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Geneva, Switzerland, WHO, 2013.  p.The World Malaria Report 2013 summarizes information received from malaria-endemic countries and other sources, and updates the analyses presented in the 2012 report. It highlights the progress made towards global malaria targets set for 2015, and describes current challenges for global malaria control and elimination.
Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response.
Geneva, Switzerland, WHO, 2010.  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)
Bulletin of the World Health Organization. 2007 Aug; 85(8):586-592.WHO's new Global Plan to Stop TB 2006-2015 advises countries with a high burden of tuberculosis (TB) to expand case-finding in the private sector as well as services for patients with HIV and multidrug-resistant TB (MDR-TB). The objective of this study was to evaluate these strategies in Thailand using data from the Thailand TB Active Surveillance Network, a demonstration project begun in 2004. In October 2004, we began contacting public and private health-care facilities monthly to record data about people diagnosed with TB, assist with patient care, provide HIV counselling and testing, and obtain sputum samples for culture and susceptibility testing. The catchment area included 3.6 million people in four provinces. We compared results from October 2004-September 2005 (referred to as 2005) to baseline data from October 2002-September 2003 (referred to as 2003). In 2005, we ascertained 5841 TB cases (164/100 000), including 2320 new smear-positive cases (65/100 000). Compared with routine passive surveillance in 2003, active surveillance increased reporting of all TB cases by 19% and of new smear-positive cases by 13%. Private facilities diagnosed 634 (11%) of all TB cases. In 2005, 1392 (24%) cases were known to be HIV positive. The proportion of cases with an unknown HIV status decreased from 66% (3226/4904) in 2003 to 23% (1329/5841) in 2005 (P< 0.01). Of 4656 pulmonary cases, mycobacterial culture was performed in 3024 (65%) and MDR-TB diagnosed in 60 (1%). In Thailand, piloting the new WHO strategy increased case-finding and collaboration with the private sector, and improved HIV services for TB patients and the diagnosis of MDR-TB. Further analysis of treatment outcomes and costs is needed to assess this programme's impact and cost effectiveness. (author's)
Lancet. 2007 Mar 3; 369(9563):715-798.South Africa is struggling to contain an outbreak of extensively drug-resistant tuberculosis, which has now spread to all the country's provinces, according to the Department of Health, and threatens to hamper HIV/AIDS treatment plans. Clare Kapp reports from South Africa. WHO is sending a permanent staff member to be based in South Africa to advise authorities struggling with an outbreak of extensively drug-resistant (XDR) tuberculosis. The Department of Health says there have now been 269 confirmed cases of XDR tuberculosis and that it has spread from the province of KwaZulu-Natal, where it was first confirmed, to all parts of South Africa. But Karin Weyer, tuberculosis research director at the Medical Research Council (MRC), said nobody really knows the true number of cases because of laboratory and diagnostics constraints and inconsistencies in reporting. So far there have been no reported cases in neighbouring southern African countries, but Weyner believes that this is because they simply do not have the laboratory testing facilities. (excerpt)
Epidemiology of antituberculosis drug resistance (the Global Project on Anti-tuberculosis Drug Resistance Surveillance): an updated analysis.
Lancet. 2006 Dec 16; 368(9553):2142-2154.The burden of tuberculosis is compounded by drug-resistant forms of the disease. This study aimed to analyse data on antituberculosis drug resistance gathered by the WHO and International Union Against Tuberculosis and Lung Disease Global Project on Anti-tuberculosis Drug Resistance Surveillance. Data on drug susceptibility testing for four antituberculosis drugs--isoniazid, rifampicin, ethambutol, and streptomycin--were gathered in the third round of the Global Project (1999-2002) from surveys or ongoing surveillance in 79 countries or geographical settings. These data were combined with those from the first two rounds of the project and analyses were done. Countries that participated followed a standardised set of guidelines to ensure comparability both between and within countries. The median prevalence of resistance to any of the four antituberculosis drugs in new cases of tuberculosis identified in 76 countries or geographical settings was 10.2% (range 0.0-57.1). The median prevalence of multidrug resistance in new cases was 1.0% (range 0.0-14.2). Kazakhstan, Tomsk Oblast (Russia), Karakalpakstan (Uzbekistan), Estonia, Israel, the Chinese provinces Liaoning and Henan, Lithuania, and Latvia reported prevalence of multidrug resistance above 6.5%. Trend analysis showed a significant increase in the prevalence of multidrug resistance in new cases in Tomsk Oblast (p < 0.0001). Hong Kong (p = 0.01) and the USA (p = 0.0002) reported significant decreasing trends in multidrug resistance in new cases of tuberculosis. Multidrug resistance represents a serious challenge for tuberculosis control in countries of the former Soviet Union and in some provinces of China. Gaps in coverage of the Global Project are substantial, and baseline information is urgently required from several countries with high tuberculosis burden to develop appropriate control interventions. (author's)
Anti-tuberculosis drug resistance in the world. Third global report. The WHO / IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance, 1999-2002.
[Geneva, Switzerland], World Health Organization [WHO], WHO / IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance, . 129 p.This is the third report of the WHO/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance. The two previous reports were published in 1997 and 2001 and included data from 35 and 58 settings respectively. The main conclusions of the two previous reports were that drug-resistant tuberculosis (TB) was present in all settings surveyed, multi-drug resistance (MDR) was identified in most settings, and that good TB control practices were associated with lower or decreasing levels of resistance. The goal of the third report is to expand knowledge of the prevalent patterns of resistance globally and explore trends in resistance over time. This report includes new data from 77 settings or countries collected in the third phase of the project, between 1999 and 2002, representing 20% of the global total of new smear-positive TB cases. It includes 39 settings not previously included in the Global Project and reports trends for 46 settings. Data were included if they adhered to the following principles: (1) the sample was representative of all TB cases in the setting under evaluation; (2) new patients were clearly distinguished from those with previous treatment; and (3) optimal laboratory performance was assured and maintained through links with a supranational reference laboratory (SRL). Data were obtained through routine or continuous surveillance of all TB cases (38 settings) or from specific surveys of sampled patients, as outlined in approved protocols (39 settings). Data were reported on a standard reporting form, either annually or at the completion of the survey. (excerpt)
Generic protocol to estimate the burden of Shigella diarrhoea and dysenteric mortality. Field test version, May 1999.
Geneva, Switzerland, World Health Organization [WHO], Department of Vaccines and Biologicals, 1999. 37 p. (WHO/V&B/99.26)The WHO Department of Vaccines and Biologicals (V&B) has an increasing interest in vaccines against Shigella, and several candidate vaccines are being tested in clinical trials. The promise of having a new generation of vaccines available in the relatively near future emphasizes the need to understand the disease burden and the epidemiology of Shigella infection in developing countries. The V&B Steering Committee on Epidemiology and Field Research and the V&B Steering Committee on Diarrhoeal Disease Vaccines jointly identified the need for a practical method for immunization programme managers and clinical epidemiologists to assess the local disease burden due to Shigella. At the request of these Steering Committees, this generic protocol was prepared by staff at the U.S National Institute of Child Health and Human Development, the University of Maryland, and the U.S. Centers for Disease Control and Prevention. This protocol provides a general outline for a study and describes the main procedures involved. However, it will need to be adapted to the local setting, and details of field work and operational procedures should be added by local investigators with experience in conducting field studies of diarrhoeal diseases. WHO provides this protocol free-of-charge. In return, WHO would appreciate being informed about studies conducted using this protocol. This WHO document should be referenced in any publication resulting from its use. Comments or suggestions for improving this generic protocol are welcome and should be sent to the Department of Vaccines and Biologicals, WHO, 1211 Geneva 27, Switzerland. (excerpt)
AIDS. 2004; 18 Suppl 3:S49-S53.The widespread use of any antimicrobial agent, including antiretroviral agents, has the potential to select drug-resistant populations of microorganisms. HIV drug-resistant strains have been recognized as a serious threat to the efficacy of current antiretroviral treatments and could jeopardize efforts to increase access to treatment in countries most affected by the HIV epidemic. The WHO Global HIV Drug Resistance Surveillance Programme aims at enhancing and enabling the response to the threat of antiretroviral drug resistance by assessing the geographical and temporal trends in HIV drug resistance, increasing our understanding of the determinants of HIV drug resistance, and identifying ways to minimize its appearance, evolution and spread. Based on a global network of experts and collaborating institutions, the programme is developing and field-testing tools and guidelines for the regular monitoring of the level and spread of HIV resistance, particularly in treatment-naive patients. Although relevant progress has been made, several important challenges still exist to the implementation of this essential and innovative programme. (author's)
Emerging Infectious Diseases. 1998 Jul-Sep; 4(3):398-403.A recent upsurge of malaria in endemic-disease areas with explosive epidemics in many parts of Africa is probably caused by many factors, including rapidly spreading resistance to antimalarial drugs, climatic changes, and population movements. In Africa, malaria is caused by Plasmodium falciparum and is transmitted by Anopheles gambiae complex. Control efforts have been piecemeal and not coordinated. Strategies for control should have a solid research base both for developing antimalarial drugs and vaccines and for better understanding the pathogenesis, vector dynamics, epidemiology, and socioeconomic aspects of the disease. An international collaborative approach is needed to build appropriate research in a national context and to effectively translate research results into practical applications in the field. The Multilateral Initiative for Malaria in Africa can combine all of the above strategies to plan and coordinate partnerships, networking, and innovative approaches between African scientists and their Northern partners. (author's)