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Article ; Online: Treatment Strategy for Rifampin-Susceptible Tuberculosis.

Burman, William / Fox, Greg J / Horsburgh, C Robert

2023 Volume 388, Issue 24, Page(s) 2296–2297

MeSH term(s)	Humans ; Rifampin/therapeutic use ; Tuberculosis/drug therapy
Chemical Substances	Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2023-06-14
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2304776
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Article: Ethical health security in the age of antimicrobial resistance.

Pahlman, Kari / Fehross, Anson / Fox, Greg J / Silva, Diego S

BMJ global health

2022 Volume 7, Issue 1

Abstract: Objective: Owing to its potential human, social and economic costs, antimicrobial resistance (AMR) is frequently referred to as a threat to health security. Simultaneously, health security and the preservation of antimicrobials are often described as a ... ...

Abstract	Objective: Owing to its potential human, social and economic costs, antimicrobial resistance (AMR) is frequently referred to as a threat to health security. Simultaneously, health security and the preservation of antimicrobials are often described as a global public good. However, how the term 'public good' is used in the context of health security, and the values that underpin it, remains ambiguous. Policymaking is never value-free, and a better examination of such values is critical to understanding how issues such as AMR are problematised and how policy decisions are informed. Design: We used McDougall's version of critical interpretive synthesis to capture the recurring concepts and arguments within public policy, political science and applied ethics literature on AMR. Articles were analysed by identifying recurring ideas and developing themes across the literature. Results: A total of 77 papers were included in our review. In the context of health security and AMR, the concept of 'public good' appears to be used interchangeably with 'common good', reflecting confusion, but sometimes meaningful differences, regarding how antimicrobials, as a good, are conceived. Main approaches to addressing AMR are statism, globalism and regionalism, which appeal to different values in guiding policymakers. Common justificatory values underpinning preservation of antimicrobials as a public good were prevention of harm, solidarity, justice and rights. Conclusion: The findings suggest that within the literature there is a lack of conceptual clarity as to whether antimicrobials constitute a public good or a common good. Moreover, the way in which antimicrobials are conceived and the approaches through which AMR as a threat to health security is addressed appear to be grounded in values that are often implicit. Being explicit about the values that underpin AMR and health security is not simply an intellectual exercise but has very real policy and programmatic implications.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/pharmacology ; Drug Resistance, Bacterial ; Humans ; Policy ; Policy Making
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2022-01-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2021-007407
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Article ; Online: Epidemiological approach to ending tuberculosis in high-burden countries.

Marks, Guy B / Horsburgh, C Robert / Fox, Greg J / Nguyen, Thu Anh

Lancet (London, England)

2022 Volume 400, Issue 10365, Page(s) 1750–1752

MeSH term(s)	Humans ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control
Language	English
Publishing date	2022-08-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(22)01433-7
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Article ; Online: Health system barriers to the implementation of the national action plan to combat antimicrobial resistance in Vietnam: a scoping review.

Pham, Giang N / Dang, Tho T H / Nguyen, Thu-Anh / Zawahir, Shukry / Le, Hien T T / Negin, Joel / Schneider, Carmen Huckel / Fox, Greg J

Antimicrobial resistance and infection control

2024 Volume 13, Issue 1, Page(s) 12

Abstract: Background: Vietnam is among 11 countries in the Western Pacific region that has developed a National Action Plan for Antimicrobial Resistance (NAPCA).: Methods: This scoping review characterises health system barriers to the implementation of the ... ...

Abstract	Background: Vietnam is among 11 countries in the Western Pacific region that has developed a National Action Plan for Antimicrobial Resistance (NAPCA). Methods: This scoping review characterises health system barriers to the implementation of the Vietnam NAPCA, with reference to the WHO Health Systems Framework. Results: Over 7 years, between 2013 and 2020, the Ministry of Health (MOH) of Vietnam has been implementing activities to achieve the six NAPCA objectives. They include revision of regulations needed for antimicrobial resistance (AMR) prevention programs; formation and operation of national management bodies; improvement of antimicrobial stewardship (AMS) in hospitals; maintenance of surveillance systems for AMR; provision of trainings on AMR and antibiotics use to doctors and pharmacists; and organization of nation-wide educational campaigns. Limited cooperation between MOH management bodies, shortages of human resource at all health system levels, a low degree of agreement between national and hospital guidelines on antibiotic use, low capability in the domestic supply of standardised drugs, and unequal training opportunities for lower-level health professionals present ongoing challenges. Actions suggested for the next period of the NAPCA include a final review of what has been achieved by the plan so far and evaluating the effectiveness of the different components of the plan. Different options on how to improve coordination across sectors in the development of a new NAPCA should be put forward. Conclusions: The 6-year implementation of the Vietnam NAPCA has yielded valuable lessons for AMS in Vietnam, guiding the development of future national plans, with a central focus on scaling up AMS in hospitals and promoting community AMS programs to combat AMR.
MeSH term(s)	Humans ; Anti-Bacterial Agents/therapeutic use ; Vietnam ; Drug Resistance, Bacterial ; Health Personnel ; Pharmacists
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-01-25
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-024-01364-x
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Article ; Online: Community-wide Screening for Tuberculosis. Reply.

Marks, Guy B / Nguyen, Nhung V / Fox, Greg J

The New England journal of medicine

2020 Volume 382, Issue 12, Page(s) 1186

MeSH term(s)	Humans ; Mass Screening ; Tuberculosis
Language	English
Publishing date	2020-03-20
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc1916666
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Article: Latent tuberculosis infection among contacts of patients with multidrug-resistant tuberculosis in New South Wales, Australia.

Chang, Vicky / Ling, Raphael Hongxi / Velen, Kavindhran / Fox, Greg J

ERJ open research

2021 Volume 7, Issue 3

Abstract: Background: Contacts of an individual with active tuberculosis (TB) disease have a higher risk of developing latent TB infection (LTBI) or active TB disease. Contact tracing is a public health measure that seeks to identify exposed contacts, screen them ...

Abstract	Background: Contacts of an individual with active tuberculosis (TB) disease have a higher risk of developing latent TB infection (LTBI) or active TB disease. Contact tracing is a public health measure that seeks to identify exposed contacts, screen them for co-prevalent TB and consider prophylactic treatment to prevent progression from LTBI to active TB disease. The investigators sought to determine the prevalence of LTBI and active TB disease among contacts of patients with multidrug-resistant (MDR)-TB in New South Wales, Australia. Methodology: A retrospective cohort study was performed among the contacts of patients diagnosed with MDR-TB between 2000 and 2016, inclusive, at seven chest clinics. Medical records were used to identify eligible contacts. Outcomes of screening and prophylactic treatment regimens offered to MDR-TB contacts with LTBI were characterised. Collected data included demographic information, screening tests results and initial management. Results: In total, 247 contacts of 55 MDR-TB patients were identified. LTBI was identified in 105 contacts (42.5%). Preventive treatment was received by 20 contacts with LTBI (32.3%) in the form of various regimens, ranging from one to three antimicrobials, with various doses and durations. One contact with LTBI who was untreated progressed to active TB disease during the study period, according to clinic notes. Conclusion: Contacts of MDR-TB patients have a high prevalence of LTBI. Management of these contacts varies substantially in New South Wales, reflecting a lack of definitive evidence for preventive therapy. Further research is required to determine the optimal management of this population.
Language	English
Publishing date	2021-09-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2827830-6
ISSN	2312-0541
ISSN	2312-0541
DOI	10.1183/23120541.00149-2021
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Article ; Online: Treatment of multidrug-resistant or rifampicin-resistant tuberculosis with an all-oral 9-month regimen containing linezolid or ethionamide in South Africa: A retrospective cohort study.

Morgan, Hannah / Ndjeka, Norbert / Hasan, Tasnim / Gegia, Medea / Mirzayev, Fuad / Nguyen, Linh / Schumacher, Samuel / Schlub, Timothy E / Naidoo, Kogieleum / Fox, Greg J

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2024

Abstract: Background: In 2019, the South African tuberculosis program replaced ethionamide with linezolid as a part of an all-oral 9-month regimen. We evaluated treatment outcomes for patients assigned to regimens including linezolid in 2019 and ethionamide in ... ...

Abstract	Background: In 2019, the South African tuberculosis program replaced ethionamide with linezolid as a part of an all-oral 9-month regimen. We evaluated treatment outcomes for patients assigned to regimens including linezolid in 2019 and ethionamide in 2017. Method: This retrospective cohort study included patients treated for multi-drug resistant/rifampicin-resistant tuberculosis throughout South Africa between 1 Jan to 31 Dec 2017 and from 1 Jan to 31 Dec 2019. The cohort treated with a 9-month regimen containing ethionamide for four months, was compared with a cohort treated with a 9-month regimen containing linezolid for two months. The regimens were otherwise identical. Inverse probability weighting of propensity scores was used to adjust for potential confounding. A log-binomial regression model was used to estimate adjusted relative risk (aRR) comparing 24-month outcomes between cohorts including treatment success, death, loss to follow up, and treatment failure. Adverse event data were available for the linezolid cohort. Findings: 817 patients were included in the cohort receiving ethionamide and 4244 in the cohort receiving linezolid. No evidence for a difference was observed between linezolid and ethionamide regimens for treatment success (aRR = 0·96, 95%CI 0·91-1·01), death (aRR = 1·01, 95%CI 0·87-1·17) or treatment failure (aRR = 0·87, 95%CI 0·44-1·75). Loss to follow up was more common in the linezolid group, although estimates were imprecise (aRR = 1·22, 95%CI 0·99-1·50). Interpretation: No significant differences in treatment success and survival were observed with substitution of linezolid for ethionamide as a part of an all-oral 9-month regimen. Linezolid is an acceptable alternative to ethionamide in this shorter regimen for treatment of multi-drug resistant/rifampicin resistant tuberculosis.
Language	English
Publishing date	2024-03-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciae145
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Article ; Online: The Effectiveness of Individual and Environmental Infection Control Measures in Reducing the Transmission of Mycobacterium tuberculosis: A Systematic Review.

Fox, Greg J / Redwood, Lisa / Chang, Vicky / Ho, Jennifer

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2020 Volume 72, Issue 1, Page(s) 15–26

Abstract: Background: Transmission of Mycobacterium tuberculosis in healthcare settings is a preventable driver of the global tuberculosis epidemic. We aimed to assess the evidence for infection control interventions, including cough etiquette, engineering and ... ...

Abstract	Background: Transmission of Mycobacterium tuberculosis in healthcare settings is a preventable driver of the global tuberculosis epidemic. We aimed to assess the evidence for infection control interventions, including cough etiquette, engineering and personal respiratory protection measures, to prevent transmission of M. tuberculosis in healthcare settings. Methods: Three independent systematic reviews were performed using 6 databases and clinical trials websites. Randomized trials, cohort studies, before-after studies, and case-control studies were included. Searches were performed for controlled studies evaluating respiratory hygiene, engineering, and personal respiratory protection measures. Outcome measures included the incidence of tuberculosis infection and disease. Studies involving transmission to either humans or animals were included. Results: Evaluation of respiratory hygiene and cough etiquette interventions identified 4 human studies, with 22 855 participants, and 1 guinea pig study. Studies in humans evaluated the effects of multiple concurrent interventions. Patient use of surgical masks reduced infection by 14.8%, and tuberculosis disease was reduced by between 0.5% and 28.9%. Engineering and environmental interventions were evaluated in 10 studies of humans, including 31 776 human participants, and 2 guinea pig studies. Mechanical ventilation was associated with between 2.9% and 14% less infection. Nine studies of personal respiratory protection were included, including 33 913 participants. Infection was reduced by between 0% and 14.8% in studies where particulate respirators were used. The quality of included studies was assessed as low. Conclusions: Respiratory hygiene, engineering, and environmental infection controls and personal respiratory protection interventions were associated with reduced transmission of M. tuberculosis and reduced tuberculosis disease in healthcare settings.
MeSH term(s)	Animals ; Guinea Pigs ; Humans ; Infection Control ; Infectious Disease Transmission, Patient-to-Professional ; Masks ; Mycobacterium tuberculosis ; Tuberculosis/epidemiology ; Tuberculosis/prevention & control
Language	English
Publishing date	2020-06-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa719
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Article: The Implementation of Mass-Vaccination against SARS-CoV-2: A Systematic Review of Existing Strategies and Guidelines.

Hasan, Tasnim / Beardsley, Justin / Marais, Ben J / Nguyen, Thu Anh / Fox, Greg J

Vaccines

2021 Volume 9, Issue 4

Abstract: The global drive to vaccinate against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) began in December 2020 with countries in Europe, Middle East, and North America leading the roll out of a mass-vaccination program. This systematic review ... ...

Abstract	The global drive to vaccinate against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) began in December 2020 with countries in Europe, Middle East, and North America leading the roll out of a mass-vaccination program. This systematic review synthesised all available English-language guidelines and research regarding mass-vaccination for COVID-19 until 1 March 2021-the first three months of the global mass-vaccination effort. Data were extracted from national websites, PubMed, Embase, Medline and medRxiv, including peer and non-peer review research findings. A total of 15 national policy documents were included. Policies were summarised according to the World Health Organisation (WHO) framework for mass vaccination. All included policies prioritised front-line health care workers and the elderly. Limited information was available regarding staffing, cold chain, communication strategies and infrastructure requirements for effective vaccine delivery. A total of 26 research studies were identified, reporting roll-out strategies, vaccine uptake and reasons for refusal, adverse effects, and real-life estimates of efficacy. Early data showed a reduction in SARS-CoV-2 cases, hospitalisation and deaths in settings with good coverage. Very low rates of vaccine-related serious adverse events were observed. These findings provide an overview of current practice and early outcomes of COVID-19 mass-vaccination, guiding countries where roll-out is yet to commence.
Language	English
Publishing date	2021-04-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines9040326
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Article ; Online: Experience in responding to COVID-19 outbreaks from Vietnam.

Nguyen, Thu Anh / Nguyen, Binh Thi Cam / Duong, Duyen Thi / Marks, Guy B / Fox, Greg J

The Lancet Regional Health. Western Pacific

2021 Volume 7, Page(s) 100077

Language	English
Publishing date	2021-01-29
Document type	Journal Article
ISSN	2666-6065
ISSN (online)	2666-6065
DOI	10.1016/j.lanwpc.2020.100077
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