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  1. AU="Samyra R Cox"
  2. AU="Steffan‐Dewenter, Ingolf"
  3. AU="Mostafa Ahmed Khairy"
  4. AU=Wilkes M S
  5. AU="Zhong, Baichang"
  6. AU="Kirsch, Harald"
  7. AU=Gibson Spencer J

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  1. Artikel ; Online: Integrating services for HIV and multidrug-resistant tuberculosis

    Kathrin Zürcher / Samyra R. Cox / Marie Ballif / Leslie A. Enane / Olivier Marcy / Marcel Yotebieng / Gary Reubenson / Worarat Imsanguan / Larissa Otero / Nishi Suryavanshi / Stephany N. Duda / Matthias Egger / Jeffrey A. Tornheim / Lukas Fenner

    PLOS Global Public Health, Vol 2, Iss

    A global cross-sectional survey among ART clinics in low- and middle-income countries

    2022  Band 3

    Abstract: Tuberculosis (TB) is the leading cause of death among PLHIV and multidrug-resistant-TB (MDR-TB) is associated with high mortality. We examined the management for adult PLHIV coinfected with MDR-TB at ART clinics in lower income countries. Between 2019 ... ...

    Abstract Tuberculosis (TB) is the leading cause of death among PLHIV and multidrug-resistant-TB (MDR-TB) is associated with high mortality. We examined the management for adult PLHIV coinfected with MDR-TB at ART clinics in lower income countries. Between 2019 and 2020, we conducted a cross-sectional survey at 29 ART clinics in high TB burden countries within the global IeDEA network. We used structured questionnaires to collect clinic-level data on the TB and HIV services and the availability of diagnostic tools and treatment for MDR-TB. Of 29 ART clinics, 25 (86%) were in urban areas and 19 (66%) were tertiary care clinics. Integrated HIV-TB services were reported at 25 (86%) ART clinics for pan-susceptible TB, and 14 (48%) clinics reported full MDR-TB services on-site, i.e. drug susceptibility testing [DST] and MDR-TB treatment. Some form of DST was available on-site at 22 (76%) clinics, while the remainder referred testing off-site. On-site DST for second-line drugs was available at 9 (31%) clinics. MDR-TB treatment was delivered on-site at 15 (52%) clinics, with 10 individualizing treatment based on DST results and five using standardized regimens alone. Bedaquiline was routinely available at 5 (17%) clinics and delamanid at 3 (10%) clinics. Although most ART clinics reported having integrated HIV and TB services, few had fully integrated MDR-TB services. There is a continued need for increased access to diagnostic and treatment options for MDR-TB patients and better integration of MDR-TB services into the HIV care continuum.
    Schlagwörter Public aspects of medicine ; RA1-1270
    Thema/Rubrik (Code) 700
    Sprache Englisch
    Erscheinungsdatum 2022-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Integrating services for HIV and multidrug-resistant tuberculosis

    Kathrin Zürcher / Samyra R Cox / Marie Ballif / Leslie A Enane / Olivier Marcy / Marcel Yotebieng / Gary Reubenson / Worarat Imsanguan / Larissa Otero / Nishi Suryavanshi / Stephany N Duda / Matthias Egger / Jeffrey A Tornheim / Lukas Fenner / International Epidemiology Databases to Evaluate AIDS (IeDEA)

    PLOS Global Public Health, Vol 2, Iss 3, p e

    A global cross-sectional survey among ART clinics in low- and middle-income countries.

    2022  Band 0000180

    Abstract: Tuberculosis (TB) is the leading cause of death among PLHIV and multidrug-resistant-TB (MDR-TB) is associated with high mortality. We examined the management for adult PLHIV coinfected with MDR-TB at ART clinics in lower income countries. Between 2019 ... ...

    Abstract Tuberculosis (TB) is the leading cause of death among PLHIV and multidrug-resistant-TB (MDR-TB) is associated with high mortality. We examined the management for adult PLHIV coinfected with MDR-TB at ART clinics in lower income countries. Between 2019 and 2020, we conducted a cross-sectional survey at 29 ART clinics in high TB burden countries within the global IeDEA network. We used structured questionnaires to collect clinic-level data on the TB and HIV services and the availability of diagnostic tools and treatment for MDR-TB. Of 29 ART clinics, 25 (86%) were in urban areas and 19 (66%) were tertiary care clinics. Integrated HIV-TB services were reported at 25 (86%) ART clinics for pan-susceptible TB, and 14 (48%) clinics reported full MDR-TB services on-site, i.e. drug susceptibility testing [DST] and MDR-TB treatment. Some form of DST was available on-site at 22 (76%) clinics, while the remainder referred testing off-site. On-site DST for second-line drugs was available at 9 (31%) clinics. MDR-TB treatment was delivered on-site at 15 (52%) clinics, with 10 individualizing treatment based on DST results and five using standardized regimens alone. Bedaquiline was routinely available at 5 (17%) clinics and delamanid at 3 (10%) clinics. Although most ART clinics reported having integrated HIV and TB services, few had fully integrated MDR-TB services. There is a continued need for increased access to diagnostic and treatment options for MDR-TB patients and better integration of MDR-TB services into the HIV care continuum.
    Schlagwörter Public aspects of medicine ; RA1-1270
    Thema/Rubrik (Code) 700
    Sprache Englisch
    Erscheinungsdatum 2022-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel ; Online: Tuberculosis (TB) Aftermath

    Samyra R. Cox / Abhay Kadam / Sachin Atre / Akshay N. Gupte / Hojoon Sohn / Nikhil Gupte / Trupti Sawant / Vishal Mhadeshwar / Ryan Thompson / Emily Kendall / Christopher Hoffmann / Nishi Suryavanshi / Deanna Kerrigan / Srikanth Tripathy / Arjunlal Kakrani / Madhusudan S. Barthwal / Vidya Mave / Jonathan E. Golub / on behalf of the TB Aftermath study team

    Trials, Vol 23, Iss 1, Pp 1-

    study protocol for a hybrid type I effectiveness-implementation non-inferiority randomized trial in India comparing two active case finding (ACF) strategies among individuals treated for TB and their household contacts

    2022  Band 16

    Abstract: Abstract Background Approximately 7% of all reported tuberculosis (TB) cases each year are recurrent, occurring among people who have had TB in the recent or distant past. TB recurrence is particularly common in India, which has the largest TB burden ... ...

    Abstract Abstract Background Approximately 7% of all reported tuberculosis (TB) cases each year are recurrent, occurring among people who have had TB in the recent or distant past. TB recurrence is particularly common in India, which has the largest TB burden worldwide. Although patients recently treated for TB are at high risk of developing TB again, evidence around effective active case finding (ACF) strategies in this population is scarce. We will conduct a hybrid type I effectiveness-implementation non-inferiority randomized trial to compare the effectiveness, cost-effectiveness, and feasibility of two ACF strategies among individuals who have completed TB treatment and their household contacts (HHCs). Methods We will enroll 1076 adults (≥ 18 years) who have completed TB treatment at a public TB unit (TU) in Pune, India, along with their HHCs (averaging two per patient, n = 2152). Participants will undergo symptom-based ACF by existing healthcare workers (HCWs) at 6-month intervals and will be randomized to either home-based ACF (HACF) or telephonic ACF (TACF). Symptomatic participants will undergo microbiologic testing through the program. Asymptomatic HHCs will be referred for TB preventive treatment (TPT) per national guidelines. The primary outcome is rate per 100 person-years of people diagnosed with new or recurrent TB by study arm, within 12 months following treatment completion. The secondary outcome is proportion of HHCs < 6 years, by study arm, initiated on TPT after ruling out TB disease. Study staff will collect socio-demographic and clinical data to identify risk factors for TB recurrence and will measure post-TB lung impairment. In both arms, an 18-month “mop-up” visit will be conducted to ascertain outcomes. We will use the RE-AIM framework to characterize implementation processes and explore acceptability through in-depth interviews with index patients, HHCs and HCWs (n = 100). Cost-effectiveness will be assessed by calculating the incremental cost per TB case detected within 12 months and ...
    Schlagwörter Tuberculosis ; Recurrence ; Active case finding ; India ; Hybrid effectiveness-implementation trial ; Medicine (General) ; R5-920
    Thema/Rubrik (Code) 380
    Sprache Englisch
    Erscheinungsdatum 2022-08-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  4. Artikel ; Online: Tuberculosis preventive treatment should be considered for all household contacts of pulmonary tuberculosis patients in India.

    Mandar Paradkar / Chandrasekaran Padmapriyadarsini / Divyashri Jain / Shri Vijay Bala Yogendra Shivakumar / Kannan Thiruvengadam / Akshay N Gupte / Beena Thomas / Aarti Kinikar / Krithika Sekar / Renu Bharadwaj / Chandra Kumar Dolla / Sanjay Gaikwad / S Elilarasi / Rahul Lokhande / Devarajulu Reddy / Lakshmi Murali / Vandana Kulkarni / Neeta Pradhan / Luke Elizabeth Hanna /
    Sathyamurthi Pattabiraman / Rewa Kohli / Rani S / Nishi Suryavanshi / Shrinivasa B M / Samyra R Cox / Sriram Selvaraju / Nikhil Gupte / Vidya Mave / Amita Gupta / Robert C Bollinger / CTRIUMPH-RePORT India Study Team

    PLoS ONE, Vol 15, Iss 7, p e

    2020  Band 0236743

    Abstract: The World Health Organization (WHO) recently changed its guidance for tuberculosis (TB) preventive treatment (TPT) recommending TPT for all pulmonary TB (PTB) exposed household contacts (HHC) to prevent incident TB disease (iTBD), regardless of TB ... ...

    Abstract The World Health Organization (WHO) recently changed its guidance for tuberculosis (TB) preventive treatment (TPT) recommending TPT for all pulmonary TB (PTB) exposed household contacts (HHC) to prevent incident TB disease (iTBD), regardless of TB infection (TBI) status. However, this recommendation was conditional as the strength of evidence was not strong. We assessed risk factors for iTBD in recently-exposed adult and pediatric Indian HHC, to determine which HHC subgroups might benefit most from TPT. We prospectively enrolled consenting HHC of adult PTB patients in Pune and Chennai, India. They underwent clinical, microbiologic and radiologic screening for TB disease (TBD) and TBI, at enrollment, 4-6, 12 and 24 months. TBI testing was performed by tuberculin skin test (TST) and Quantiferon®- Gold-in-Tube (QGIT) assay. HHC without baseline TBD were followed for development of iTBI and iTBD. Using mixed-effect Poisson regression, we assessed baseline characteristics including TBI status, and incident TBI (iTBI) using several TST and/or QGIT cut-offs, as potential risk factors for iTBD. Of 1051 HHC enrolled, 42 (4%) with baseline TBD and 12 (1%) with no baseline TBI test available, were excluded. Of the remaining 997 HHC, 707 (71%) had baseline TBI (TST #x2265; 5 mm or QGIT #x2265; 0.35 IU/ml). Overall, 20 HHC (2%) developed iTBD (12 cases/1000 person-years, 95%CI: 8-19). HIV infection (aIRR = 29.08, 95% CI: 2.38-355.77, p = 0.01) and undernutrition (aIRR = 6.16, 95% CI: 1.89-20.03, p = 0.003) were independently associated with iTBD. iTBD was not associated with age, diabetes mellitus, smoking, alcohol, and baseline TBI, or iTBI, regardless of TST (#x2265; 5 mm, #x2265; 10 mm, #x2265; 6 mm increase) or QGIT (#x2265; 0.35 IU/ml, #x2265; 0.7 IU/ml) cut-offs. Given the high overall risk of iTBD among recently exposed HHCs, and the lack of association between TBI status and iTBD, our findings support the new WHO recommendation to offer TPT to all HHC of PTB patients residing in a high TB burden country such as ...
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2020-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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