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  1. 1

    Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response.

    World Health Organization [WHO]. Stop TB Department

    Geneva, Switzerland, WHO, 2010. [71] p.

    This new report on anti-tuberculosis (TB) drug resistance by the World Health Organization (WHO) updates "Anti-tuberculosis drug resistance in the world: Report No. 4" published by WHO in 2008. It summarizes the latest data and provides latest estimates of the global epidemic of multidrug and extensively drug-resistant tuberculosis (M/XDR-TB). For the first time, this report includes an assessment of the progress countries are making to diagnose and treat MDR-TB cases. (Excerpt)
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  2. 2
    Peer Reviewed


    Mabey DC; Solomon AW; Foster A

    Lancet. 2003 Jul 19; 362(9379):223-229.

    Trachoma is the most common infectious cause of blindness. It is caused by ocular serovars of Chlamydia trachomatis. Transmission is favoured in poor communities, where crowding is common and access to water and sanitation inadequate. Repeated reinfection over many years causes dense scarring of the upper eyelid. The resultant inversion of the lashes abrades the eyeball, and the abrasion leads to corneal opacification and visual impairment. The host immune response is probably at least partly the cause of this process. The “SAFE” strategy is used for the control of trachoma: surgery for inturned lashes, antibiotics for active disease, facial cleanliness, and environmental improvement. The demonstration that a single oral dose of the antibiotic azithromycin is as effective as 6 weeks of topical tetracycline was an important advance in trachoma control. By means of the SAFE strategy, WHO and its partners aim to eliminate trachoma as a public-health problem by the year 2020. (author's)
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  3. 3

    Epidemiology of an outbreak of cholera in Senegal (West Africa) in 1985: modes of transmission and mortality.

    Fontaine O; Garenne M; Maire B; Schneider D

    [Unpublished] [1986]. 24, [4] p.

    A cholera outbreak in villages under demographic surveillance by a team of ORSTOM researchers in the center part of Senegal during the first three months of 1985 is described. Health authorities started a vaccination campaign and disinfection of the wells. The ORSTOM team helped to treat cholera cases and a house-to-house survey of the area was started immediately. All cases of cholera-like diarrhea and vomiting that occurred during January-March 1985 in the villages were recorded on special forms. Most cases (63%) and most deaths occurred in January. The epidemic reached a peak during the fourth week of January, then plunged. Interventions started at the end of the third week with a mass vaccination campaign, chlorinization of wells, treatment of cases with oral rehydration therapy (ORT) and tetracycline (4 x 500 mg per day for 2 days), and chemoprophylaxis of cholera patient contacts with sulfadoxine. The pattern of the disease transmission was clearly identified from retrospective interviews in 4% of all cases. Among the 102 identified cases, 56% showed evidence of primary contamination at a funeral ceremony and 44% were secondary cases within the household caused by person-to-person cholera transmission. 70% of adults were contaminated at a burial ceremony and 82% of children inside the compound. 31% of all cholera patients were below 15 years of age (more than 44% of the total population), while 28% of all cholera cases were among the population aged over 50 (14% of the population). During these 3 months, 235 cases of cholera with 44 deaths were recorded. The overall attack rate was 1.9/100 population, and the global lethality rate was 18.7%. However, below age 50 the case-fatality rate was 10%, and after age 50 it rose to 40%. 24.7% of males vs. 14.5% of females were at risk of dying. The drop from a peak of 43% lethality to less than 10% a week later was most probably attributable to ORT and tetracycline treatment.
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  4. 4

    Surveillance of resistance to antituberculosis drugs in developing countries.

    Nunn P; Felten M

    TUBERCLE AND LUNG DISEASE. 1994 Jun; 75(3):163-7.

    Poor management of tuberculosis (TB) control is responsible for resistance to antituberculosis drugs. It leads to treatment failure, relapse, transmission of resistant TB, and multi-drug resistant TB. In developing countries, where resources are already limited, an epidemic of multi-drug resistant TB would jeopardize TB control. The effect of HIV infection is likely to worsen drug resistance-related problems. Specifically, streptomycin injections pose a risk of HIV transmission. It appears that withdrawal of thiacetazone from HIV infected TB patients causes resistance to more powerful drugs. If these 2 antibiotics cannot be used to treat TB patients, the armamentarium available to control TB in high HIV prevalence countries is reduced, which could foster resistance to the fewer remaining antibiotics. Good management and supervision is needed to prevent resistance to antituberculosis drugs. Surveillance of drug resistance is also needed to monitor the current level and characteristics of the drug resistance problem and to identify effective solutions. Specifically, at the national level, a TB surveillance system can assess the TB control program's performance and assess the need to modify the current treatment policy. It can identify districts or health centers with high levels of drug resistance and determine the risk factors for resistance. WHO will assist developing countries in developing their own surveillance systems. WHO and the International Union Against Tuberculosis and Lung Disease plan on setting up a network of supranational reference laboratories to determine the quality control and standardization of susceptibility testing needed for international comparison. WHO also plans on supporting national reference laboratories in developing countries.
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