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Book: Case presentations in clinical tuberculosis

Davis, Peter D. O. / Ormerod, Lawrence Peter

1999

Author's details	Peter D. O. Davis and L. Peter Ormerod
Language	English
Size	XIV, 299 S. : zahlr. Ill.
Publisher	Arnold
Publishing place	London u.a.
Publishing country	Great Britain
Document type	Book
HBZ-ID	HT010915480
ISBN	0-340-74159-7 ; 978-0-340-74159-7
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Drug therapy for children with tuberculosis.

Ormerod, L Peter

Archives of disease in childhood

2012 Volume 97, Issue 12, Page(s) 1097–1101

Abstract: The scientific basis of drug treatment for both active tuberculosis (TB) disease and TB infection, has been established, with treatment in children being largely extrapolated from adult active disease trials. It is essential that active TB disease is ... ...

Abstract	The scientific basis of drug treatment for both active tuberculosis (TB) disease and TB infection, has been established, with treatment in children being largely extrapolated from adult active disease trials. It is essential that active TB disease is excluded before asymptomatic TB infection is diagnosed and treated. Nearly half of all children with active TB disease are found as asymptomatic tuberculin, or interferon gamma release assay (IGRA), positive contacts on screening by local TB services, usually of sputum TB microscopy positive adult relatives or other index cases, but with evidence of lung infiltrate or mediastinal lymphadenopathy on the child's chest x-ray. New drug regimens for both active disease and latent infection are in development, and also some novel drugs. However, none of these have yet been tested in children, and so again data will need to be extrapolated from adult results. In addition, there are issues regarding pharmacokinetics and dosing for current drugs, particularly isoniazid.
MeSH term(s)	Antitubercular Agents/immunology ; Antitubercular Agents/therapeutic use ; Child ; Humans ; Latent Tuberculosis/drug therapy ; Latent Tuberculosis/immunology ; Sputum/microbiology ; Tuberculin Test ; Tuberculosis/drug therapy ; Tuberculosis/immunology
Chemical Substances	Antitubercular Agents
Language	English
Publishing date	2012-12
Publishing country	England
Document type	Journal Article
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2012-301925
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Article: Role of surgery in pulmonary multidrug-resistant tuberculosis.

Ormerod, L Peter

Thorax

2007 Volume 62, Issue 5, Page(s) 377

MeSH term(s)	Antitubercular Agents/therapeutic use ; Humans ; Tuberculosis, Multidrug-Resistant/surgery
Chemical Substances	Antitubercular Agents
Language	English
Publishing date	2007-05
Publishing country	England
Document type	Comment ; Editorial
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thx.2005.056135
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Article ; Online: High prevalence of TB disease in contacts of adults with extrapulmonary TB.

Wingfield, Tom / MacPherson, Peter / Cleary, Paul / Ormerod, L Peter

Thorax

2017 Volume 73, Issue 8, Page(s) 785–787

Abstract: UK guidelines no longer recommend routine screening of household contacts of adult patients with extrapulmonary TB (EPTB). From 27 March 2012 to 28 June 2016, we investigated the prevalence of active TB disease in household contacts of 1023 EPTB index ... ...

Abstract	UK guidelines no longer recommend routine screening of household contacts of adult patients with extrapulmonary TB (EPTB). From 27 March 2012 to 28 June 2016, we investigated the prevalence of active TB disease in household contacts of 1023 EPTB index cases in North West England, and compared estimates with: published new entrant migrant screening programme prevalence (~147/100 000 person-years); London-based contact screening data (700/100 000 contacts screened); and National Institute for Health and Care Excellence (NICE) new entrant TB screening thresholds (TB prevalence >40/100 000 people). Active TB disease prevalence in EPTB contacts was 440/100 000 contacts screened, similar to UK new entrant screening programmes, London EPTB contact prevalence and >10 times NICE's threshold for new entrant screening. The decision to no longer recommend routine screening of EPTB contacts should be re-evaluated and cost-effectiveness analyses of screening strategies for EPTB contacts should be performed.
MeSH term(s)	Adult ; Contact Tracing ; Female ; Humans ; London/epidemiology ; Male ; Population Surveillance ; Prevalence ; Retrospective Studies ; Transients and Migrants ; Tuberculosis, Pulmonary/epidemiology
Language	English
Publishing date	2017-11-16
Publishing country	England
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thoraxjnl-2017-210202
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Article: Assessing risk and managing Mycobacterium tuberculosis infection and disease in patients due to start anti-TNFalpha treatment.

Ormerod, L Peter

Cytokine

2004 Volume 28, Issue 4-5, Page(s) 179–181

Abstract: This short paper describes the rationale being applied in the United Kingdom to the problem of treating latent TB infection in persons requiring anti-TNF-alpha treatment. This will largely have to be done by an individual risk/benefit analysis based on ... ...

Abstract	This short paper describes the rationale being applied in the United Kingdom to the problem of treating latent TB infection in persons requiring anti-TNF-alpha treatment. This will largely have to be done by an individual risk/benefit analysis based on the risks of developing disease from national epidemiology compared with the risks of significant hepatotoxicity from treatment of latent infection.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Antibiotic Prophylaxis ; Antitubercular Agents/adverse effects ; Antitubercular Agents/therapeutic use ; Continental Population Groups ; Female ; Humans ; Male ; Mycobacterium tuberculosis/physiology ; Risk Assessment ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology ; Tuberculosis/microbiology ; Tuberculosis/pathology ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; United Kingdom/epidemiology
Chemical Substances	Antitubercular Agents ; Tumor Necrosis Factor-alpha
Language	English
Publishing date	2004-11
Publishing country	England
Document type	Journal Article
ZDB-ID	1018055-2
ISSN	1096-0023 ; 1043-4666
ISSN (online)	1096-0023
ISSN	1043-4666
DOI	10.1016/j.cyto.2004.07.013
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Article ; Online: Evaluating 17 years of latent tuberculosis infection screening in north-west England: a retrospective cohort study of reactivation.

Zenner, Dominik / Loutet, Miranda G / Harris, Ross / Wilson, Stephen / Ormerod, L Peter

The European respiratory journal

2017 Volume 50, Issue 1

Abstract: Approximately 72% of tuberculosis (TB) cases in England occur among non-UK born individuals, mostly as a result of reactivation of latent TB infection (LTBI). Programmatic LTBI screening is a key intervention of the TB strategy for England. This article ... ...

Abstract	Approximately 72% of tuberculosis (TB) cases in England occur among non-UK born individuals, mostly as a result of reactivation of latent TB infection (LTBI). Programmatic LTBI screening is a key intervention of the TB strategy for England. This article reviews the results of a long-standing LTBI screening initiative in England.A retrospective cohort was created through probabilistic linkage between LTBI screening data and national TB case notifications. Screened persons were followed until they died, became a case, emigrated or until cohort-end. TB incidence rates and rate ratios (IRR) were calculated.97 out of 1820 individuals screened for LTBI were reported to have active TB. Crude incidence rates among LTBI-positive, treatment-naïve individuals were 4.1 and 2.3 per 100 person-years in the QuantiFERON and tuberculin skin test cohorts, respectively. Among the QuantiFERON cohort, Poisson regression showed that LTBI positivity (IRR 22.6, 95% CI 6.8-74.6) and no chemoprophylaxis increased the probability of becoming a TB case (IRR 0.17, 95% CI 0.05-0.6).We found high TB rates in LTBI-positive, treatment-naïve individuals and a strong association between no treatment and becoming a TB case, demonstrating feasibility and effectiveness of LTBI screening and providing important policy lessons for LTBI screening in England and beyond.
MeSH term(s)	Adult ; Databases, Factual ; England/epidemiology ; Female ; Humans ; Interferon-gamma/blood ; Latent Tuberculosis/blood ; Latent Tuberculosis/diagnosis ; Latent Tuberculosis/epidemiology ; Male ; Mass Screening ; Multivariate Analysis ; Regression Analysis ; Retrospective Studies ; Tuberculin Test ; Young Adult
Chemical Substances	IFNG protein, human ; Interferon-gamma (82115-62-6)
Language	English
Publishing date	2017
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/13993003.02505-2016
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Article ; Online: Rethinking TB screening: politics, practicalities and the press.

Moore-Gillon, J / Davies, Peter D O / Ormerod, L Peter

Thorax

2010 Volume 65, Issue 8, Page(s) 663–665

MeSH term(s)	Emigrants and Immigrants ; Humans ; Mass Media ; Mass Screening/methods ; Mass Screening/organization & administration ; Politics ; Tuberculosis, Pulmonary/diagnosis
Language	English
Publishing date	2010-08
Publishing country	England
Document type	Editorial
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thx.2009.132373
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Article ; Online: Increasing reports of non-tuberculous mycobacteria in England, Wales and Northern Ireland, 1995-2006.

Moore, Jonathan E / Kruijshaar, Michelle E / Ormerod, L Peter / Drobniewski, Francis / Abubakar, Ibrahim

BMC public health

2010 Volume 10, Page(s) 612

Abstract: Background: Non-tuberculous mycobacteria have long been identified as capable of causing human disease and the number at risk, due to immune-suppression, is rising. Several reports have suggested incidence to be increasing, yet routine surveillance- ... ...

Abstract	Background: Non-tuberculous mycobacteria have long been identified as capable of causing human disease and the number at risk, due to immune-suppression, is rising. Several reports have suggested incidence to be increasing, yet routine surveillance-based evidence is lacking. We investigated recent trends in, and the epidemiology of, non-tuberculous mycobacterial infections in England, Wales and Northern Ireland, 1995-2006. Methods: Hospital laboratories voluntarily report non-tuberculous mycobacterial infections to the Health Protection Agency Centre for Infections. Details reported include age and sex of the patient, species, specimen type and source laboratory. All reports were analysed. Results: The rate of non-tuberculous mycobacteria reports rose from 0.9 per 100,000 population in 1995 to 2.9 per 100,000 in 2006 (1608 reports). Increases were mainly in pulmonary specimens and people aged 60+ years. The most commonly reported species was Mycobacterium avium-intracellulare (43%); M. malmoense and M. kansasii were also commonly reported. M. gordonae showed the biggest increase over the study period rising from one report in 1995 to 153 in 2006. Clinical information was rarely reported. Conclusions: The number and rate of reports increased considerably between 1995 and 2006, primarily in older age groups and pulmonary specimens. Increases in some species are likely to be artefacts but real changes in more pathogenic species, some of which will require clinical care, should not be excluded. Enhanced surveillance is needed to understand the true epidemiology of these infections and their impact on human health.
MeSH term(s)	Adult ; Female ; Humans ; Laboratories, Hospital ; Male ; Mandatory Reporting ; Middle Aged ; Mycobacterium/classification ; Mycobacterium/isolation & purification ; Mycobacterium/pathogenicity ; Mycobacterium Infections/epidemiology ; Population Surveillance ; United Kingdom/epidemiology
Language	English
Publishing date	2010-10-15
Publishing country	England
Document type	Journal Article
ISSN	1471-2458
ISSN (online)	1471-2458
DOI	10.1186/1471-2458-10-612
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Article ; Online: Screening of immigrants in the UK for imported latent tuberculosis: a multicentre cohort study and cost-effectiveness analysis.

Pareek, Manish / Watson, John P / Ormerod, L Peter / Kon, Onn Min / Woltmann, Gerrit / White, Peter J / Abubakar, Ibrahim / Lalvani, Ajit

The Lancet. Infectious diseases

2011 Volume 11, Issue 6, Page(s) 435–444

Abstract: Background: Continuing rises in tuberculosis notifications in the UK are attributable to cases in foreign-born immigrants. National guidance for immigrant screening is hampered by a lack of data about the prevalence of, and risk factors for, latent ... ...

Abstract	Background: Continuing rises in tuberculosis notifications in the UK are attributable to cases in foreign-born immigrants. National guidance for immigrant screening is hampered by a lack of data about the prevalence of, and risk factors for, latent tuberculosis infection in immigrants. We aimed to determine the prevalence of latent infection in immigrants to the UK to define which groups should be screened and to quantify cost-effectiveness. Methods: In our multicentre cohort study and cost-effectiveness analysis we analysed demographic and test results from three centres in the UK (from 2008 to 2010) that used interferon-γ release-assay (IGRA) to screen immigrants aged 35 years or younger for latent tuberculosis infection. We assessed factors associated with latent infection by use of logistic regression and calculated the yields and cost-effectiveness of screening at different levels of tuberculosis incidence in immigrants' countries of origin with a decision analysis model. Findings: Results for IGRA-based screening were positive in 245 of 1229 immigrants (20%), negative in 982 (80%), and indeterminate in two (0·2%). Positive results were independently associated with increases in tuberculosis incidence in immigrants' countries of origin (p=0·0006), male sex (p = 0·046), and age (p < 0·0001). National policy thus far would fail to detect 71% of individuals with latent infection. The two most cost-effective strategies were to screen individuals from countries with a tuberculosis incidence of more than 250 cases per 100,000 (incremental cost-effectiveness ratio [ICER] was £17,956 [£1=US$1·60] per prevented case of tuberculosis) and at more than 150 cases per 100,000 (including immigrants from the Indian subcontinent), which identified 92% of infected immigrants and prevented an additional 29 cases at an ICER of £20,819 per additional case averted. Interpretation: Screening for latent infection can be implemented cost-effectively at a level of incidence that identifies most immigrants with latent tuberculosis, thereby preventing substantial numbers of future cases of active tuberculosis. Funding: Medical Research Council and Wellcome Trust.
MeSH term(s)	Adolescent ; Adult ; Child ; Child, Preschool ; Cohort Studies ; Cost-Benefit Analysis ; Decision Trees ; Emigrants and Immigrants ; Female ; Humans ; Incidence ; Interferon-gamma/blood ; Latent Tuberculosis/diagnosis ; Latent Tuberculosis/economics ; Latent Tuberculosis/epidemiology ; Male ; Mass Screening/economics ; Mass Screening/methods ; Prevalence ; Prospective Studies ; Regression Analysis ; United Kingdom/epidemiology ; Young Adult
Chemical Substances	Interferon-gamma (82115-62-6)
Language	English
Publishing date	2011-04-20
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(11)70069-X
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Article ; Online: Percutaneous Device Closure of Paravalvular Leak: Combined Experience From the United Kingdom and Ireland.

Calvert, Patrick A / Northridge, David B / Malik, Iqbal S / Shapiro, Leonard / Ludman, Peter / Qureshi, Shakeel A / Mullen, Michael / Henderson, Robert / Turner, Mark / Been, Martin / Walsh, Kevin P / Casserly, Ivan / Morrison, Lindsay / Walker, Nicola L / Thomson, John / Spence, Mark S / Mahadevan, Vaikom S / Hoye, Angela / MacCarthy, Philip A /

Daniels, Matthew J / Clift, Paul / Davies, William R / Adamson, Philip D / Morgan, Gareth / Aggarwal, Suneil K / Ismail, Yasmin / Ormerod, Julian O M / Khan, Habib R / Chandran, Sujay Subash / de Giovanni, Joseph / Rana, Bushra S / Ormerod, Oliver / Hildick-Smith, David

Circulation

2016 Volume 134, Issue 13, Page(s) 934–944

Abstract: Background: Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery.: Methods: All UK and Ireland centers undertaking percutaneous PVL ... ...

Abstract	Background: Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery. Methods: All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data were analyzed for association with death and major adverse cardiovascular events (MACE) at follow-up. Results: Three hundred eight PVL closure procedures were attempted in 259 patients in 20 centers (2004-2015). Patient age was 67±13 years; 28% were female. The main indications for closure were heart failure (80%) and hemolysis (16%). Devices were successfully implanted in 91% of patients, via radial (7%), femoral arterial (52%), femoral venous (33%), and apical (7%) approaches. Nineteen percent of patients required repeat procedures. The target valve was mitral (44%), aortic (48%), both (2%), pulmonic (0.4%), or transcatheter aortic valve replacement (5%). Preprocedural leak was severe (61%), moderate (34%), or mild (5.7%) and was multiple in 37%. PVL improved postprocedure (P<0.001) and was none (33.3%), mild (41.4%), moderate (18.6%), or severe (6.7%) at last follow-up. Mean New York Heart Association class improved from 2.7±0.8 preprocedure to 1.6±0.8 (P<0.001) after a median follow-up of 110 (7-452) days. Hospital mortality was 2.9% (elective), 6.8% (in-hospital urgent), and 50% (emergency) (P<0.001). MACE during follow-up included death (16%), valve surgery (6%), late device embolization (0.4%), and new hemolysis requiring transfusion (1.6%). Mitral PVL was associated with higher MACE (hazard ratio [HR], 1.83; P=0.011). Factors independently associated with death were the degree of persisting leak (HR, 2.87; P=0.037), New York Heart Association class (HR, 2.00; P=0.015) at follow-up and baseline creatinine (HR, 8.19; P=0.001). The only factor independently associated with MACE was the degree of persisting leak at follow-up (HR, 3.01; P=0.002). Conclusion: Percutaneous closure of PVL is an effective procedure that improves PVL severity and symptoms. Severity of persisting leak at follow-up is independently associated with both MACE and death. Percutaneous closure should be considered as an alternative to repeat surgery.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cardiac Catheterization/methods ; Female ; Heart Failure/etiology ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/methods ; Humans ; Ireland ; Male ; Middle Aged ; Mitral Valve/surgery ; Postoperative Complications/etiology ; Prosthesis Failure/adverse effects ; Reoperation/methods ; Transcatheter Aortic Valve Replacement/methods ; United Kingdom
Language	English
Publishing date	2016-09-01
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	80099-5
ISSN	1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
ISSN (online)	1524-4539
ISSN	0009-7322 ; 0069-4193 ; 0065-8499
DOI	10.1161/CIRCULATIONAHA.116.022684
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