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Ajouter le résultat dans votre panier Affiner la rechercheAnnual tobacco related deaths expected to reach 10 million by 2030 / International Union Against Tuberculosis and Lung Disease (09/11/2007)
Titre : Annual tobacco related deaths expected to reach 10 million by 2030 : health experts gather in South Africa to urge global fight against tobacco use Type de document : texte imprimé Auteurs : International Union Against Tuberculosis and Lung Disease, Auteur Année de publication : 09/11/2007 Langues : Anglais (eng) Catégories : [DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du Sud
[DIVERS] géographie:pays en développement
[DIVERS] personne:par sexe:femme
[NICO] économie du tabac
[NICO] tabagisme:pathologie:pathologie respiratoire:tuberculose pulmonaireIndex. décimale : TA 8.7 Coût du tabagisme (santé, pension, entreprise, incendie, assurances, déforestation…) Résumé : Presentations focus on tobacco economics practical skills for tobacco control in low-income countries, South Africa and international tobacco control women and tobacco in low-income countries, and tuberculosis and tobacco. Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=3037 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa / Nicolas A. Menzies (2016)
Titre : Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa : a combined analysis of nine models Type de document : document électronique Auteurs : Nicolas A. Menzies, Auteur ; Gabriela B. Gomez, Auteur ; Fiammetta Bozzani, Auteur Editeur : Elsevier Année de publication : 2016 Collection : Lancet Global Health num. vol. 4 issue 11 Importance : e816-e826 Présentation : graph. Langues : Anglais (eng) Catégories : [DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du Sud
[DIVERS] géographie:Asie:Asie du Sud:Inde
[DIVERS] géographie:Asie:Extrême-Orient:Chine
[TUBER] dépistage
[TUBER] étude:épidémiologie
[TUBER] traitement:traitement préventifIndex. décimale : TU 8.3. Traitement préventif Résumé : Background: The post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality by 75% by 2025. We aimed to assess resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa.
Methods: We examined intervention scenarios developed in consultation with country stakeholders, which scaled up existing interventions to high but feasible coverage by 2025. Nine independent modelling groups collaborated to estimate policy outcomes, and we estimated the cost of each scenario by synthesising service use estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health effects (ie, disability-adjusted life-years averted) and resource implications for 2016-35, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios with a base case representing continued current practice.
Findings: Incremental tuberculosis service costs differed by scenario and country, and in some cases they more than doubled existing funding needs. In general, expansion of tuberculosis services substantially reduced patient-incurred costs and, in India and China, produced net cost savings for most interventions under a societal perspective. In all three countries, expansion of access to care produced substantial health gains. Compared with current practice and conventional cost-effectiveness thresholds, most intervention approaches seemed highly cost-effective.
Interpretation: Expansion of tuberculosis services seems cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, although substantial new funding would be required. Further work to determine the optimal intervention mix for each country is necessary.
Funding: Bill & Melinda Gates Foundation.En ligne : https://doi.org/10.1016/s2214-109x(16)30265-0 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10857 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India : a combined analysis of 11 mathematical models Type de document : document électronique Auteurs : Rein MGJ Houben, Auteur ; Nicolas A. Menzies, Auteur ; Tom Sumner, Auteur Editeur : Elsevier Année de publication : 2016 Collection : Lancet Global Health num. vol. 4 issue 11 Importance : e806-e815 Présentation : graph. ; tab. Langues : Anglais (eng) Catégories : [DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du Sud
[DIVERS] géographie:Asie:Asie du Sud:Inde
[DIVERS] géographie:Asie:Extrême-Orient:Chine
[TUBER] dépistage
[TUBER] étude:épidémiologie
[TUBER] traitement:traitement préventifIndex. décimale : TU 8.3. Traitement préventif Résumé : Background
The post-2015 End TB Strategy proposes targets of 50% reduction in tuberculosis incidence and 75% reduction in mortality from tuberculosis by 2025. We aimed to assess whether these targets are feasible in three high-burden countries with contrasting epidemiology and previous programmatic achievements.
Methods
11 independently developed mathematical models of tuberculosis transmission projected the epidemiological impact of currently available tuberculosis interventions for prevention, diagnosis, and treatment in China, India, and South Africa. Models were calibrated with data on tuberculosis incidence and mortality in 2012. Representatives from national tuberculosis programmes and the advocacy community provided distinct country-specific intervention scenarios, which included screening for symptoms, active case finding, and preventive therapy.
Findings
Aggressive scale-up of any single intervention scenario could not achieve the post-2015 End TB Strategy targets in any country. However, the models projected that, in the South Africa national tuberculosis programme scenario, a combination of continuous isoniazid preventive therapy for individuals on antiretroviral therapy, expanded facility-based screening for symptoms of tuberculosis at health centres, and improved tuberculosis care could achieve a 55% reduction in incidence (range 31–62%) and a 72% reduction in mortality (range 64–82%) compared with 2015 levels. For India, and particularly for China, full scale-up of all interventions in tuberculosis-programme performance fell short of the 2025 targets, despite preventing a cumulative 3·4 million cases. The advocacy scenarios illustrated the high impact of detecting and treating latent tuberculosis.
Interpretation
Major reductions in tuberculosis burden seem possible with current interventions. However, additional interventions, adapted to country-specific tuberculosis epidemiology and health systems, are needed to reach the post-2015 End TB Strategy targets at country level.
Funding
Bill and Melinda Gates FoundationEn ligne : https://doi.org/10.1016/s2214-109x(16)30199-1 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10856 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
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Titre : Outcomes, infectiousness, and transmission dynamics of patients with extensively drug-resistant tuberculosis and home-discharged patients with programmatically incurable tuberculosis : a prospective cohort study Type de document : document électronique Auteurs : Keertan Dheda, Auteur ; Jason D. Limberis, Auteur ; Elize Pietersen, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. vol. 5 Importance : p.269-281 Présentation : ill. ; graph. ; tab. Langues : Anglais (eng) Catégories : [TUBER] étude:épidémiologie
[TUBER] traitement:résistance:multirésistance
[TUBER] traitement:traitement curatif
[DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du SudIndex. décimale : TU 4.1. MDR (Multi Drug Resistance) / XDR (X-treme Drug Resistance) Résumé : Background
The emergence of programmatically incurable tuberculosis threatens to destabilise control efforts. The aim of this study was to collect prospective patient-level data to inform treatment and containment strategies.
Methods
In a prospective cohort study, 273 South African patients with extensively drug-resistant tuberculosis, or resistance beyond extensively drug-resistant tuberculosis, were followed up over a period of 6 years. Transmission dynamics, infectiousness, and drug susceptibility were analysed in a subset of patients from the Western Cape using whole-genome sequencing (WGS; n=149), a cough aerosol sampling system (CASS; n=26), and phenotypic testing for 18 drugs (n=179).
Findings
Between Oct 1, 2008, and Oct 31, 2012, we enrolled and followed up 273 patients for a median of 20·3 months (IQR 9·6–27·8). 203 (74%) had programmatically incurable tuberculosis and unfavourable outcomes (treatment failure, relapse, default, or death despite treatment with a regimen based on capreomycin, aminosalicylic acid, or both). 172 (63%) patients were discharged home, of whom 104 (60%) had an unfavourable outcome. 54 (31%) home-discharged patients had failed treatment, with a median time to death after discharge of 9·9 months (IQR 4·2–17·4). 35 (20%) home-discharged cases were smear-positive at discharge. Using CASS, six (23%) of 26 home-discharged cases with data available expectorated infectious culture-positive cough aerosols in the respirable range (<5 μm), and most reported inter-person contact with suboptimal protective mask usage. WGS identified 17 (19%) of the 90 patients (with available sequence data) that were discharged home before the diagnosis of 20 downstream cases of extensively drug-resistant tuberculosis with almost identical sequencing profiles suggestive of community-based transmission (five or fewer single nucleotide polymorphisms different and with identical resistance-encoding mutations for 14 drugs). 11 (55%) of these downstream cases had HIV co-infection and ten (50%) had died by the end of the study. 22 (56%) of 39 isolates in patients discharged home after treatment failure were resistant to eight or more drugs. However, five (16%) of 31 isolates were susceptible to rifabutin and more than 90% were likely to be sensitive to linezolid, bedaquiline, and delamanid.
Interpretation
More than half of the patients with programmatically incurable tuberculosis were discharged into the community where they remained for an average of 16 months, were at risk of expectorating infectious cough aerosols, and posed a threat of transmission of extensively drug-resistant tuberculosis. Urgent action, including appropriate containment strategies, is needed to address this situation. Access to delamanid, bedaquiline, linezolid, and rifabutin, when appropriate, must be accelerated along with comprehensive drug susceptibility testing.En ligne : http://dx.doi.org/10.1016/S2213-2600(16)30433-7 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10909 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Population-based resistance of Mycobacterium tuberculosis isolates to pyrazinamide and fluoroquinolones : results from a multicountry surveillance project Type de document : document électronique Auteurs : Matteo Zignol, Auteur ; Anna Dean, Auteur ; Natavan Alikhanova, Auteur Editeur : Lancet Année de publication : 2016 Collection : The Lancet Infectious diseases, ISSN 1473-3099 num. 16(10) Importance : p. 1185–1192 Langues : Anglais (eng) Catégories : [DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du Sud
[DIVERS] géographie:Europe:Europe centrale et orientale
[TUBER] traitement:résistance
[TUBER] traitement:traitement curatif
[PROMOSAN] étude:enquêteIndex. décimale : TU 8.2. Traitement curatif Résumé : Background
Pyrazinamide and fluoroquinolones are essential antituberculosis drugs in new rifampicin-sparing regimens. However, little information about the extent of resistance to these drugs at the population level is available.
Methods
In a molecular epidemiology analysis, we used population-based surveys from Azerbaijan, Bangladesh, Belarus, Pakistan, and South Africa to investigate resistance to pyrazinamide and fluoroquinolones among patients with tuberculosis. Resistance to pyrazinamide was assessed by gene sequencing with the detection of resistance-conferring mutations in the pncA gene, and susceptibility testing to fluoroquinolones was conducted using the MGIT system.
Findings
Pyrazinamide resistance was assessed in 4972 patients. Levels of resistance varied substantially in the surveyed settings (3·0–42·1%). In all settings, pyrazinamide resistance was significantly associated with rifampicin resistance. Among 5015 patients who underwent susceptibility testing to fluoroquinolones, proportions of resistance ranged from 1·0–16·6% for ofloxacin, to 0·5–12·4% for levofloxacin, and 0·9–14·6% for moxifloxacin when tested at 0·5 μg/mL. High levels of ofloxacin resistance were detected in Pakistan. Resistance to moxifloxacin and gatifloxacin
when tested at 2 μg/mL was low in all countries.
Interpretation
Although pyrazinamide resistance was significantly associated with rifampicin resistance, this drug may still be effective in 19–63% of patients with rifampicin-resistant tuberculosis. Even though the high level of resistance to ofloxacin found in Pakistan is worrisome because it might be the expression of extensive and unregulated use of fluoroquinolones in some parts of Asia, the negligible levels of resistance to fourth-generation fluoroquinolones documented in all survey sites is an encouraging finding. Rational use of this class of antibiotics should therefore be ensured to preserve its effectiveness.En ligne : https://doi.org/10.1016/S1473-3099(16)30190-6 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10783 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Les Sud-Africains libres de fumer un joint en privé Type de document : texte imprimé Auteurs : Valérie Hirsch, Auteur Editeur : Rossel Année de publication : 19 septembre 2018 Collection : Le Soir Importance : p.13 Langues : Français (fre) Catégories : [NICO] tabagisme:aspect social:liberté de fumer
[DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du SudIndex. décimale : TA 9.3 Législation européenne et mondiale Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=8774 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis Type de document : document électronique Auteurs : Keertan Dheda, Auteur ; Tawanda Gumbo, Auteur ; Gary Maartens, Auteur Editeur : Lancet Année de publication : 2017 Collection : The Lancet Respiratory Medicine, ISSN 2213-2600 num. vol. 5 Importance : p.291-360 Présentation : ill. ; graph. ; tab. Langues : Anglais (eng) Catégories : [TUBER] étude:épidémiologie
[TUBER] traitement:résistance:multirésistance
[TUBER] traitement:traitement curatif
[DIVERS] géographie:Afrique:Afrique subsaharienne:Afrique du SudIndex. décimale : TU 4.1. MDR (Multi Drug Resistance) / XDR (X-treme Drug Resistance) Résumé : Global tuberculosis incidence has declined marginally over the past decade, and tuberculosis remains out of control in several parts of the world including Africa and Asia. Although tuberculosis control has been effective in some regions of the world, these gains are threatened by the increasing burden of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. XDR tuberculosis has evolved in several tuberculosis-endemic countries to drug-incurable or programmatically incurable tuberculosis (totally drug-resistant tuberculosis). This poses several challenges similar to those encountered in the pre-chemotherapy era, including the inability to cure tuberculosis, high mortality, and the need for alternative methods to prevent disease transmission. This phenomenon mirrors the worldwide increase in antimicrobial resistance and the emergence of other MDR pathogens, such as malaria, HIV, and Gram-negative bacteria. MDR and XDR tuberculosis are associated with high morbidity and substantial mortality, are a threat to health-care workers, prohibitively expensive to treat, and are therefore a serious public health problem. In this Commission, we examine several aspects of drug-resistant tuberculosis. The traditional view that acquired resistance to antituberculous drugs is driven by poor compliance and programmatic failure is now being questioned, and several lines of evidence suggest that alternative mechanisms—including pharmacokinetic variability, induction of efflux pumps that transport the drug out of cells, and suboptimal drug penetration into tuberculosis lesions—are likely crucial to the pathogenesis of drug-resistant tuberculosis. These factors have implications for the design of new interventions, drug delivery and dosing mechanisms, and public health policy. We discuss epidemiology and transmission dynamics, including new insights into the fundamental biology of transmission, and we review the utility of newer diagnostic tools, including molecular tests and next-generation whole-genome sequencing, and their potential for clinical effectiveness. Relevant research priorities are highlighted, including optimal medical and surgical management, the role of newer and repurposed drugs (including bedaquiline, delamanid, and linezolid), pharmacokinetic and pharmacodynamic considerations, preventive strategies (such as prophylaxis in MDR and XDR contacts), palliative and patient-orientated care aspects, and medicolegal and ethical issues. En ligne : http://dx.doi.org/10.1016/S2213-2600(17)30079-6 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10910 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
