclinical pneumonia and 20% to 30% develop clinical pneumonia that requires treatment. It is now well... (Review)
Review
Foals become infected shortly after birth; most develop subclinical pneumonia and 20% to 30% develop clinical pneumonia that requires treatment. It is now well established that the combination of screening programs based on thoracic ultrasonography and treatment of subclinical foals with antimicrobials has led to the development of resistant Rhodococcus equi strains. Thus, targeted treatment programs are needed. Administration of R equi-specific hyperimmune plasma shortly after birth is beneficial as foals develop less severe pneumonia but does not seem to prevent infection. This article provides a summary of clinically relevant research published during this past decade.
Topics: Animals; Horses; Rhodococcus equi; Actinomycetales Infections; Horse Diseases; Pneumonia
PubMed: 36898784
DOI: 10.1016/j.cveq.2022.11.002 -
Lancet (London, England) Sep 2019
Topics: Humans; Tuberculosis; Tuberculosis, Multidrug-Resistant
PubMed: 31526720
DOI: 10.1016/S0140-6736(19)32082-3 -
Indian Journal of Pediatrics Aug 2019
Topics: Antitubercular Agents; Child; Communicable Disease Control; Humans; India; Microbial Sensitivity Tests; Molecular Diagnostic Techniques; Tuberculosis; Tuberculosis, Multidrug-Resistant
PubMed: 31209764
DOI: 10.1007/s12098-019-03005-3