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Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally. Structural mechanism for rifampicin inhibition of bacterial RNA polymerase.

3. Initiating treatment for latent tuberculosis

Kan M. Current status of tuberculosis in Taiwan. Crofton J, Mitchison D. Streptomycin resistance in pulmonary tuberculosis.

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Br Med J. An outbreak of multidrug-resistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome. N Engl J Med. An outbreak of tuberculosis caused by multiple-drug-resistant tubercle bacilli among patients with HIV infection. Ann Intern Med. International union against tuberculosis and lung disease.

Clin Infect Dis. Zhang Y, Telenti A. Genetics of drug resistance in Mycobacterium tuberculosis. Molecular Genetics of Mycobacteria. Influence of initial drug resistance on the response to short-course chemotherapy of pulmonary tuberculosis. Am Rev Respir Dis. Drug resistant Mycobacterium tuberculosis in Benue, Nigeria. Br Microbiol Res J. Evaluation of Mycobacterium tuberculosis drug susceptibility in clinical specimens from Nigeria using genotype mtbdrplus and mtbdrsl assays.

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Initial resistance of Mycobacterium tuberculosis in Northern Nigeria. Estimates of incidence [please see incidence indicator] are based on a consultative and analytical process in WHO and are published annually see reference 5. The DOTS detection rate for new smear-positive cases is calculated by dividing the number of new smear-positive cases treated in DOTS programmes and notified to WHO divided by the estimated number of incident smear-positive cases for the same year, expressed as a percentage. Estimates of incidence for additional details, please refer to the TB incidence indicator metadata are based on a consultative and analytical process lead by the WHO and are published annually.

References 1. Dye C et al. Global burden of tuberculosis: estimated incidence, prevalence and mortality by country. Journal of the American Medical Association , — Corbett EL et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Archives of Internal Medicine , — Global tuberculosis control: surveillance, planning, financing. WHO report Database Global TB database: www. Sputum smear-positive cases are the focus of this indicator because they are the principal sources of infection to others, because sputum smear microscopy is a highly specific if somewhat insensitive method of diagnosis, and because patients with smear-positive disease typically suffer higher rates of morbidity and mortality than smear-negative patients.

However, national TB control programmes should aim to provide treatment to all patients, as set out in the Stop TB Strategy. In principle, there is no discrepancy between global and national figures as national data are not modified. The number of new smear-positive cases detected by DOTS programmes is collected as part of the routine surveillance recording and reporting that is an essential component of DOTS. Quarterly reports of the number of TB cases registered are compiled and sent either directly or via intermediate levels to the central office of the national TB control programme.

Annual case notifications and other data on programme performance are collected by WHO via an annual data collection form, distributed to national TB control programmes through WHO regional and country offices. Close the funding gap for DOTS. Fully fund TB-control programs. The current economic crisis has directly impacted financial spending on various TB and other health-related programs for which the impact is most directly felt on impoverished populations [ 82 , 83 ]. If governments in countries with a high burden of TB cannot support these efforts, the burden of funding will inevitably fall on nongovernmental agencies, international organizations, and resource-rich countries [ 84—86 ].

Cost-effective strategies may be immediately implemented using currently available technologies in resource-limited settings.


For example, results from a centralized TB culture program serving HIV-infected patients in urban areas in Brazil suggest that solid TB media culture alone has substantial impact and reasonable cost-effectiveness when used in this setting. Several critical gaps can be identified in worldwide TB-control efforts.

Evidence of these gaps is that the global rate of decrease in the number of TB cases is less than what would be required to achieve the Millennium Development goal of TB elimination by Moreover, these gaps have led to the increase in the number of drug-resistant cases most prominently in population-dense countries, such as China and India. Although the greater burden of disease has largely fallen on resource-limited nations, the increasingly globalized environment has shown that the responsibility for action must be sought in all international arenas.

Many solutions are immediately available, but the funding gaps to realize these initiatives are a major obstacle. Strategies that should be considered include policies that enhance DOTS by improving diagnostics to increase case detection, including using private practitioners and closing the funding gap in DOTS-based programs.

Risk factors for continued TB transmission could be addressed by reducing socioeconomic health disparities and improving financial support to national TB-control programs. Better management of HIV and TB coinfection may occur by enhancing diagnostic applications of both disease processes and using isoniazid prophylactic therapy. These strategies could serve as part of the foundation to address the emergence of drug-resistant TB and, ultimately, the elimination of the disease.

Underlying any effort in TB elimination, however, will be increased funding and political will from both the international community and national health sectors. Financial support. National Institute of Allergy and Infectious Diseases awards , , , and Supplement sponsorship.

- Document - Global tuberculosis control Surveillance, planning, financing

Directly observed treatment, short course DOTS 5-part framework, which provided a cost-effective public health strategy on both individual and societal levels. Three key time points in achieving tuberculosis TB elimination by , if all criteria established by the Stop TB Partnership are effectively obtained [ 27 , 28 ]. Estimated number of new tuberculosis TB cases in The 5 countries that rank first to fifth in terms of total numbers of cases in were India 2.

TB in such countries with a high burden usually affects persons in their economic prime. Geneva: World Health Organization, [ 26 ]. Antiretroviral therapy coverage in sub-Saharan Africa in Major progress in HIV testing has been undertaken in the African region, compared with previous surveillance data.

Global tuberculosis control: surveillance planning financing. WHO report 2003.

Of the , HIV-positive patients with TB in this region, only , initiated antiretroviral therapy. The progress in HIV testing, which still requires improvement, is outpacing antiretroviral therapy.

If this continues, the TB epidemic will be sustained in these settings [ 23 , 26 , 33 , 62 ]. The number of patients in the cohort is shown under each bar.

A notable feature in all categories is the prominent percentage of death and defaulted or failed treatment. Oxford University Press is a department of the University of Oxford.

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