When Dr. Anne Crowe began working at Freeport in the early ‘80s, the Kitchener hospital was a home for people needing long-term care.
But the hospital was on the verge of evolving into something new.
Change is a constant at Freeport, from its beginning as a sanatorium for tuberculosis patients in the early 1900s to its current incarnation as a complex continuing care and rehabilitation centre.
http://news.therecord.com/News/Local/article/696360
Wednesday, 14 April 2010
Canada, Sanatorium history
2010 is the 100th anniversary of the opening of the Queen Alexandra Tuberculosis Sanatorium in London. The name was later changed to the Beck Memorial Sanatorium. The sanatorium closed in 1972.
http://www.lfpress.com/comment/2010/04/09/13530836.html
http://www.lfpress.com/comment/2010/04/09/13530836.html
Canada -- high rate of Tbc in First Nations
Manitoba's former tuberculosis control director will testify in front of a federal health committee to push for action to eliminate a disease critics call a national embarrassment.
Longtime TB control director Dr. Earl Hershfield will appear alongside other TB experts and First Nations representatives at a health committee hearing in Ottawa on April 20. Recommendations stemming from the testimony will be debated in Parliament, raising hopes the Harper government will address the poverty, poor housing and lack of access to medical care that help TB spread.
Hershfield spent 37 years at the helm of Manitoba's TB control program and recently blasted provincial health officials for losing track of sick TB patients, saying the system is "falling apart."
Hershfield said he will likely raise his concerns about gaps in tracking and treating TB patients at the upcoming hearing and offer his opinion on what could be done to improve it.
"That's not the way to run tuberculosis control," Hershfield said. "You need a director to make the policy and people to carry it out in the field."
Manitoba recently recorded the highest TB rates of any province, making it a national hot spot of an infectious disease that experts say is a by-product of overcrowded homes, malnutrition and poor overall health. The airborne disease is rampant in many northern Manitoba communities where cramped living quarters help it spread.
Winnipeg MP and NDP health critic Judy Wasylycia-Leis brought TB to the federal health committee's attention after a Free Press series revealed some Manitoba communities recorded some of the highest TB rates in the world.
Some northern First Nations communities have recorded more than 600 cases of TB per 100,000 people. By comparison, Canada's national rate is five cases per 100,000 and the rate in Bangladesh is slightly below 400 cases per 100,000.
Wasylycia-Leis said she's hopeful the federal government will be forced to act on the recommendations from the hearings.
She said eliminating TB should be a priority, and that Canada needs a better national strategy to eradicate it.
http://www.winnipegfreepress.com/local/experts-seek-to-push-ottawa-into-action-90460139.html
Longtime TB control director Dr. Earl Hershfield will appear alongside other TB experts and First Nations representatives at a health committee hearing in Ottawa on April 20. Recommendations stemming from the testimony will be debated in Parliament, raising hopes the Harper government will address the poverty, poor housing and lack of access to medical care that help TB spread.
Hershfield spent 37 years at the helm of Manitoba's TB control program and recently blasted provincial health officials for losing track of sick TB patients, saying the system is "falling apart."
Hershfield said he will likely raise his concerns about gaps in tracking and treating TB patients at the upcoming hearing and offer his opinion on what could be done to improve it.
"That's not the way to run tuberculosis control," Hershfield said. "You need a director to make the policy and people to carry it out in the field."
Manitoba recently recorded the highest TB rates of any province, making it a national hot spot of an infectious disease that experts say is a by-product of overcrowded homes, malnutrition and poor overall health. The airborne disease is rampant in many northern Manitoba communities where cramped living quarters help it spread.
Winnipeg MP and NDP health critic Judy Wasylycia-Leis brought TB to the federal health committee's attention after a Free Press series revealed some Manitoba communities recorded some of the highest TB rates in the world.
Some northern First Nations communities have recorded more than 600 cases of TB per 100,000 people. By comparison, Canada's national rate is five cases per 100,000 and the rate in Bangladesh is slightly below 400 cases per 100,000.
Wasylycia-Leis said she's hopeful the federal government will be forced to act on the recommendations from the hearings.
She said eliminating TB should be a priority, and that Canada needs a better national strategy to eradicate it.
http://www.winnipegfreepress.com/local/experts-seek-to-push-ottawa-into-action-90460139.html
India, Tbc & Malnutrition
Pointing to the malnutrition figures provided by the National Nutrition Monitoring Bureau, which says 33 per cent of the population, including 50 per cent of scheduled tribes and 60 per cent of scheduled castes, suffer from chronic under-nutrition, Dr. Sen wondered what prevented the administration from addressing this situation in regions not affected by Maoist presence.
Referring to a long-term study undertaken by a small non-governmental organisation, Jan Swarth Sahyog, which functions from the Ganiyari village in Chhattisgarh's Bilaspur district, he said the people in the region suffer from chronic malnutrition and malnutrition-related diseases like malaria and pulmonary tuberculosis during the period of August to November each year.
“There is no Maoist in this area. So the government argument that Maoist violence is responsible for the terrible level of under-development, poverty and inequity does not hold here…if body mass index is monitored on a monthly basis, there is a dip of BMI when rice harvest from the previous year runs out…The starvation leads to low immunity of the body and so malaria sets in. Also 95 per cent of the pulmonary tuberculosis cases have been found with BMI less than 18.5,” Dr. Sen said.
http://beta.thehindu.com/news/national/article394024.ece
Referring to a long-term study undertaken by a small non-governmental organisation, Jan Swarth Sahyog, which functions from the Ganiyari village in Chhattisgarh's Bilaspur district, he said the people in the region suffer from chronic malnutrition and malnutrition-related diseases like malaria and pulmonary tuberculosis during the period of August to November each year.
“There is no Maoist in this area. So the government argument that Maoist violence is responsible for the terrible level of under-development, poverty and inequity does not hold here…if body mass index is monitored on a monthly basis, there is a dip of BMI when rice harvest from the previous year runs out…The starvation leads to low immunity of the body and so malaria sets in. Also 95 per cent of the pulmonary tuberculosis cases have been found with BMI less than 18.5,” Dr. Sen said.
http://beta.thehindu.com/news/national/article394024.ece
Saturday, 10 April 2010
PA-824
Tuberculosis is a disease that infects approximately one-third of the world's population. Many individuals have latent tuberculosis, in which they are infected with Mycobacterium tuberculosis, but the bacterium is dormant in the lungs, causing no signs of infection. Latent infection is difficult to treat because the bacteria are not dividing while they exist in this dormant state. Antimicrobial drugs work to kill bacteria when they are actively growing and multiplying; latent tuberculosis cannot, therefore, be treated effectively until the bacteria begin to multiply. A new drug, PA-824, produces nitric oxide (NO) gas when it is metabolized inside the bacterial cell. This gas can kill the bacterium from within, “exploding” it and causing bacterial death even when the bacterium is not multiplying, which may in turn lead to new and effective treatments for latent tuberculosis.
http://www.accessscience.com/abstract.aspx?id=YB100011&referURL=http%3a%2f%2fwww.accessscience.com%2fcontent.aspx%3fid%3dYB100011
http://www.accessscience.com/abstract.aspx?id=YB100011&referURL=http%3a%2f%2fwww.accessscience.com%2fcontent.aspx%3fid%3dYB100011
USA statistics
According to the U.S. Centers for Disease Control and Prevention (CDC), 12,904 cases of tuberculosis were reported in the U.S. in 2008--the lowest number on record. However, tuberculosis (TB) remains a major public health threat globally. TB infections can be latent or active. With latent TB, the bacteria are inactive and cause no symptoms; latent TB is not contagious. With active TB, the causative bacteria--Mycobacterium tuberculosis--are actively multiplying causing a symptomatic and contagious illness.
http://www.livestrong.com/article/99117-active-tuberculosis-symptoms/
http://www.livestrong.com/article/99117-active-tuberculosis-symptoms/
Diagnosic delay: effect on cost of treatment
Delays seeking care worsen the burden of tuberculosis and cost of care for patients, families and the public health system. This study investigates costs of tuberculosis diagnosis incurred by patients, escorts and the public health system in 10 districts of Ethiopia.
Conclusions
The costs of tuberculosis diagnosis incurred by patients and escorts represent a significant portion of their monthly income. The costs arising from time lost in seeking care comprised a major portion of the total cost of diagnosis, and may worsen the economic position of patients and their families. Getting treatment from alternative sources and low index of suspicion public health providers were key problems contributing to increased cost of tuberculosis diagnosis. Thus, the institution of effective systems of referral, ensuring screening of suspects across the district public health system and the involvement of alternative care providers in district tuberculosis control can reduce delays and the financial burden to patients and escorts. open source database, has given us permission to reproduce articles, of particulat interest is the BMC International Journal of Human Rights
http://www.reliefweb.int/rw/rwb.nsf/db900sid/MYAI-8436VH?OpenDocument
Conclusions
The costs of tuberculosis diagnosis incurred by patients and escorts represent a significant portion of their monthly income. The costs arising from time lost in seeking care comprised a major portion of the total cost of diagnosis, and may worsen the economic position of patients and their families. Getting treatment from alternative sources and low index of suspicion public health providers were key problems contributing to increased cost of tuberculosis diagnosis. Thus, the institution of effective systems of referral, ensuring screening of suspects across the district public health system and the involvement of alternative care providers in district tuberculosis control can reduce delays and the financial burden to patients and escorts. open source database, has given us permission to reproduce articles, of particulat interest is the BMC International Journal of Human Rights
http://www.reliefweb.int/rw/rwb.nsf/db900sid/MYAI-8436VH?OpenDocument
Chemokines
CCL5 participates in early protection against Mycobacterium tuberculosis.
J Leukoc Biol. 2010 Apr 6;
Authors: Vesosky B, Rottinghaus EK, Stromberg P, Turner J, Beamer G
Control of M.tb, the causative agent of TB, requires immune cell recruitment to form lung granulomas. The chemokines and chemokine receptors that promote cell migration for granuloma formation, however, are not defined completely. As immunity to M.tb manifests slowly in the lungs, a better understanding of specific roles for chemokines, in particular those that promote M.tb-protective TH1 responses, may identify targets that could accelerate granuloma formation. The chemokine CCL5 has been detected in patients with TB and implicated in control of M.tb infection. To define a role for CCL5 in vivo during M.tb infection, CCL5 KO mice were infected with a low dose of aerosolized M.tb. During early M.tb infection, CCL5 KO mice localized fewer APCs and chemokine receptor-positive T cells to the lungs and had microscopic evidence of altered cell trafficking to M.tb granulomas. Early acquired immunity and granuloma function were transiently impaired when CCL5 was absent, evident by delayed IFN-gamma responses and poor control of M.tb growth. Lung cells from M.tb-infected CCL5 KO mice eventually reached or exceeded the levels of WT mice, likely as a result of partial compensation by the CCL5-related ligand, CCL4, and not because of CCL3. Finally, our results suggest that most T cells use CCR5 but not CCR1 to interact with these ligands. Overall, these results contribute to a model of M.tb granuloma formation dependent on temporal regulation of chemokines rather than on redundant or promiscuous interactions.
http://medicine.journalfeeds.com/hematology/j-leukoc-biol/ccl5-participates-in-early-protection-against-mycobacterium-tuberculosis/20100408/
J Leukoc Biol. 2010 Apr 6;
Authors: Vesosky B, Rottinghaus EK, Stromberg P, Turner J, Beamer G
Control of M.tb, the causative agent of TB, requires immune cell recruitment to form lung granulomas. The chemokines and chemokine receptors that promote cell migration for granuloma formation, however, are not defined completely. As immunity to M.tb manifests slowly in the lungs, a better understanding of specific roles for chemokines, in particular those that promote M.tb-protective TH1 responses, may identify targets that could accelerate granuloma formation. The chemokine CCL5 has been detected in patients with TB and implicated in control of M.tb infection. To define a role for CCL5 in vivo during M.tb infection, CCL5 KO mice were infected with a low dose of aerosolized M.tb. During early M.tb infection, CCL5 KO mice localized fewer APCs and chemokine receptor-positive T cells to the lungs and had microscopic evidence of altered cell trafficking to M.tb granulomas. Early acquired immunity and granuloma function were transiently impaired when CCL5 was absent, evident by delayed IFN-gamma responses and poor control of M.tb growth. Lung cells from M.tb-infected CCL5 KO mice eventually reached or exceeded the levels of WT mice, likely as a result of partial compensation by the CCL5-related ligand, CCL4, and not because of CCL3. Finally, our results suggest that most T cells use CCR5 but not CCR1 to interact with these ligands. Overall, these results contribute to a model of M.tb granuloma formation dependent on temporal regulation of chemokines rather than on redundant or promiscuous interactions.
http://medicine.journalfeeds.com/hematology/j-leukoc-biol/ccl5-participates-in-early-protection-against-mycobacterium-tuberculosis/20100408/
South Africa statistics
Minister of Health Dr Leslie Ramsammy said the country has experienced a gradual decline in the incidence of tuberculosis, but he believes progress has been slow and that not enough is being done to educate people.
Tuberculosis (TB) is considered a serious public health challenge and last year some 629 persons joined the local treatment programme. The incidence rate is currently 83 per 100,000 and statistics show that about 60 persons died each year from TB, but many were also HIV positive.
Ramsammy, in a message to mark World TB Day on Sunday, underscored the challenges of co-infection in the health sector saying they are working to lower the rate of TB patients living with HIV to around 12 percent because as of 2009, some 23 percent of TB patients were listed as HIV positive. “Because these two diseases combined to be a serious killer, we need to ensure we protect persons living with HIV from TB and also protect persons infected with TB from HIV”, Ramsammy said.
http://www.stabroeknews.com/2010/stories/04/08/gradual-decline-in-tb-cases-ramsammy/
Tuberculosis (TB) is considered a serious public health challenge and last year some 629 persons joined the local treatment programme. The incidence rate is currently 83 per 100,000 and statistics show that about 60 persons died each year from TB, but many were also HIV positive.
Ramsammy, in a message to mark World TB Day on Sunday, underscored the challenges of co-infection in the health sector saying they are working to lower the rate of TB patients living with HIV to around 12 percent because as of 2009, some 23 percent of TB patients were listed as HIV positive. “Because these two diseases combined to be a serious killer, we need to ensure we protect persons living with HIV from TB and also protect persons infected with TB from HIV”, Ramsammy said.
http://www.stabroeknews.com/2010/stories/04/08/gradual-decline-in-tb-cases-ramsammy/
Africa: Expenditure on Health Care Statistics
DAKAR, 8 April 2010 (IRIN) - In Africa government spending on health care, as a percentage of national expenses, rose just 0.3 percent from 2001 to 2007, while donor funding of the sector during the same period increased from 15.3 to 20.1 percent, according to a review of 52 African countries’ health spending by The Global Fund to Fight AIDS, Tuberculosis and Malaria. In the 1990s donors spent US$7.5 billion on health care worldwide, $21.8 billion in 2007. Below are some highlights from the report:
Donors covered 43 percent of health care expenses in Ethiopia in 2006, up four times from 2002. Over the same period donor backing for health care in Benin dropped 10 percent to 13.4 percent
Donors spent $43.74 per person in development assistance to health (DAH) in Namibia in 2007 versus 65 US cents in Mauritius
DAH increased the most in East Africa from 2002 to 2006 (19.6 to 28.4 percent), versus 22 percent in West and Central Africa, 20.3 percent in Southern Africa and 11.5 percent in North Africa
In 2007 half of African countries set aside at least 5 percent of their national income for health care
In 2007 seven African countries spent less than 5 percent of total budgets on health care, compared to eight in 2001
Patients in Africa’s lowest income countries paid out-of-pocket for more than half their health care, with governments pitching in 46 percent
By 2007 four countries had met or all but met the Abuja Declaration goal of spending 15 percent of annual budgets on health: Burkina Faso (14.8 percent), Botswana (17.3 percent), Djibouti (15.1 percent) and Rwanda (18.8 percent). Liberia and Malawi had exceeded the target in 2006 at 16.4 and 18 percent, respectively, but then dropped to 6.4 and 12.1 percent in 2007
Botswana and Rwanda had the biggest jumps in health care spending as a percentage of overall expenses from 1999 to 2007 – 8.9 and 9.7 percent, respectively, while Ghana and Benin had the largest drops – 6.1 and 3.6 percent
Nigeria spent 3.5 percent of its 2007 budget on health care, a nearly 2-percent drop since 1999. The oil sector has accounted for more than 80 percent of government revenue, according to Extractive Industries Transparency Initiative
http://www.irinnews.org/Report.aspx?ReportId=88735
Donors covered 43 percent of health care expenses in Ethiopia in 2006, up four times from 2002. Over the same period donor backing for health care in Benin dropped 10 percent to 13.4 percent
Donors spent $43.74 per person in development assistance to health (DAH) in Namibia in 2007 versus 65 US cents in Mauritius
DAH increased the most in East Africa from 2002 to 2006 (19.6 to 28.4 percent), versus 22 percent in West and Central Africa, 20.3 percent in Southern Africa and 11.5 percent in North Africa
In 2007 half of African countries set aside at least 5 percent of their national income for health care
In 2007 seven African countries spent less than 5 percent of total budgets on health care, compared to eight in 2001
Patients in Africa’s lowest income countries paid out-of-pocket for more than half their health care, with governments pitching in 46 percent
By 2007 four countries had met or all but met the Abuja Declaration goal of spending 15 percent of annual budgets on health: Burkina Faso (14.8 percent), Botswana (17.3 percent), Djibouti (15.1 percent) and Rwanda (18.8 percent). Liberia and Malawi had exceeded the target in 2006 at 16.4 and 18 percent, respectively, but then dropped to 6.4 and 12.1 percent in 2007
Botswana and Rwanda had the biggest jumps in health care spending as a percentage of overall expenses from 1999 to 2007 – 8.9 and 9.7 percent, respectively, while Ghana and Benin had the largest drops – 6.1 and 3.6 percent
Nigeria spent 3.5 percent of its 2007 budget on health care, a nearly 2-percent drop since 1999. The oil sector has accounted for more than 80 percent of government revenue, according to Extractive Industries Transparency Initiative
http://www.irinnews.org/Report.aspx?ReportId=88735
Diagnosis of Tbc
Tuberculosis (TB) remains a public health threat in the United States, with as many as 14 million Americans infected with the bacteria. At any given time, members from this large pool of infected people can develop full-blown, highly contagious forms of the disease.
According to the World Health Organization, about one person dies of TB every 17 seconds, causing nearly 2 million deaths annually. The disease continues to be a contagious scourge in developing countries, and with the world shrinking rapidly due to global migration, it is a major public health threat in developed nations as well, including the United States. Each infected person represents a potential yet preventable future outbreak, WHO says. Testing for TB infection is necessary in order to quickly identify the appropriate persons for treatment and thereby prevent its spread.
New data from a meta-analysis of existing literature published this week in CHEST, the official journal of the American College of Chest Physicians, provide evidence supporting a new, scientifically-proven standard for detecting TB infection. The study demonstrates that Interferon Gamma Release Assays (IGRAs) are superior to the previous standard in diagnostics, the 100+-year-old tuberculin skin test (TST), for detecting confirmed active TB disease. This was especially true when the IGRAs -- both QuantiFERON®-TB Gold (QFT) and T-SPOT®-TB (T-Spot) -- were administered in developed countries.
http://ohsonline.com/articles/2010/04/08/more-accurate-way-to-diagnose-tb.aspx?admgarea=news
According to the World Health Organization, about one person dies of TB every 17 seconds, causing nearly 2 million deaths annually. The disease continues to be a contagious scourge in developing countries, and with the world shrinking rapidly due to global migration, it is a major public health threat in developed nations as well, including the United States. Each infected person represents a potential yet preventable future outbreak, WHO says. Testing for TB infection is necessary in order to quickly identify the appropriate persons for treatment and thereby prevent its spread.
New data from a meta-analysis of existing literature published this week in CHEST, the official journal of the American College of Chest Physicians, provide evidence supporting a new, scientifically-proven standard for detecting TB infection. The study demonstrates that Interferon Gamma Release Assays (IGRAs) are superior to the previous standard in diagnostics, the 100+-year-old tuberculin skin test (TST), for detecting confirmed active TB disease. This was especially true when the IGRAs -- both QuantiFERON®-TB Gold (QFT) and T-SPOT®-TB (T-Spot) -- were administered in developed countries.
http://ohsonline.com/articles/2010/04/08/more-accurate-way-to-diagnose-tb.aspx?admgarea=news
Florida Tbc
Health Department officials in Lee County confirmed a case of tuberculosis in a student at Edison State College late Wednesday night.
College spokeswoman Catherine Bergerson said the school is working with the health department to notify all 46 people believed to have come in close contact with the student at Edison’s Lee County campus: four faculty members and 42 students. All 46 people have been asked to take a tuberculosis test, which will be administered by health department officials at Edison early next week.
Lee County Health Department spokeswoman Jennifer James-Mesloh said her office does not have any information on where the student picked up the illness, but said it is usually shared by people who come in close contact. No other details on the student, including her condition, were available Thursday.
"The people that are going to be tested are going to be classmates of the student," she said. "The whole entire Edison campus doesn't need to think they need to be tested. It doesn't mean if you pass someone in the hallway you're going to get it."
The most recent statistics for tuberculosis in Lee County are from 2008, when 32 people had confirmed cases of tuberculosis. That is consistent with the rest of the state, James-Mesloh said.
http://www.naplesnews.com/news/2010/apr/08/tuberculosis-case-identified-edison-state-college/
College spokeswoman Catherine Bergerson said the school is working with the health department to notify all 46 people believed to have come in close contact with the student at Edison’s Lee County campus: four faculty members and 42 students. All 46 people have been asked to take a tuberculosis test, which will be administered by health department officials at Edison early next week.
Lee County Health Department spokeswoman Jennifer James-Mesloh said her office does not have any information on where the student picked up the illness, but said it is usually shared by people who come in close contact. No other details on the student, including her condition, were available Thursday.
"The people that are going to be tested are going to be classmates of the student," she said. "The whole entire Edison campus doesn't need to think they need to be tested. It doesn't mean if you pass someone in the hallway you're going to get it."
The most recent statistics for tuberculosis in Lee County are from 2008, when 32 people had confirmed cases of tuberculosis. That is consistent with the rest of the state, James-Mesloh said.
http://www.naplesnews.com/news/2010/apr/08/tuberculosis-case-identified-edison-state-college/
Automated reading microscopy sputum slides
Guardian Technologies International Inc. (OTCBB: GDTI) today announced that it has joined forces with two prominent industry leaders in laboratory solutions, Prior Scientific (www.prior.com) and Olympus Soft Imaging (www.soft-imaging.net), to create and accelerate the integration of Guardian's Signature Mapping™ (SM TBDx™) diagnostic software into a first-of-its-kind, fully automated sputum microscopy solution for the computer-aided-detection of tuberculosis.
SM TBDx's 92.86% accuracy in positive cases and 3.75% false positive field of views, in the November 2009 clinical trials, far exceeded the NHLS program objectives of 80% accuracy and no more than 20% false positives, as well as industry norms of less than 70% accuracy.
http://money.cnn.com/news/newsfeeds/articles/marketwire/0605567.htm
SM TBDx's 92.86% accuracy in positive cases and 3.75% false positive field of views, in the November 2009 clinical trials, far exceeded the NHLS program objectives of 80% accuracy and no more than 20% false positives, as well as industry norms of less than 70% accuracy.
http://money.cnn.com/news/newsfeeds/articles/marketwire/0605567.htm
Thursday, 8 April 2010
Market for Tbc medications
GIA announces the release of a comprehensive global report on Tuberculosis (TB) Therapeutics markets. Global tuberculosis therapeutics market is expected to exceed US$846 million by 2015. Outbreak of TB-HIV co-infections, emergence of MDR- and XDR- TB strains, and widespread disease prevalence in high burden regions such as Africa and Asia, where case detection rates are critically low posing significant challenge for the control of this disease, all indicate high unmet needs in diagnosis and treatment. The scenario presents excellent commercial opportunity for existing as well as new companies in this marketplace.
While modern medicine has rendered this highly contagious, and life-threatening disease curable, and treatable, the disease continues to challenge the medical community even to the present day. As the bacterium causing TB continues to evolve, mutate, and develop resistance against modern drugs, there exists an urgent and dire need to develop newer next generation drugs to fight the disease. The growing prevalence of XDR (extensively drug resistant) TB and MDR (multi-drug resistant) TB strains has created the need for newer diagnostics tools, and drugs to manage and control tuberculosis. R&D in this area confronts its toughest challenge ever, with global investments, and R& D funding on total TB research still continuing to fall short of requirements. The uncertainties over the level of the US government's contribution towards the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) has also taken its toll on research funding, leading to funding deficits. This shortfall in funds has knifed the availability of finances in high-burden regions, such as the Sub-Saharan region.
http://www.newsguide.us/health-medical/infectious-diseases/Global-Tuberculosis-TB-Therapeutics-Market-is-Projected-to-Exceed-US-846-Million-by-2015-According-to-New-Report-by-Global-Industry-Analysts-Inc/
While modern medicine has rendered this highly contagious, and life-threatening disease curable, and treatable, the disease continues to challenge the medical community even to the present day. As the bacterium causing TB continues to evolve, mutate, and develop resistance against modern drugs, there exists an urgent and dire need to develop newer next generation drugs to fight the disease. The growing prevalence of XDR (extensively drug resistant) TB and MDR (multi-drug resistant) TB strains has created the need for newer diagnostics tools, and drugs to manage and control tuberculosis. R&D in this area confronts its toughest challenge ever, with global investments, and R& D funding on total TB research still continuing to fall short of requirements. The uncertainties over the level of the US government's contribution towards the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) has also taken its toll on research funding, leading to funding deficits. This shortfall in funds has knifed the availability of finances in high-burden regions, such as the Sub-Saharan region.
http://www.newsguide.us/health-medical/infectious-diseases/Global-Tuberculosis-TB-Therapeutics-Market-is-Projected-to-Exceed-US-846-Million-by-2015-According-to-New-Report-by-Global-Industry-Analysts-Inc/
Tbc in Illinois
According to the Illinois Department of Public Health in 2009, 418 cases of active tuberculosis were reported in the state, a marked decrease from 469 in 2008. But according to the Centers for Disease Control and Prevention, the state ranks fifth in the nation for the highest number of cases.
"Despite seeing the lowest number of new tuberculosis cases in Illinois during 2009, we've already experienced a tuberculosis outbreak in the state this year," State Public Health Director Dr. Damon T. Arnold said in a press release announcing World TB Day. "Although most of us don't think about tuberculosis much anymore thanks to the advances in medicine, this outbreak reminds us that TB is still circulating in Illinois. I urge all citizens to increase their awareness of tuberculosis and to join the global effort to stop the spread of this disease."
http://www.herald-review.com/news/local/b137b9be-3c09-11df-8f0c-001cc4c002e0.html
"Despite seeing the lowest number of new tuberculosis cases in Illinois during 2009, we've already experienced a tuberculosis outbreak in the state this year," State Public Health Director Dr. Damon T. Arnold said in a press release announcing World TB Day. "Although most of us don't think about tuberculosis much anymore thanks to the advances in medicine, this outbreak reminds us that TB is still circulating in Illinois. I urge all citizens to increase their awareness of tuberculosis and to join the global effort to stop the spread of this disease."
http://www.herald-review.com/news/local/b137b9be-3c09-11df-8f0c-001cc4c002e0.html
U.S. Strategy Expands Tuberculosis Treatment
30 March 2010
U.S. Strategy Expands Tuberculosis Treatment, Control
Goals include faster TB detection, more HIV tests, stronger health systems
By Cheryl PellerinScience Writer
Washington ― On World Tuberculosis Day, March 24, the United States released a five-year strategy for dealing with the ancient and relentless contagious lung disease that sickens 9 million people a year and kills nearly 5,000 every day in some of the world’s poorest nations.
The strategy, called for by the 2008 Lantos-Hyde Leadership Act Against AIDS, TB and Malaria, details the government’s plans from 2009 to 2014 to address the global public health threat of TB, including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), forms of the disease that threaten to undermine recent progress in controlling TB.
“As part of the President’s Global Health Initiative we are accelerating our programs to control TB,” Dr. Rajiv Shah, administrator of the U.S. Agency for International Development (USAID), said in a video March 24 as he released the strategy.
“Working with our many partners,” he said, “we believe it will be possible to halve the number of TB cases and deaths by 2015. In doing so, 14 million lives could be saved.” The plan lays the groundwork for detecting and treating TB in 2.6 million people and 57,200 MDR patients.
“This is our blueprint for expanded treatment and control over the next five years,” Shah said. “We will work in close partnerships with host nations to implement this strategy.”
DEADLY CONTAGION
One-third of the planet’s population is infected with TB, which can be deadly if it becomes active in the body and is left untreated. The immune system can keep TB bacteria under control after a person becomes infected, but bacteria can become active when something — a medical condition such as HIV, for example — reduces a person’s immunity.
People in almost every country are infected with TB, but 22 countries account for 80 percent of the TB cases. The countries, in order, are India, China, Indonesia, Nigeria, South Africa, Bangladesh, Ethiopia, Pakistan, Philippines, Democratic Republic of Congo, Russia, Vietnam, Kenya, Brazil, Tanzania, Uganda, Zimbabwe, Thailand, Mozambique, Burma, Cambodia and Afghanistan.
TB is treated with a six- to nine-month course of “first-line” (most effective) drugs that cost less than $20. If patients do not complete the drug course or are treated improperly, they can develop MDR-TB. These patients must be treated with more expensive, less effective second-line drugs for 18 to 24 months.
If patients do not complete this course or are treated with the wrong drugs, they can develop XDR-TB, whose bacteria strains are resistant to all TB drugs. Fewer than 30 percent of XDR-TB patients who are otherwise healthy and whose immune systems are not compromised can be cured. More than half of those with XDR-TB die within five years of diagnosis.
http://www.america.gov/st/scitech-english/2010/March/20100330131534lcnirellep0.721081.html
U.S. Strategy Expands Tuberculosis Treatment, Control
Goals include faster TB detection, more HIV tests, stronger health systems
By Cheryl PellerinScience Writer
Washington ― On World Tuberculosis Day, March 24, the United States released a five-year strategy for dealing with the ancient and relentless contagious lung disease that sickens 9 million people a year and kills nearly 5,000 every day in some of the world’s poorest nations.
The strategy, called for by the 2008 Lantos-Hyde Leadership Act Against AIDS, TB and Malaria, details the government’s plans from 2009 to 2014 to address the global public health threat of TB, including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), forms of the disease that threaten to undermine recent progress in controlling TB.
“As part of the President’s Global Health Initiative we are accelerating our programs to control TB,” Dr. Rajiv Shah, administrator of the U.S. Agency for International Development (USAID), said in a video March 24 as he released the strategy.
“Working with our many partners,” he said, “we believe it will be possible to halve the number of TB cases and deaths by 2015. In doing so, 14 million lives could be saved.” The plan lays the groundwork for detecting and treating TB in 2.6 million people and 57,200 MDR patients.
“This is our blueprint for expanded treatment and control over the next five years,” Shah said. “We will work in close partnerships with host nations to implement this strategy.”
DEADLY CONTAGION
One-third of the planet’s population is infected with TB, which can be deadly if it becomes active in the body and is left untreated. The immune system can keep TB bacteria under control after a person becomes infected, but bacteria can become active when something — a medical condition such as HIV, for example — reduces a person’s immunity.
People in almost every country are infected with TB, but 22 countries account for 80 percent of the TB cases. The countries, in order, are India, China, Indonesia, Nigeria, South Africa, Bangladesh, Ethiopia, Pakistan, Philippines, Democratic Republic of Congo, Russia, Vietnam, Kenya, Brazil, Tanzania, Uganda, Zimbabwe, Thailand, Mozambique, Burma, Cambodia and Afghanistan.
TB is treated with a six- to nine-month course of “first-line” (most effective) drugs that cost less than $20. If patients do not complete the drug course or are treated improperly, they can develop MDR-TB. These patients must be treated with more expensive, less effective second-line drugs for 18 to 24 months.
If patients do not complete this course or are treated with the wrong drugs, they can develop XDR-TB, whose bacteria strains are resistant to all TB drugs. Fewer than 30 percent of XDR-TB patients who are otherwise healthy and whose immune systems are not compromised can be cured. More than half of those with XDR-TB die within five years of diagnosis.
http://www.america.gov/st/scitech-english/2010/March/20100330131534lcnirellep0.721081.html
Multi Drug Resistant Tb, Treatment Outcomes
Treatment outcomes for multidrug-resistant Mycobacterium Tuberculosis (MDRTB) are generally poor compared to drug sensitive disease. We sought to estimate treatment outcomes and identify risk factors associated with poor outcomes in patients with MDRTB.
Methodology/Principal Findings
We performed a systematic search (to December 2008) to identify trials describing outcomes of patients treated for MDRTB. We pooled appropriate data to estimate WHO-defined outcomes at the end of treatment and follow-up. Where appropriate, pooled covariates were analyzed to identify factors associated with worse outcomes. Among articles identified, 36 met our inclusion criteria, representing 31 treatment programmes from 21 countries. In a pooled analysis, 62% [95% CI 57–67] of patients had successful outcomes, while 13% [9]–[17] defaulted, 11% [9]–[13] died, and 2% [1]–[4] were transferred out. Factors associated with worse outcome included male gender 0.61 (OR for successful outcome) [0.46–0.82], alcohol abuse 0.49 [0.39–0.63], low BMI 0.41[0.23–0.72], smear positivity at diagnosis 0.53 [0.31–0.91], fluoroquinolone resistance 0.45 [0.22–0.91] and the presence of an XDR resistance pattern 0.57 [0.41–0.80]. Factors associated with successful outcome were surgical intervention 1.91 [1.44–2.53], no previous treatment 1.42 [1.05–1.94], and fluoroquinolone use 2.20 [1.19–4.09].
Conclusions/Significance
We have identified several factors associated with poor outcomes where interventions may be targeted. In addition, we have identified high rates of default, which likely contributes to the development and spread of MDRTB.
http://sciencestage.com/resources/treatment-outcomes-multidrug-resistant-tuberculosis-systematic-review-and-meta-analysis-1
Methodology/Principal Findings
We performed a systematic search (to December 2008) to identify trials describing outcomes of patients treated for MDRTB. We pooled appropriate data to estimate WHO-defined outcomes at the end of treatment and follow-up. Where appropriate, pooled covariates were analyzed to identify factors associated with worse outcomes. Among articles identified, 36 met our inclusion criteria, representing 31 treatment programmes from 21 countries. In a pooled analysis, 62% [95% CI 57–67] of patients had successful outcomes, while 13% [9]–[17] defaulted, 11% [9]–[13] died, and 2% [1]–[4] were transferred out. Factors associated with worse outcome included male gender 0.61 (OR for successful outcome) [0.46–0.82], alcohol abuse 0.49 [0.39–0.63], low BMI 0.41[0.23–0.72], smear positivity at diagnosis 0.53 [0.31–0.91], fluoroquinolone resistance 0.45 [0.22–0.91] and the presence of an XDR resistance pattern 0.57 [0.41–0.80]. Factors associated with successful outcome were surgical intervention 1.91 [1.44–2.53], no previous treatment 1.42 [1.05–1.94], and fluoroquinolone use 2.20 [1.19–4.09].
Conclusions/Significance
We have identified several factors associated with poor outcomes where interventions may be targeted. In addition, we have identified high rates of default, which likely contributes to the development and spread of MDRTB.
http://sciencestage.com/resources/treatment-outcomes-multidrug-resistant-tuberculosis-systematic-review-and-meta-analysis-1
Granuloma Encapsulation Is a Key Factor for Containing Tuberculosis Infection in Minipigs
April 7, 2010
A transthoracic infection involving a low dose of Mycobacterium tuberculosis has been used to establish a new model of infection in minipigs. The 20-week monitoring period showed a marked Th1 response and poor humoral response for the whole infection. A detailed histopathological analysis was performed after slicing the formalin-fixed whole lungs of each animal. All lesions were recorded and classified according to their microscopic aspect, their relationship with the intralobular connective network and their degree of maturity in order to obtain a dissemination ratio (DR) between recent and old lesions. CFU counts and evolution of the DR with time showed that the proposed model correlated with a contained infection, decreasing from week 9 onwards. These findings suggest that the infection induces an initial Th1 response, which is followed by local fibrosis and encapsulation of the granulomas, thereby decreasing the onset of new lesions. Two therapeutic strategies were applied in order to understand how they could influence the model. Thus, chemotherapy with isoniazid alone helped to decrease the total number of lesions, despite the increase in DR after week 9, with similar kinetics to those of the control group, whereas addition of a therapeutic M. tuberculosis fragment-based vaccine after chemotherapy increased the Th1 and humoral responses, as well as the number of lesions, but decreased the DR. By providing a local pulmonary structure similar to that in humans, the mini-pig model highlights new aspects that could be key to a better understanding tuberculosis infection control in humans.
http://elitestv.com/pub/2010/04/granuloma-encapsulation-is-a-key-factor-for-containing-tuberculosis-infection-in-minipigs
A transthoracic infection involving a low dose of Mycobacterium tuberculosis has been used to establish a new model of infection in minipigs. The 20-week monitoring period showed a marked Th1 response and poor humoral response for the whole infection. A detailed histopathological analysis was performed after slicing the formalin-fixed whole lungs of each animal. All lesions were recorded and classified according to their microscopic aspect, their relationship with the intralobular connective network and their degree of maturity in order to obtain a dissemination ratio (DR) between recent and old lesions. CFU counts and evolution of the DR with time showed that the proposed model correlated with a contained infection, decreasing from week 9 onwards. These findings suggest that the infection induces an initial Th1 response, which is followed by local fibrosis and encapsulation of the granulomas, thereby decreasing the onset of new lesions. Two therapeutic strategies were applied in order to understand how they could influence the model. Thus, chemotherapy with isoniazid alone helped to decrease the total number of lesions, despite the increase in DR after week 9, with similar kinetics to those of the control group, whereas addition of a therapeutic M. tuberculosis fragment-based vaccine after chemotherapy increased the Th1 and humoral responses, as well as the number of lesions, but decreased the DR. By providing a local pulmonary structure similar to that in humans, the mini-pig model highlights new aspects that could be key to a better understanding tuberculosis infection control in humans.
http://elitestv.com/pub/2010/04/granuloma-encapsulation-is-a-key-factor-for-containing-tuberculosis-infection-in-minipigs
Cedars Sinai Hospital, LA
The medical center was founded by Jewish philanthropists, who continue to be its primary support, among them numerous Hollywood celebrities.
Its forerunner was established in 1902, mainly to provide free treatment for tuberculosis-stricken Jewish workers from the sweatshops of New York and other East Coast cities.
http://www.jewishjournal.com/community/article/cedars-sinai_hit_with_47_million_payment_to_surgeon_20100407/
Its forerunner was established in 1902, mainly to provide free treatment for tuberculosis-stricken Jewish workers from the sweatshops of New York and other East Coast cities.
http://www.jewishjournal.com/community/article/cedars-sinai_hit_with_47_million_payment_to_surgeon_20100407/
Seaview Hospital, Staten Island
Two of the buildings of the historic Seaview Hospital and Home on Staten Island, NY were recently restored and converted into 104 apartments for senior citizens. The Hospital complex was designed by Raymond Almilrall and built between 1905 and 1938. Many of the buildings are in the Spanish Mission style. In the early 20th century, it was the largest tuberculosis hospital in the United States at a time when fresh air was considered the most effective treatment of "the white plague."
http://www.mycentraljersey.com/fdcp/?1270734986156
http://www.mycentraljersey.com/fdcp/?1270734986156
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