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| (02/05/08) Increasing Drug Resistant TB in the UK - BMJ article |
A changing population structure and ongoing migration have increased cases of drug resistant tuberculosis, according to a study published on bmj.com today.
The incidence of tuberculosis in England, Wales and Northern Ireland has been on the increase with more than 8000 cases reported in 2006. In addition, resistance to antituberculosis drugs has been increasing globally.
Of mounting concern is the increasing transmission of drug resistant tuberculosis among difficult to treat, marginalised groups in urban areas such as London, and the problems this could create for tuberculosis control.
Dr Michelle Kruijshaar and colleagues present the latest trends in resistance to antituberculosis drugs between 1998 and 2005 using data from the National Surveillance System, involving 28 620 confirmed cases of tuberculosis.
Overall, the researchers found that the proportion of cases resistant to any first line drug had increased from 5.6% to 7.9%. They report an increasing proportion of isoniazid resistance (6.9%) and small increases in rifampicin resistance (1.2%) and multidrug resistance (0.9%).
Importantly, outside London there was a significant increase in resistance to isoniazid. The authors suggest this reflects the increasing number of patients with tuberculosis who are not born in the UK. Analyses showed an increase in the number of cases in people from Sub-Saharan Africa and the Indian subcontinent that could be related.
In London, the rise in isoniazid resistance has been linked to an ongoing outbreak from 1999 that has involved over 300 cases to date. This outbreak has been associated with imprisonment and drug misuse and includes mainly the UK born population. The authors reinforce the importance of recognising symptoms early in this group.
They also note that the proportion of multidrug resistance showed a small increase (from 0.8% to 0.9%)—with the levels seen in the UK similar to those in other Western European countries—and suggest that most multidrug resistance cases occur due to problems with patient management rather than as a result of transmission within the UK.
These findings highlight the importance of early case detection by clinicians, rapid testing of susceptibility to drugs, additional support services to ensure that patients complete treatment, as well as continuous surveillance, and more help with tuberculosis control in countries with high incidence, conclude the authors.
The rising incidence of tuberculosis in the UK, combined with the rising proportion of resistant cases, increases the potential for onward transmission, warn the authors of an accompanying editorial.
James Lewis and Violet Chihota call for a range of strategies to be implemented including strengthening tuberculosis control and improving research into new diagnostics and drugs for multidrug resistant strains.
“Drug resistant tuberculosis in the UK cannot be controlled solely with local strategies —a global perspective is needed”, they conclude.
In response, Professor Peter Davies lead clinician for the National Multi-Drug Resistant Tuberculosis Service (MDRTB Service) in Liverpool and TB Alert Trustee said:
The problem with drug resistant tuberculosis is that is is still relatively uncommon but increasing. Individual clinicians will have very little experiencing in managing cases. Since Jan 1st 2008 the MDRTB Service has been in operation. This is an electronically linked instant reaction expert group who can give advice and direct management of cases across the country.
The Baltic states have operated a similar system for some years with good success in reducing their cases.
By assisting clinicians in the management of cases of drug resistant TB the national MDRTB service offers our best hope in overcoming the increasing problem of drug resistance until new drugs become available.
Click here to view full article: http://press.psprings.co.uk/bmj/may/ac6924463.pdf
Click here to view full editorial: http://press.psprings.co.uk/bmj/may/tbedit.doc
id: bmj020508 |
| (07/04/08) Information Officer - job advertisement and details |
20hours per week, £19,463 0.6FTE pro rata (NJC Scale 5 point 23, cost of living increase pending), plus outer fringe weighting. Our UK office is in Brighton.
Tuberculosis has been on the increase in the UK for twenty years, with more new diagnosed cases in 2005 than either HIV or Hepatitis C. TB Alert, the UK’s national tuberculosis charity, has been working for several years to increase the profile of the disease and is now looking to expand its UK work in a major project to raise awareness among vulnerable groups. As part of this project, we are establishing a new post to provide information and resources to health professionals, patients and the general public to increase knowledge about TB.
The post holder will respond to telephone and email enquiries regarding Tuberculosis, administrate a small patient hardship fund, facilitate and provide secretariat support for meetings and discussions of a network of TB service user advocates and collect and analyse monitoring data relating to the nature of information requests.
The successful candidate will have demonstrable skills in the handling of health-related information requests, experience in providing secretariat support to committees, proficiency and self-sufficiency with use of information technology and the ability to be fully self-servicing with regards to all administrative needs. Fluency in a second language commonly spoken by a BME community and knowledge of tuberculosis or related health matters such as HIV would be desirable.
For job description, person specification and application details click here.
Application deadline: 9.30am, Monday 21st April 2008
It would be helpful for our future recruitment if you could let us know where you saw the post advertised.
If you have any problems downloading the files for this post, please call:
Paul Dawson on 01273 234029 during office hours.
id: Informationofficer |
| (24/03/08)World TB Day marked by formation of new UK Coalition to Stop TB |
A number of organisations from the private sector, civil society and the public sector joined together on World Stop TB Day (24th March) to form a new UK Coalition to Stop TB. The aim of the coalition will be to raise awareness of TB and to ensure that fighting TB remains a high political priority for the UK Government.
TB Alert is delighted to have been part of the intial group, which it is hoped will expand in time. All of the people and organisations within the coalition are well known to us, and we have worked in partnership with many of them over the years, however this formal coalition will certainly be stronger than the sum of its parts.
Read a letter, written by the coalition, published in the Times 26/3/08
The coalition currently consists of (in alphabetical order)
Aeras Global Vaccine Foundation
AMREF
AstraZeneca
British Medical Journal
British Red Cross
FIND
COMDIS (Research Programme Consortium: 'Communicable disease, vulnerability and risk')
Global Alliance for TB Drug Development
MSF (Medicins Sans Frontieres
Munro & Forster
Panos
RESULTS UK (who initiated the group)
Target Tuberculosis
TB Alert
TB Survival Project
id: UKcoalition |
| (24/03/08) Luis Figo gets on the Team |
 Luis Figo has appeared on lamp post banners in London, Manchester and the Midlands raising awareness of TB. The campaign was co-ordinated by the StopTB partnership with TB Alert, RESULTS UK and other partners.
Luis Figo said:
MY GOAL: STOPPING TB
Football has always been my passion, but I have another that is no less intense. I dream of a world where all people have the opportunity to be healthy and improve their quality of life. I dream of an even playing field for all women, men and children everywhere.
TB is one of the most unfair fouls in the game of life. The disease most often strikes people in their prime working years, imposing a heavy cost on families' incomes. Children are vulnerable to TB as well, and the disease may force them out of school, limiting their future job prospects.
TB is curable, but TB kills. There are 8.8 million new cases of infectious TB each year, and 1.6 million people each year, or 4400 people per day, die from the disease. This is unacceptable.
That is why I have made a commitment to the global fight against TB. Please join my team -- pick up the ball and run with me to stop TB.
Luis Figo
Read more about Luis Figo's work as StopTB Ambassador
id: figo |
| (20/03/08) TB in the Archers again |
This time it is Grange Farm affected by Bovine TB - Sterling Gold (Oliver Sterling's cheese made from unpasteurised milk) is off the menu! Read more about TB in Ambridge
To find out more about TB in animals - click here
id: enter an unique id here |
| (18/03/08) Pace of Progress is slowing says WHO |
The pace of progress in detecting new tuberculosis cases worldwide is slowing, according to the 12th annual report on TB control released Monday by the World Health Organization, the New York Times reports. According to the report -- titled "Global Tuberculosis Control 2008 -- Surveillance, Planning, Financing"-- the rate of increase in detecting new TB cases was 3% from 2005 to 2006, compared with the previous average of 6% recorded from 2001 to 2005 (Altman, New York Times, 3/18). The report found that out of the total 14.4 million people living with TB in 2006, the last year for which statistics are available, 9.2 million were new cases. Global deaths from the disease decreased by 2.6% in 2006 to 1.7 million people when compared with 2005 figures, the report found (Dunham, Reuters, 3/17). TB incidence worldwide decreased by 0.6% in 2006, but the decrease was so modest compared with 2005 that the increase in the world's population meant there were actually more TB cases, the report noted (Reuters, 3/17). Health officials said that they ideally want to see TB incidence decline by 5% to 7% annually (Cheng, AP/Google.com, 3/17).
About 700,000 of the TB cases and 200,000 deaths occurred among people who are HIV-positive, WHO reported. WHO's Africa, Southeast Asia and Western Pacific regions accounted for 83% of the total cases reported. The African region has 363 cases per 100,000 people, which is the world's highest incidence rate per capita, the report said. It found that China, India, Indonesia, Nigeria and South Africa topped the list in terms of absolute numbers of TB cases. The information is based on data provided by 202 countries and territories (New York Times, 3/18). WHO estimated that 61% of all TB cases worldwide are registered (AFP/Google.com, 3/17).
About 30 million people, or 84.7% of reported TB cases, have successfully completed treatment, according to the report. That figure is close to WHO's target of 85%. However, the report found that WHO's treatment programs have "not yet had a major impact on TB transmission and incidence around the world." In addition, the report found that TB rates had fallen in some regions, stabilized in Europe and increased at least fivefold in Africa since the 1990s (AP/Google.com, 3/17).
The report identified multi-drug resistant TB and HIV/TB coinfection as two factors that could further slow progress toward controlling TB, according to a WHO release. Countries predict they will treat only about 10% of people with MDR-TB in 2008 because of limited laboratory and treatment capacities, according to the report. Funding also is a concern, the report said. Despite increases in resources from the Global Fund To Fight AIDS, Tuberculosis and Malaria and some middle-income countries, TB budgets likely will not increase in 2008 in nearly all of the countries most heavily burdened by the disease, the report said. Ninety countries in which 91% of the world's TB cases are recorded provided complete financial data for the report. These 90 countries need about $1 billion to meet the 2008 targets of the Global Plan to Stop TB, 2006-2015, the report said (WHO release, 3/17). In addition, WHO said that there is a funding shortfall of $2.5 billion of the $4.8 billion needed in 2008 for overall TB control in low- and middle-income countries (New York Times, 3/18).
Reaction
Margaret Chan, WHO director-general, said the slowing progress documented in the report "comes at a time when numbers are still way too high" (AFP/Google.com, 3/17). Mario Raviglione, director of WHO's Stop TB Department, said, "We're really in a very uncertain situation, so I don't feel happy at all, actually, that it is really getting controlled" (Reuters, 3/17). He added that data are worrisome because the "more cases that are detected early interrupt transmission and provide a better chance of cure, and that ultimately has a greater impact on the incidence of the disease" (New York Times, 3/18).
Joanne Carter of RESULTS said the data should "serve as a warning to the global community that we must do more and be more aggressive in supporting TB programs or face a continued erosion of progress." She added that "on top of last month's data on high rates of drug resistance, we should take this very seriously and act with urgency" (Reuters, 3/17).
The report "clearly demonstrates how closely TB and HIV are" related, UNAIDS Executive Director Peter Piot said, adding that TB is the "single most important cause of death for people living with HIV" (AFP/Google.com, 3/17).
Some experts criticized WHO for not taking into account people living with TB who have not been diagnosed, the AP/Google.com reports. Critics also said the statistics were gathered from governments without being verified independently. "This is a compilation of what the countries want to show ... Some of these data are too good to be true," Francis Varaine, coordinator of Medecins Sans Frontieres' Tuberculosis Working Group, said (AP/Google.com, 3/17).
Raviglione said that countries should either create facilities to detect more cases or "depend more and more on the private sector" because "more and more we are realizing that nongovernmental agencies and faith-based organizations that contribute to caring for AIDS cases now have an increased role" in TB (New York Times, 3/18).
 The report is available online.
 Updated TB information from the 2008 WHO report is now available at the Kaiser Family Foundation's GlobalHealthReporting.org and GlobalHealthFacts.org.
id: WHOreport0308 |
| (14/03/08) 2008 Stop TB Partnership Kochon Prize |
The Stop TB Partnership and the Kochon Foundation have announced that nominations are open for the 2008 Stop TB Partnership Kochon Prize.
The prize is awarded to persons, institutions or organizations that have made a major contribution to stopping tuberculosis.
The deadline for nominations is 11 April 2008.
More information is available at http://www.stoptb.org/bi/kochon/application.asp
id: prize |
(14/03/08) INITIATIVE-OVERKILL – The Health Sector’s Newest Sickness?
|
The Health Initiatives of European Governments – Who and How Do They Really Help?”
Welthungerhilfe and terre des hommes as the German partners of Action for Global Health are hosting a conference on World Health Day at the mid-point towards the target date for the Millennium Development Goals. It is intended as a contribution to the debate on the linkages between Health and Development, fighting poverty and the three Health Millennium Development Goals (reduction in child mortality, improved maternal health, fight against HIV&AIDS, Malaria and Tuberculosis).
As the title of this conference: "Initiative-overkill –The Health Sector’s Newest Sickness?" implies, the primary focus will be on the numerous health initiatives recently launched by various European governments: who and how do they really help? Are they coordinated and effective? The effectiveness of aid is the central theme in 2008, when the Paris Declaration on Aid Effectiveness will be reviewed. The aim of this conference is a critical analysis of some of these new health initiatives: are they the right tools to reach the health-MDGs – or are they merely diverting attention away from the fact that there is insufficient official development aid (ODA) in total, an insufficient proportion of ODA related to health and that aid needs to be more effective? And how is civil society also involved in all this? These questions, among others, will be discussed in a dialogue between government, parliament, academia and civil society. The languages of the conference are English and German.
Click here for flyer
For more information please contact Stephan Kreischer on +49 (0)30 / 288 749 11 or Stephan.Kreischer@welthungerhilfe.de.
To register please return the reply card to Betul.Yilmaz@welthungerhilfe.de or by fax on +49 30-288-749-19 by 20th March 2008.
id: conference |
| (13/03/08) Policy and Advocacy Manager Global Health- job advertisement and details |
Brighton circa £26-£29K, plus pension
TB Alert is one of three UK-based partners who comprise Action for Global Health in the UK. This network is developing European civil society capacity to advocate for the health Millennium Development Goals.
We are seeking candidates who have significant experience of advocacy; a good background in at least one of policy formulation, research, or communications; ability to work in a network. The postholder will be employed by TB Alert and work with an existing team member at International HIV/AIDS Alliance and a new team member being recruited by Interact WorldWide. The posts are funded for 3 ½ years.
For the TB Alert post only, if you would like to discuss the post before applying you can call Paul Sommerfeld, Chair of Trustees, TB Alert is available at any reasonable time of the day on 0208 9694830.
click to download full advert, job description, person specification and application form Application deadline 09.30 a.m. on Monday, 7th April 2008
It would be helpful for our future recruitment if you could let us know where you saw the post advertised.
If you have any problems downloading the files for this post, please call:
Paul Dawson on 01273 234029 during office hours.
id: Advocacypost |
| (10/03/08)
TB Alliance Develops Handbook of TB Drugs |
Information relevant to TB drug research is very scattered and frequently resides in decades-old original literature. Researchers often need to spend a significant amount of time locating important information because a comprehensive source of such data is lacking. Recognizing this need, the TB Alliance has developed a Handbook of Anti-Tuberculosis Agents. The Handbook has been published in the March 10th issue of the journal Tuberculosis.
The Handbook brings together information on a total of 27 drugs, including all drugs approved to treat tuberculosis, drugs in clinical development for TB, and some approved drugs being investigated for potential use in TB, such as moxifloxacin. Referenced data include physical characteristics, basic biology, efficacy and safety in humans, and results on absorption, distribution, metabolism and excretion (ADME).
Aggregation of data like these would be useful in many drug discovery areas, but it is especially important for TB researchers, who are faced with data scattered over many decades and many different studies. Review articles have pulled together these data but usually only by covering a single topic in depth, concentrating, for example, on comparisons of clinical options, animal models or physical characteristics. Meanwhile, there have been few places where comprehensive data can be found on more than one aspect of the various drugs.
The Handbook was developed as a resource for the TB drug research community, and will be available on the TB Alliance website. It will be updated periodically. Researchers are encouraged to send comments and suggestions to database@tballiance.org.
To download the handbook, please click here.
id: handbook |
| (06/03/08) Scientists identify TB Bacteria protein; Finding could lead to development of new drugs |
Scientists from the University of Leicester's Department of Biochemistry on Thursday announced that they have identified two proteins in Mycobacterium tuberculosis that might play a significant role in allowing TB to thrive in white blood cells, the PA/Google.com reports (PA/Google.com, 3/6).
The researchers have been focusing on identifying specific TB molecules and isolating them to understand their function and find a way to "minimize their effects," Mark Carr, lead researcher from the University of Leicester, said. The complex formed by the two newly identified proteins, called ESAT-6 and CFP-10, is "one of the most important of these molecular weapons," Carr said. He added that the proteins work together to allow M. tuberculosis to thrive inside white blood cells in the body during initial infection. Carr said that removing the genes from this complex makes the TB bacteria unable to cause the disease, which shows "how important this particular weapon is to the bacteria" (University of Leicester release, 3/6).
Carr said the researchers are at least five to 10 years away from creating a new TB drug based on their findings. "This is a major success for a U.K. research group," he said, adding, "It's a significant step. When we started, there wasn't a single TB protein that was directly associated as having the ability to cause the disease" (PA/Google.com, 3/6).
The researchers are working to identify which human white blood cell components the complex targets, according to Carr. He added that this finding would give scientists a better idea about the actions of TB molecules (University of Leicester release, 3/6
id: tbprotein |
| (04/03/08) 'Desperate' Need for New Diagnostics, Drugs, Letter to Editor Says |
As multi-drug resistant tuberculosis rates increase globally, "so does the gap between those who are treated and those who are not," Tido von Schoen-Angerer, executive director of Medecins Sans Frontieres' Campaign for Access to Essential Medicines, writes in a New York Times letter to the editor. The letter was written in response to a recent article on a World Health Organization report about the spread of drug-resistant TB worldwide.
Although WHO estimates that there are 490,000 new cases of MDR-TB annually, only 30,000 people with the disease were treated last year, according to von Schoen-Angerer. There is a "desperate" need for new TB diagnostics and drugs, especially for MDR-TB and HIV/TB coinfection, he writes, adding that "the pipeline to ensure our ability to treat TB in the future has too few drugs in development."
According to von Schoen-Angerer, new diagnostic techniques "rely on sophisticated laboratories that simply do not exist in many impoverished countries." In order to have "any chance of making a substantial impact in the coming years," funding for research and development must be "increased at least fivefold," he writes. Although "we must continue to do the best we can with existing options ... this catastrophic situation will not be controlled unless there are new diagnostics and medicines," von Schoen-Angerer concludes (von Schoen-Angerer, New York Times, 3/4
id: newneeds |
| (04/03/08) Partnership working in Brighton |
TB Alert is teaming up with Target Tuberculosis, another Brighton based charity, to raise awareness of
the disease in our home town throughout March 2008. An exhibition explaining what TB is, and exploding some myths about the disease, as well as highlighting the work of both charities will be
touring locations in East Sussex, including Hove Public Library, the University Libraries and Brighton Station, from early
March.
id: ttbexhibition |
| (04/03/08) TB Alert PCT Services Manager - job advertisement and details |
Salary: £30,598 (NJC Scale point PO38, cost of living increase pending), plus outer fringe weighting and pension.
Tuberculosis has been on the increase in the UK for twenty years, with more new diagnosed cases in 2005 than either HIV or Hepatitis C. TB Alert, the UK’s national tuberculosis charity, has been working for several years to increase the profile of the disease and is now looking to expand its UK work in a major project to raise awareness among vulnerable groups. As part of this project, we are establishing a new post to establish relationships with Primary Care Trusts (PCTs) in England and provide them with locally appropriate materials to carry out awareness campaigns.
We need someone to build effective, income generating relationships with PCT commissioners, to promote and disseminate TB awareness materials and to identify and build strategic partnerships with the appropriate departments within PCTs, encouraging and helping them to undertake campaigns to raise awareness of TB within the general public and particularly vulnerable groups.
Our UK office is in Brighton, although some degree of home-working could be agreed if you have appropriate IT resources.
For job description, person specification and application details click here.
Application deadline: 10pm, 24th March 2008
It would be helpful for our future recruitment if you could let us know where you saw the post advertised.
If you have any problems downloading the files for this post, please call:
Paul Dawson on 01273 234029 during office hours.
id: PCT Services Manager |
| (03/03/08) High Hopes for TB Vaccine |
Trials in children of a new TB vaccine are underway in South Africa. Read the BBC report.
id: highhopes |
| (01/03/08)
Synchotron used for research into TB's 'staying power'
|
From the Univ-Newsletter. Dr Isaac Westwood (1998) is part of a team at Oxford University whose research may lead to the development of new therapies which help to control the tuberculosis epidemic. Using the Oxfordshire Diamond synchrotron, the scientists and colleagues have built a complete picture of HsaD: a protein that enables the tuberculosis bacteria to survive in the human body. Understanding the three-dimensional structure of the protein should help in the development of drugs to treat the disease.
Read more...
id: univnews |
| (29/02/08) Guardian Letter questions TB priorities. |
Sir,
A £200 million a year cost to the tax payer to slaughter TB infected cows ( and badgers) is a lot of money. Yet this is done because of the threat of transmitting disease to humans which, with the pastuerisation of milk, is virtually nil.
The 8,000 cases of human tuberculosis a year in the UK probably cost a tenth of this sum to treat and it is these patients, not cows, which are the threat of transmission to other humans. Is it not time for a big rethink about the appropriate managment of bovine tuberulcosis?
Professor Peter DO Davies
Secretary TB Alert and Consultant Chest Physician
To read more about TB and animals, click here.
id: trusteeletter |
| (26/02/08)New report finds highest rates of drug-resistant tuberculosis to date |
Multidrug-resistant tuberculosis (MDR-TB) has been recorded at the highest rates ever, according to a new report that presents findings from the largest survey to date on the scale of drug resistance in tuberculosis.
The WHO Stop TB Department report, Anti-Tuberculosis Drug Resistance in the World, released today, is based on information collected between 2002 and 2006 on 90 000 TB patients in 81 countries. It also found that extensively drug-resistant tuberculosis (XDR-TB), a virtually untreatable form of the respiratory disease, has been recorded in 45 countries.
The report also found a link between HIV infection and MDR-TB. Surveys in Latvia and Donetsk, Ukraine found nearly twice the level of MDR-TB among TB patients living with HIV compared with TB patients without HIV.
Based on analysis of the survey data, WHO estimates there are nearly half a million new cases of MDR-TB--about 5% of the total nine million new TB cases--worldwide each year.
Click here for the press release or here to
download the report
id: whoreport |
| (19/02/08) 'Electronic Nose' an Easy Way to Diagnose TB |
This article was originally published on page 5 of The Cape Argus on February 19, 2008 By Di Caelers
Hundreds of Capetonians with tuberculosis are centre-stage in an international study which has boosted hopes that a simple breath test will replace current complex diagnostics to determine TB infection.
And children especially are likely to benefit from the method, which is being tested in a collaboration between the University of Stellenbosch and the Royal Tropical Institute in Amsterdam.
About 300 children and adults, from Elsies River, Ravensmead and Uitsig, have already offered themselves as "guinea pigs", and by the end of the year researchers expect to have recruited as many as 600 people.
Clinical researcher Dr Mareli Claassens of Stellenbosch University's Desmond Tutu TB Centre explained that although adults could be diagnosed relatively quickly, children needed a far more complex procedure, including a gastric washing, that could take up to six weeks.
The machine at the centre of the new method, which requires people to simply blow into a clear plastic bag, has been dubbed the "electronic nose".
The sample is then transferred into a tube that looks exactly like a long copper screw with nuts and bolts on either end.
Claassens explained that instead of looking for actual TB organisms, the machine identified "volatile organic compounds" effectively "something you can smell" which were produced specifically by patients with the disease.
The technology is similar to that used in the wine or perfume environments, she said.
The machine, which is still being tweaked as testing continues in a bid to reach a 99 percent efficacy level, has been travelling between Cape Town and the Netherlands, and is expected back at the Desmond Tutu TB Centre in April.
"What the overseas researchers do is come here and analyse our samples, then take the data back with them to continue the development of the machine.
"All the bumps haven't yet been ironed out, so the electronic nose is basically a new diagnostic tool still in progress," Claassens said.
All the information was being backed up with urine, blood and sputum samples from the adults, and gastric washings from the children.
The adult samples were being used to "train" the machine so it could be used to then identify TB in children.
The children are all recruited at Tygerberg Hospital, and the adults in surrounding clinics, and all are being investigated anyway for TB.
"We've had an excellent response from the community because TB is very common and they are extremely willing to try to help find a solution that would benefit everyone in the long term," Claassens said.
id: ENcape |
| (12/02/08) Doubts About WHO TB Programme |
Further studies are needed to resolve whether the remarkable public health gains achieved under the WHO's anti-tuberculosis programme are at risk, say G. E. Davies and S. B. Squire in this British Medical Journal editorial.
Davies says that a review of the international organisation's DOTS (directly observed therapy short course) programme — which comes 15 years after the introduction of DOTS — has found worrying differences in relapse rates after treatment, the most important measure of treatment efficacy in clinical trials.
Doubts have been raised about the effectiveness of direct observation strategies as opposed to self-administration. "If neither the direct observation nor the short course components of the strategy is as evidence-based as we thought, where does this leave the scientific credibility of DOTS?" ask the authors.
A better understanding of the associations between the bacterial markers used to monitor treatment and the pharmacodynamic processes that underly them, along with more extensive molecular epidemiological studies, would help clarify the findings of the review.
Link to full article in the British Medical Journal
id: WHODOTS |
| (29/02/08) New TB Drug Could be Available in Five Years, Scientist Says. |
A new tuberculosis drug that could reduce the length of treatment from six months to two months with fewer side effects might be available within five years, Stewart Cole, director of the Swiss Global Health Institute, said on Monday at the 11th Centre for DNA Fingerprinting and Diagnostics Foundation Day Lecture in Hyderabad, India, UNI/Big News reports. Cole said that GHI is participating in the New Medicines for Tuberculosis project, which receives funding from the European Commission.
Five TB drugs are in either Phase II or Phase III trials under the project, Cole said. He noted that researchers have observed positive results from the drugs during studies on mice (UNI/Big News, 1/28). In addition, Cole said that safety tests have shown the drugs do not cause cancer and are not toxic (The Hindu, 1/29). He added that at least one of the drugs would complete clinical trials in five years.
According to Cole, scientists are working to make new drugs compatible with antiretroviral treatment because a large percentage of HIV-positive people worldwide also have TB. Other important goals in development include protection against persistent TB bacilli, identifying new drug target classes, focusing on treatment of Mycobacterium tuberculosis and compatibility with DOTS, Cole said (UNI/Big News, 1/28).
id: newdrug |
| (29/01/08) People with Vitamin D Deficiency More Likely to Have TB, Study Says. |
People with low levels of vitamin D are more likely to have tuberculosis than those with adequate levels of the vitamin, according to a study published in the Feb. 1 issue of Clinical Infectious Diseases, Reuters reports. For the study, Katherine Gibney from the Royal Melbourne Hospital and colleagues tested 375 people from sub-Saharan Africa who were treated at a hospital in Melbourne, Australia, between 2003 and 2006. The researchers found average to critical vitamin D deficiency among 78% of people with TB or those who previously had the disease.
"Low vitamin D levels are associated with an increased likelihood of primary infection with Mycobacterium tuberculosis and also, once infected, are associated with increased likelihood of having active TB," Gibney said. According to the researchers, previous studies have shown that people with vitamin D deficiencies are more likely to have active TB, but this study is the first to show that the same is true for latent TB. The researchers recommended that doctors consider vitamin D supplements as a way to prevent and treat TB (Fox, Reuters, 1/28).
 The study is available online.
id: vitD |
| (21/01/08)
RESULTS UK calls on UK government and civil society to do more |
The UK is failing to effectively address the joint and resurgent TB/HIV epidemic, according to a report published by RESULTS UK in November 2007.
'An Inadequate Response: More than Two Decades of Complacency in the TB/HIV Co-Epidemic', assesses Government funding and policy for TB/HIV and the response of UK-based civil society organisations. It finds that both have failed to adequately implement coordinated TB/HIV activities despite the known benefits of an integrated approach and the fact that the co-epidemic was first acknowledged over two decades ago. Such a failure has resulted in millions of unnecessary deaths.
Click here to access the report from the RESULTS webpage
id: resultsreport |
| (21/01/08) MP calls for leadership to address the "scandal" of TB deaths |
From the RESULTS website, we learn that following a recent visit to South Africa to attend the World Conference on TB and Lung Disease, Arundel and South Downs MP Nick Herbert called (in November 2007) for international leadership to address the “scandal” of 1.6 million deaths across the globe every year as a result of TB.
Mr Herbert, who is Co-Chairman of the All Party Parliamentary Group (APPG) on Global TB addressed the Conference on Cape Town as part of a fact-finding visit to learn more about the impact of TB and HIV in Africa.
Read Nick Herbert's press release
id: tbdeaths |
| (07/01/08)
Stop TB Partnership welcomes increased US funding for global TB control |
During the last week of December, President George W. Bush approved US$153 million in spending for global TB control programmes for 2008--up US$72 million from 2007 spending. An additional $150 million is dedicated by the US President's Emergency Plan for AIDS Relief to address the TB-HIV co-epidemic in 2008.
Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership, applauded this effort. "The U.S. should be commended for its leadership and wise investment in the global fight against TB," he said. "As a recent World Bank study concluded, the economic benefits of TB control are substantially greater than the costs. I would like to thank our partners and advocates in the U.S. Congress for their dedication and persistence. This funding increase will contribute to the implementation of the Global Plan to Stop TB; with direct benefits to men, women and children affected by TB across the globe."
id: stoptb |
| (13/12/07) Congratulations to Prof Ormerod for making it into Who's Who |
A DOCTOR who became an expert in treating tuberculosis after contracting the disease as a child has been given one of high society's top accolades - an entry in Who's Who.
Professor Lawrence Ormerod - known by his middle name Peter - is one of the UK's most respected experts in prevention and treatment of TB and the Royal Blackburn Hospital's consultant in respiratory medicine.
He joins supermodel Kate Moss and acclaimed comedy director Armando Iannucci among the new entries for 2008 in the book, which lists mini-biographies of aristocrats, along with those who have reached the top of their profession.
Read more from Camilla Sutcliffe in This is Lancashire
Professor Ormerod has been a great supporter of TB Alert over the years and we are delighted that his work has been recognised by this prestigious directory. Professor Ormerod is shown above right pushing his grandson (who, Peter tells us, had the good sense to be born on World TB Day!) in a fancy dress sponsored walk organised by the boys of Bolton Boys Junior. Our thanks to the Bolton Boys who raised over £5,000 for TB Alert, and to Peter for motivating the boys to support us.
id: ormerod |
| (12/12/07) World Bank Research Report |
A new World Bank research report finds that 22 countries with the world’s highest numbers of TB cases could earn significantly more than they spend on TB diagnosis and treatment if they signed onto the Stop TB Partnership's Global Plan to Stop TB. Highly affected African countries could gain up to 9 times their investments in TB control; and those outside Africa a 15-fold return. The study also warns about the need to step-up TB control worldwide with the growing emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) in Southern Africa, Eastern Europe and Central Asia.
"We already had sufficient reasons to step up the fight against TB. But this study provides a new incentive. It demonstrates that fighting TB is not only about preventing illness and death --it is also a smart investment. We urge our partners and all countries affected by TB to take notice and accelerate their efforts to accelerate TB diagnosis and treatment in line with the Global Plan," said Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership.
Press release
Economic Benefit of Tuberculosis Control
id: wbreport |
| (12/12/07) TB Alert Programme Officer - job advertisement and details |
3 days a week for £17 000 p.a. plus pension (Based on £28 000 full-time equivalent). Brighton Based.
Tuberculosis, with HIV and malaria, is one of the three greatest killer diseases in the world today. TB Alert, Britain’s national tuberculosis charity, already has a cohort of projects in Central Africa and India with a focus on community outreach to increase detection and to support patients through diagnosis and the long months of treatment.
We need someone to administer our links with existing projects; ensure proper monitoring; develop new project proposals to statutory and other funders; ensure dissemination of lessons learnt from our projects; and, given bids in the pipeline, manage a major increase in programme responsibilities.
Our UK office is in Brighton, Some degree of home-working could be agreed if you have appropriate IT resources. While the post is offered as three days a week, we expect to pay for extra days when developing proposals and visiting projects.
You will have several years’ experience of programme development with resource-poor countries. A background in health is desirable but not essential.
For job description, person specification and application details click here.
Deadline for applications (to be sent by email): 9.30 am on Wednesday, 9th January 2008
If you have any problems downloading the pdf file, please call:
Melanie Matthews on 0845 223 5293 during office hours (our office is closed from end 21st December and re-opens 2nd January); or
Paul Sommerfeld on 0845 223 5294 or 07976 860266 evenings and weekends (not Christmas day please!)
id: progoff |
| (11/12/07) TB Found in 500,000-Year-Old Fossil in Turkey |
Evidence of tuberculosis has been found in a 500,000-year-old hominid fossil in Turkey, according to a study published in the Dec. 7 issue of the American Journal of Physical Anthropology, United Press International reports (United Press International, 12/7). John Kappelman, professor of anthropology at the University of Texas-Austin, and colleagues from Germany, Turkey and the U.S. found characteristic signs of the disease on the skull of a male Homo erectus, the first hominid species believed to have migrated out of Africa, BBC News reports.
The researchers examined a series of small lesions on the bone of the cranium. The shape and location of the lesions are characteristic of Leptomeningitis tuberculosa, a form of TB that affects the meninges lining of the brain, according to the scientists (BBC News, 12/7). It is likely that Homo erectus had dark skin because the species evolved in the tropics, but after it moved north, it had to adapt to more seasonal climates, Kappelman said. According to researchers, the young man's body produced less vitamin D, which weakened his immune system and made him more vulnerable to TB (University of Texas release, 12/7).
Until this finding, the most ancient case of TB was documented in remains found in Italy that date back 5,000 years, Simon Mays of the historic environmental organization English Heritage said. He added that it would be necessary to have "very firm proof that the skull lesions described are indeed from TB and not something else" (BBC News, 12/7). The research was funded by the Leakey Foundation and the Scientific and Technical Research Council of Turkey (University of Texas release, 12/7).
The study is available online
id: tbfossil |
| (11/12/07) DOTS Best Method To Control TB/HIV Coinfection in Nepal |
Almost 50% of HIV-positive people living in Nepal will develop active tuberculosis, and it therefore is necessary to use DOTS or DOTS Plus to control the spread of the disease, speakers at the 23rd South Asian Association for Regional Cooperation Charter Day said Sunday in Kathmandu, Nepal, the Rising Nepal reports. The Nepalese government is focusing on programs in rural areas that work with people to modify their behavior to prevent the spread of HIV and TB, Govinda Ojha, director of the Department of Health Services, said. Mahesh Maskey, chair of the Nepal Health Research Council, said the country's TB program could be applied to other health initiatives in Nepal.
At the event, physician V.S. Salhotra said the World Health Organization estimates that 3.5 % of TB cases in Southeast Asia are multi-drug resistant. He said a lack of funding for TB control efforts is part of the reason that more than 400,000 cases of MDR-TB are reported in the region annually. He added that poor drug management and inadequate infection control measures also are fueling the spread of MDR-TB. He said that DOTS Plus has been implemented in India and Nepal and that Bangladesh plans to use the program. Data about extensively drug-resistant TB, which is resistant to the two most potent first-line drugs and some of the available second-line drugs, in the region are not available, Salhotra said.
Also at the event, Lochana Shrestha, an epidemiologist at the SAARC TB Center, presented a paper about the media's role in TB and HIV/AIDS control. Shrestha said the media can play a key role in mobilizing public support, reducing social stigma of the diseases and creating community awareness. She added that because TB and HIV/AIDS have social and economic dimensions, the public health sector alone cannot address the challenges posed by the diseases.
About 45% of Nepal's population has TB, and 40,000 new active cases are reported each year, the Rising Nepal reports. Between 5,000 and 7,000 people in the country die annually from the disease, according to the SAARC TB and HIV/AIDS Center. The prevalence of HIV/AIDS among people with TB in the SAARC region is about 0.05% in Afghanistan, 0.1% in Bangladesh, 0.2% in Bhutan, 5.2% in India, 2.4% in Nepal, 0.6% in Pakistan and 0.2% in Sri Lanka (Rising Nepal, 12/11).
id: tbnepal |
| (03/12/07) TB Alert Chief Executive - job advertisement and details |
Salary £45k p/a. plus pension. Brighton Based.
Can you take on a young, yet successful and respected organisation, be its first salaried CEO, and deliver a major step-change in our level of work and impact?
The successful candidate will understand both development and public health issues, and have the skills to lead the organisation and manage a professional staff team. Experience in project development, advocacy, or fundraising would be useful but essential are a sense of urgency and commitment, combined with ability, to respond to one of the world’s great killer diseases.
For job description, person specification and application details click here.
Application deadline: End of Sunday, 13th January 2008
If you have any problems downloading the pdf file, please call:
Melanie Matthews on 0845 223 5293 during office hours (our office is closed from end 21st December and re-opens 2nd January); or
Paul
Sommerfeld on 0845 223 5294 or 07976 860266 evenings and weekends (not Christmas day please!)
id: ceo |
| (01/12/07) World Aids Day statement from Dr Espinal |
On the occasion of World AIDS Day 2007, Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership, is calling on all countries, working with their partners, to do more to address the massive global epidemic of tuberculosis (TB) among people living with HIV. "Too many people are dying needlessly as a result of TB, which is still a leading cause of death among people living with HIV. Every day that goes by without action adds to the unacceptable death toll in people and communities affected by TB and HIV," he said.
Throughout the world, 12% of all TB deaths occur in people living with HIV. TB kills up to half of all AIDS patients in some settings. Yet TB is a curable and preventable disease.
The majority of cases of tuberculosis in people living with HIV occur in sub-Saharan Africa, where up to 80% of TB patients may be co-infected with HIV." "The burden on Africa is of such high magnitude that there are grave concerns about this region reaching the Millennium Development Goal related to TB. Some African countries are stepping up their efforts on TB/HIV, however, which is very encouraging," Dr Espinal said.
Nevertheless greater investment by both endemic countries and donors is crucial, he stressed. "Investing in TB control is also an investment in HIV care; you cannot effectively deal with one without addressing the other," he said. "More investment in research to develop new diagnostics, medicines and vaccines also is critical."
Dr Espinal answered some frequently asked questions on the TB/HIV pandemic.
id: worldaidsday |
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