Tuberculosis in 2016 (free full text review from Nature Reviews Disease Primers)

New disease Primer provides a comprehensive overview of TB epidemiology, prevention, diagnosis and treatment – just published and open access for 30 days. This comprehensive Primer puts into context the current clinical and translational challenges in tackling TB globally and reviews the latest advances in the science of TB, which may lead to better tools and help us meet End TB targets. 

Tuberculosis (TB) is an airborne infectious disease caused by organisms of the Mycobacterium tuberculosis complex. Although primarily a pulmonary pathogen, M. tuberculosis can cause disease in almost any part of the body. Infection with M. tuberculosis can evolve from containment in the host, in which the bacteria are isolated within granulomas (latent TB infection), to a contagious state, in which the patient will show symptoms that can include cough, fever, night sweats and weight loss. Only active pulmonary TB is contagious. In many low-income and middle-income countries, TB continues to be a major cause of morbidity and mortality, and drug-resistant TB is a major concern in many settings. Although several new TB diagnostics have been developed, including rapid molecular tests, there is a need for simpler point-of-care tests. Treatment usually requires a prolonged course of multiple antimicrobials, stimulating efforts to develop shorter drug regimens. Although the Bacillus Calmette–Guérin (BCG) vaccine is used worldwide, mainly to prevent life-threatening TB in infants and young children, it has been ineffective in controlling the global TB epidemic. Thus, efforts are underway to develop newer vaccines with improved efficacy. New tools as well as improved programme implementation and financing are necessary to end the global TB epidemic by 2035.

Read more:

http://www.nature.com/articles/nrdp201676

World Tuberculosis Day 2016

World TB Day, falling on March 24th each year, is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of nearly one-and-a-half million people each year, mostly in developing countries. It commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus. At the time of Koch's announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Koch's discovery opened the way towards diagnosing and curing TB.

2014 World Tuberculosis Day

For the 2014 World TB (Tuberculosis) Day on 24 March 2014 many individuals, groups and organizations are standing together to spread the message of ZERO STIGMA. As the international leader in the fight against TB, Dr. Mario Raviglione, the director of the Global TB Programme at the WHO shared this ZERO STIGMA message. Take up his call to action and join the cause! 

Roadmap for Childhood Tuberculosis

"Any child who dies from TB is one child too many," said Dr Mario Raviglione, Director, Global Tuberculosis Programme at WHO in commenting on the importance of this campaign. "TB is preventable and treatable, and WHO is working towards translating this roadmap to action in countries to stop children dying."

To build public awareness and offer a plan of action, in 2013 a group of seven partner organizations worked together to produce a new "Roadmap for Childhood Tuberculosis" with leadership from the Stop TB Partnership's Childhood TB Subgroup, the global umbrella that advocates for all TB-related topics.

New Guidelines of Treatment of Multidrug-Resistant Tuberculosis

Dear Respiratory we are happy to present New Guidelines of Treatment of Multidrug-Resistant Tuberculosis!

It can be a Revolution in treatment of Multidrug-Resistant Tuberculosis!

Multidrug-resistant tuberculosis (MDR TB) is caused by Mycobacterium tuberculosis that is resistant to at least isoniazid and rifampin, the two most effective of the four first-line TB drugs (the other two drugs being ethambutol and pyrazinamide). MDR TB includes the subcategory of extensively drug-resistant TB (XDR TB), which is MDR TB with additional resistance to any fluoroquinolone and to at least one of three injectable anti-TB drugs (i.e., kanamycin, capreomycin, or amikacin). MDR TB is difficult to cure, requiring 18–24 months of treatment after sputum culture conversion with a regimen that consists of four to six medications with toxic side effects, and carries a mortality risk greater than that of drug-susceptible TB.

Bedaquiline fumarate (Sirturo or bedaquiline) is an oral diarylquinoline. On December 28, 2012, on the basis of data from two Phase IIb trials (i.e., well-controlled trials to evaluate the efficacy and safety of drugs in patients with a disease or condition to be treated, diagnosed, or prevented), the Food and Drug Administration (FDA) approved use of bedaquiline under the provisions of the accelerated approval regulations for "serious or life-threatening illnesses" (21CFR314.500) (Cox EM. FDA accelerated approval letter to Janssen Research and Development.

The MDR-TB Time bomb: Identifying the real risk of drug resistant tuberculosis in Europe

Today we are sharing with you video about tuberculosis produced by European Respiratory Society!

A critical update from Europe's leading specialists on the increasing threat of multidrug-resistant tuberculosis.

Using the latest statistics and patient experiences the film highlights the risk to the European population and the region's health systems.

Experts in the field of TB share their recommendations, investigate on-going inspirational initiatives and call on all stakeholders in respiratory medicine to take action to manage the disease and the factors that contribute to its progress in the community.

The ERS/WHO Consilium providing advice on the treatment of drug-resistant TB

Multidrug-resistant tuberculosis (MDR-TB), defined as active TB cases infected by Mycobacterium tuberculosis strains that are resistant to isoniazid and rifampicin (the two most important anti-TB drugs currently in use), and extensively drug resistant tuberculosis (XDR-TB), defined as active TB cases caused by infection with strains that are resistant to at least one fluoroquinolone and one injectable second-line anti-TB drug in addition to resistance to isoniazid and rifampicin, attract interest at different levels. In recent years the alarming rates of MDR- or XDR-TB in Eastern Europe and some other parts of the world, have resulted in strong expressions of concern from national and international partners, health authorities, and professional societies. 

A new online system, which will provide advice on the clinical management of complicated TB cases, is due to be launched by the European Respiratory Society (ERS) -WHO Electronic Consilium.

The consilium, which was launched during the ERS Congress in 2012, was established to provide the opportunity for clinicians and other professionals with TB expertise to support physicians in Europe in the management of TB.

The consilium will provide advice on the treatment of drug-resistant TB and other difficult-to-treat TB cases, including co-infection with HIV and paediatric cases.

A secondary aim of the online system will be to monitor and evaluate clinical practice and look at common pitfalls and trends in treatment of the condition. It is hoped that this will allow for comparison of how cases are treated to help improve TB control.

More info:
http://erj.ersjournals.com/content/41/3/491.full

APOPO Hero Rats: Course at the Research Centre Borstel/Germany on January 29th 2013

Today we are happy to present you special report from our friend Cordula from Take That TB organization:

We are happy to welcome Bart Weetjens today who is the founder of APOPO. He told us many interesting things concerning the APOPO idea, the rat training and the amazing work of these small intelligent animals. There are many things to say. The rats are originally trained for landmine detection but Bart found out that people dying from landmines compared with people dying from Tuberculosis, are the minority. He says that every life hast the same value but that detecting TB is an urgent need as every 20 seconds a human being dies because of TB. TB has to be detected as early as t to give the patients an adequate treatment.

Bart Weetjens loved playing with his pet rats when he was a young boy. Years later, as a student at the University of Antwerp, Bart applied the idea of using rodents for mine detection as an outcome of his analysis of the global mine detection problem.

Due to his childhood experience, he knew that rats, with their strong sense of smell and trainability, could provide a cheaper, more efficient, and locally available means to detect landmines. Early research into this technology began in Belgium, with initial financial support given from the Belgian Directorate for International Co-operation (DGIS) in 1997 to develop the concept.

In 2000, APOPO moved its headquarters to Morogoro, Tanzania, following partnerships with the Sokoine University of Agriculture and the Tanzanian People’s Defence Force. Now housed by the University, APOPO trains the rats – termed HeroRATs because of their life-saving capabilities – in near-to-real conditions.

In 2003, APOPO won the World Bank Development Marketplace Global Competition, which provided seed funding to commence research into another application of detection rats technology: Tuberculosis (TB) detection.

In 2008, APOPO provided proof of principle for the utilization of trained rats in detecting pulmonary tuberculosis in human sputum samples. In 2010, APOPO launched a three-year research plan to closely examine the effectiveness of detection rats in diagnosing tuberculosis, in comparison to other diagnostic technologies, and to focus on future implementation models.

Detecting tuberculosis by scent

Tuberculosis is one of the deadliest diseases in the world, responsible for 9.2 million new illnesses and 1.7 million deaths each year, mainly in poor countries. Rat detection technology is aiding DOTS programs to help diagnose vulnerable populations.

APOPO trains Detection Rats to detect Mycobacterium tuberculosis in human sputum samples. In APOPO’s laboratory in Tanzania, rats sniff a series of 10 holes in a line cage, under which human sputum samples are placed for evaluation. When a rat detects TB, it indicates by keeping its nose in the sample hole and scratching at the surface of the line cage.

Advantages over microscopy

Currently, in most of the world, tuberculosis is detected through microscopy, a method that has not changed significantly in the last 100 years. Microscopy is relatively slow: on average, a laboratory technician can process 40 samples per day, while a trained rat can evaluate the same number of samples in less than seven minutes.

APOPO’s Detection Rats provide second-line screening to eight partner DOTS Centres, located in Dar es Salaam and Morogoro, Tanzania. In 2010, this second-line screening increased new TB case detection rates of APOPO’s partner hospitals by 43%.

Plans

In the future, APOPO hopes Detection Rats will become a key instrument in curbing the spread of Tuberculosis worldwide. Exceptionally fast, accurate, and cost-effective, Detection Rats have an important role to play in screening large and at-risk populations

Awards

·        Ashoka: Innovators for the Public Fellowship awarded to founder, Bart Weetjens

·        The Skoll Award for Social Entrepreneurship in 2008 from the Skoll Foundation

·        Fellow for the Schwab Foundation for Social Entrepreneurship - Awarded to founder, Bart Weetjens

For further information please read the annual report 2011 here: http://www.apopo.org/en/about-apopo/press/annual-reports

Please support the wonderful work by adopting a rat:

http://donate.apopo.org/adoptarat.php?lang=en

Read more about APOPO here:

http://www.apopo.org/en/

TBNET Academy: FREE fellowships grants

The 2nd TBNET Academy will take place in Chisinau, Moldova from May 19th to May 23rd, 2013.

The TBNET-Academy provides a forum for young clinicians and scientists in the field of TB to exchange ideas and to learn from each other under expert guidance and mentorship. Especially the 2nd TBNET-Academy in Chisinau will draw attention to the particular problems of TB control and treatment in high incidence countries by addressing local problems and learning from international and local experts.

More information:

Keynote lectures on:
Tuberculosis in Europe
TBNET: Collaborative Research in Europe
The future on TB treatment
Non tuberculous mycobacteria infections
Tb control and elimination
Special features:
How to prepare a research project?
How to get funded?
How to write a manuscript?

Photo exhibition at Hannover: STOP TB! Tuberculosis - A Global Threat

"STOP TB! Tuberculosis - A Global Threat. "Under this title, Kunsthalle Faust, Hannover cooperates with the Stop TB Partnership for the first time. A large selection of photos of the "Images to Stop Tuberculosis Photo Award 'in Europe following the successfully conducted, great photojournalism project (the Stop TB Partnership in Rio de Janeiro) will be shown by the work of five internationally renowned photographer Jean Chung, Sailendra Kharel, Riccardo Venturi, David Roch Child and David Orr. The photojournalists have documented the situation of TB patients worldwide.

Picture by Jean Chung

Showing more than 50 photographic works and four photo stories as a multimedia presentation, the large-size exhibits impressively show the suffering and the hope of the people who are affected by tuberculosis. In the exhibition, unique shots from different countries are shown, which are most affected by the disease, such as India, Nepal, Sudan and Brazil. The representation of a Sudanese boy who is cared for by his parents lovingly or moribund patients in an Indian hospital left a profound and lasting impressions. Other photographs show patients treated successfully and provide unique examples of the perseverance of the individual and the hope for a cure, despite serious illness.

Picture by Jean Chung

Take That TB: TB has many faces and many languages!

Dear friends, we are happy to present today to you our new partners international organization Take That TB! We had meeting at Vienna and discuss about this exiting project dedicated and created for patient with tuberculosis.

We are publishing very inspirational manifesto by Take That TB:

We are a group of former patients from Europe and Australia and we are trying to build a meeting area “From Patients For Patients”.
Our aim is the exchange between patients and the discussion about our experiences with TB.
We want to be a platform for patients on treatment and for former patients who want to exchange about their experiences with TB.
We want to be a chatroom for patients in isolation.
While others are busy working hard in the fight to develop better drugs and treatment regimes, we want to be a place for patients to get the support and understanding that only other patients can give…
Collectively we can offer great support to each other, and help raise the awareness of TB in our communities, and help remove the stigma this disease has unfortunately associated with it.
We welcome doctors and hospital staff to join us, to help you understand TB from another point of view… to help you have another resource to offer your patients to help them through their experience. 

We want to talk about our experiences during treatment and afterwards and make the stay in hospital a little bit better.
As a result of our exchange we want to make an ebook / book or journal with TB patient stories from as many countries as possible. We want to write this in our / your mother tongue (and English) to show that TB can be found worldwide and that TB has many faces and many languages!!
Not all patients have the possibility to use the Internet for information and many patients also have no computer.
So this document should also show these patients that TB has got not only THEM but many others, from all countries, all age groups and all social classes.
It could be support for the TB patients on treatment and a review for former patients.

United Nations on World TB Day 2012

Today, we are happy to publish message from United Nations General Secretary Ban Ki-Moon on Tuberculosis!

For too long, tuberculosis has not received sufficient attention. The result of this neglect is needless suffering: in 2010 alone, nearly 9 million people fell ill with TB and 1.4 million died, with 95 per cent of these deaths occurring in developing countries. These numbers make tuberculosis the second top infectious killer of adults worldwide.
The impact reverberates far beyond the individuals directly affected. TB takes a heavy toll on families and communities. Millions of children have lost their parents. Children who are exposed to sick family members are at high risk of contracting the disease. Far too many go untreated, since TB is often difficult to diagnose and treat in children. That is why this year we should aim to expand awareness of how children are affected by the disease.
It is critical to support those who lack the means to respond with the care and treatment they need to enjoy healthy and productive lives.
With the right interventions, we can make a major difference. We know how to end all forms of TB, including multi-drug resistant TB - which has emerged in most countries - before it leads to severe manifestations that are costly to treat and cause additional suffering. Where we have taken strong and proven measures, the number of people falling ill with TB has declined markedly.
The World Health Organization reports that our concerted efforts have helped to cut death rates by 40 per cent since 1990. Forty-six million people have been cured and seven million lives have been saved since 1995 thanks to the efforts of the United Nations, governments, donors, civil society groups, private partners, public health experts, and tens of thousands of health workers and affected families and communities.
Now is the time to be even more ambitious and "Stop TB in our lifetime," the theme of this year's World TB Day.

I call for intensified global solidarity to ensure that all people are free from fear of tuberculosis and its devastating effects. Let us vow to end the neglect of TB and to end deaths from this disease in our lifetime.