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  1. 1
    378054
    Peer Reviewed

    Assessing the impact of defining a global priority research agenda to address HIV-associated tuberculosis.

    Odone A; Matteelli A; Chiesa V; Cella P; Ferrari A

    Tropical Medicine and International Health. 2016 Nov; 21(11):1420-1427.

    Objectives In 2010, the WHO issued 77 priority research questions (PRQs) to address HIV-associated TB. Objective of the this study was to assess the impact of defining the research agenda in stimulating and directing research around priority research questions. Methods We used number and type of scientific publications as a proxy to quantitatively assess the impact of research agenda setting. We conducted 77 single systematic reviews -one for every PRQ -building 77 different search strategies using PRQs’ keywords. Multivariate logistic regression models were applied to assess the quantity and quality of research produced over time and accounting for selected covariates. Results In 2009-2015, PRQs were addressed by 1631 publications (median: 11 studies published per PRQ, range 1-96). The most published area was ‘Intensified TB case finding’ (median: 23 studies/PRQ, range: 2-74). The majority (62.1%, n = 1013) were published as original studies, and more than half (58%, n = 585) were conducted in the African region. Original studies’ publication increased over the study period (P trend = <0.001). They focused more on the ‘Intensified TB case finding’ (OR = 2.17, 95% CI: 1.56-2.93) and ‘Drug-resistant TB and HIV infection’ (OR = 2.12, 95% CI: 1.47-3.06) areas than non-original studies. Original studies were published in journals of lower impact factor and received a smaller number of citations than non-original studies (OR = 0.54, 95% CI: 0.42-0.69). Conclusion The generation of evidence to address PRQs has increased over time particularly in selected fields. Setting a priority research agenda for HIV-associated TB might have positively influenced the direction and the conduct of research and contributed to the global response to such a major threat to health.
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  2. 2
    373335

    [The results of implementation of the International Bank for Reconstruction and Development Loan Project "Prevention, diagnosis, and treatment of tuberculosis and AIDS", a "tuberculosis" component]

    Tuberkulez I Bolezni Legkikh. 2010; (3):10-7.

    Due to the implementation of the International Bank for Reconstruction and Development (IBRD) loan project "Prevention, diagnosis, treatment of tuberculosis and AIDS", a "Tuberculosis" component that is an addition to the national tuberculosis control program in 15 subjects of the Russian Federation, followed up by the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, the 2005-2008 measures stipulated by the Project have caused substantial changes in the organization of tuberculosis control: implementation of Orders Nos. 109, 50, and 690 and supervision of their implementation; modernization of the laboratories of the general medical network and antituberbulosis service (404 kits have been delivered for clinical diagnostic laboratories and 12 for bacteriological laboratories, including BACTEC 960 that has been provided in 6 areas); 91 training seminars have been held at the federal and regional levels; 1492 medical workers have been trained in the detection, diagnosis, and treatment of patients with tuberculosis; 8 manuals and guidelines have been prepared and sent to all areas. In the period 2005-2008, the tuberculosis morbidity and mortality rates in the followed-up areas reduced by 1.2 and 18.6%, respectively. The analysis of patient cohorts in 2007 and 2005 revealed that the therapeutic efficiency evaluated from sputum smear microscopy increased by 16.3%; there were reductions in the proportion of patients having ineffective chemotherapy (from 16.1 to 11.1%), patients who died from tuberculosis (from 11.6 to 9.9%), and those who interrupted therapy ahead of time (from 11.8 to 7.8%). Implementation of the IBR project has contributed to the improvement of the national strategy and the enhancement of the efficiency of tuberculosis control.
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  3. 3
    371803

    Working together with businesses. Guidance on TB and TB/HIV prevention, diagnosis, treatment and care in the workplace.

    Dias HM; Uplekar; Amekudzi K; Reid A; Hsu LN; Wilburn S; Mohaupt D

    Geneva, Switzerland, World Health Organization {WHO], 2012. 46 p.

    The corporate and business sector belong to a wide range of care providers that offer TB and HIV care to significant proportions of working populations. While considerable literature is now available on diverse public-private mix interventions for TB care and control, there is a dearth of documentation and updated guidance on business sector initiatives in TB care. To address the need for guiding principles to initiate and scale up the engagement of the business sector in TB and HIV care, the WHO in collaboration with ILO, UNAIDS and other partners conducted an assessment of business sector initiatives to address TB and TB/HIV, documented working examples on the ground, and organized an expert consultation to discuss and draw lessons from available evidence. The purpose of this document is to capitalize on the untapped potential of the business sector to respond to these two epidemics. Built on the 2003 guidelines on contribution of workplaces to TB control prepared jointly by the ILO and WHO, these guidelines should help capitalize on increased awareness about TB and HIV and their impact on businesses, and strengthen partnerships between national TB programmes, national HIV programmes, and the business sector to improve TB and HIV prevention, treatment and care activities. Existing guidance to facilitate business participation predominantly focuses on HIV. This document is therefore principally centred on TB prevention, treatment and care and it’s linkages with HIV. This document is designed to provide guidance to TB and HIV programme managers, employers, workers organizations, occupational health staff and other partners on the need and ways to work in partnership to design and implement workplace TB/HIV prevention, treatment and care programmes integrated with occupational health and HIV workplace programmes where relevant. (excerpt)
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  4. 4
    369532
    Peer Reviewed

    Implementation and Operational Research: Implementation of the WHO 2011 Recommendations for Isoniazid Preventive Therapy (IPT) in Children Living With HIV/AIDS: A Ugandan Experience.

    Costenaro P; Massavon W; Lundin R; Nabachwa SM; Fregonese F; Morelli E; Alowo A; Nannyonga Musoke M; Namisi CP; Kizito S; Bilardi D; Mazza A; Cotton MF; Giaquinto C; Penazzato M

    Journal of Acquired Immune Deficiency Syndromes. 2016 Jan 1; 71(1):e1-8.

    BACKGROUND: Intensified tuberculosis (TB) case finding and isoniazid preventive therapy (IPT) are strongly recommended for children who are HIV infected. Data are needed to assess the feasibility of the WHO 2011 intensified tuberculosis case finding/IPT clinical algorithm. METHODS: Children who are HIV infected and attending Nsambya Home Care at Nsambya Hospital, Uganda, were screened for TB following WHO recommendations. IPT was given for 6 months after excluding TB. Factors associated with time to IPT initiation were investigated by multivariate Cox proportional hazard regression. Health care workers were interviewed on reasons for delay in IPT initiation. RESULTS: Among the 899 (49% male) children with HIV, 529 (58.8%) were screened for TB from January 2011 to February 2013. Children with active TB were 36/529 (6.8%), 24 (4.5%) were lost to follow-ups and 280 (52.9%) started IPT, 86/280 (30.7%) within 3 months of TB screening and 194/280 (69.3%) thereafter. Among the 529 children screened for TB, longer time to IPT initiation was independently associated with cough at TB screening (hazard ratio 0.62, P = 0.02, 95% confidence interval: 0.41 to 0.94). Four children (1% of those starting treatments) interrupted IPT because of a 5-fold increase in liver function measurements. In the survey, Health care workers reported poor adherence to antiretroviral therapy, poor attendance to periodic HIV follow-ups, and pill burden as the 3 main reasons to delay IPT. CONCLUSION: In resource-constrained settings, considerable delays in IPT initiation may occur, particularly in children with HIV who are presenting with cough at TB screening. The good safety profile of isoniazid in antiretroviral-therapy-experienced children provides further support to IPT implementation in this population.
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  5. 5
    333337

    Getting to zero: 2011-2015 strategy, Joint United Nations Programme on HIV / AIDS (UNAIDS).

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 2010 Dec. [64] p. (UNAIDS/10.12E/JC2034E)

    This Strategy has been developed through wide consultation, informed by the best evidence and driven by a moral imperative to achieve universal access to HIV prevention, treatment, care and support and the Millennium Development Goals.
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  6. 6
    332082

    Report to Congress by the U.S. Global AIDS Coordinator on the involvement of faith-based organizations in activities of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

    United States. Office of the United States Global AIDS Coordinator

    [Washington, D.C.], Office of the United States Global AIDS Coordinator, 2008 May. 40 p.

    The Administration provides this Report pursuant to Section 625(b) of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2008 (Division J, Public Law 110-161), which requires the U.S. Secretary of State to submit a report to the Committees on Appropriations "on the involvement of faith-based organizations in Global Fund Programs. The report shall include (1) on a country-by-country basis -(A) a description of the amount of grants and subgrants provided to faith-based organizations; and (B) a detailed description of the involvement of faith-based organizations in the Country Coordinating Mechanism (CCM) process of the Global Fund; and (2) a description of actions the Global Fund is taking to enhance the involvement of faith-based organizations in the CCM process, particularly in countries in which the involvement of faith-based organizations has been underrepresented.
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  7. 7
    325742
    Peer Reviewed

    Kevin De Cock: Guiding HIV / AIDS policy at WHO.

    Shetty P

    Lancet Infectious Diseases. 2008 Feb; 8(2):98-100.

    Kevin De Cock is director of WHO's HIV/AIDS department. Formerly director of the US Centers for Disease Control and Prevention in Kenya, he is an infectious disease specialist, with expertise in HIV/ AIDS, tuberculosis, liver disease, and tropical diseases such as yellow fever and viral haemorrhagic fevers. TLID: How has your time as WHO's HIV/AIDS director been? KDC: It has been extremely interesting. AIDS policy is always challenging and changing. WHO's HIV efforts up to 2005 were very much oriented around the 3 by 5 initiative. The G8 in 2005 made an announcement about working towards universal access, which became an AIDS rallying cry. So we've had to reorganise ourselves around that as a theme. Some internal reorganisation was necessary to focus not only on treatment, but also on broader issues. We now have five key strategic directions: increasing access to HIV testing and counselling, maximising prevention, accelerating treatment scale-up, strengthening health systems, and investing in strategic information. We have also been working on some important technical areas. One is the issuing of guidance on both provider-initiated testing and male circumcision. In April, 2007, we also issued a report, in response to a request from the World Health Assembly, on the health sector's progress towards universal access. (excerpt)
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  8. 8
    325346
    Peer Reviewed

    Tuberculosis in Africa - combating an HIV-driven crisis.

    Chaisson RE; Martinson NA

    New England Journal of Medicine. 2008 Mar 13; 358(11):1089-1092.

    Africa is facing the worst tuberculosis epidemic since the advent of the antibiotic era. Driven by a generalized human immunodeficiency virus (HIV) epidemic and compounded by weak health care systems, inadequate laboratories, and conditions that promote transmission of infection, this devastating situation has steadily worsened, exacerbated by the emergence of drug-resistant strains of tuberculosis. Africa, home to 11% of the world's population, carries 29% of the global burden of tuberculosis cases and 34% of related deaths, and the challenges of controlling the disease in the region have never been greater. The World Health Organization (WHO) estimates that the average incidence of tuberculosis in African countries more than doubled between 1990 and 2005, from 149 to 343 per 100,000 population (see maps) - a stark contrast to the stable or declining rates in all other regions during this period. In 1990, two African countries, Mali and Togo, had an incidence greater than 300 per 100,000; by 2005, 25 countries had reached that level, and 8 of them had an incidence at least twice that high. (excerpt)
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  9. 9
    322017

    Antiretroviral therapy for HIV infection in infants and children: towards universal access. Recommendations for a public health approach.

    World Health Organization [WHO]. Department of HIV / AIDS

    Geneva, Switzerland, WHO, 2007. [147] p.

    These stand-alone treatment guidelines serve as a framework for selecting the most potent and feasible first-line and second-line ARV regimens as components of expanded national responses for the care of HIV-infected infants and children. Recommendations are provided on: diagnosing HIV infection in infants and children; when to start ART, including situations where severe HIV disease in children less than 18 months of age has been presumptively diagnosed; clinical and laboratory monitoring of ART; substitution of ARVs for toxicities. The guidelines consider ART in different situations, e.g. where infants and children are coinfected with HIV and TB or have been exposed to ARVs either for the prevention of MTCT (PMTCT) or because of breastfeeding from an HIV-infected mother on ART. They address the importance of nutrition in the HIV-infected child and of severe malnutrition in relation to the provision of ART. Adherence to therapy and viral resistance to ARVs are both discussed with reference to infants and children. A section on ART in adolescents briefly outlines key issues related to treatment in this age group. (excerpt)
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  10. 10
    318629
    Peer Reviewed

    Treatment strategies for HIV-infected patients with tuberculosis: Ongoing and planned clinical trials.

    Blanc FX; Havlir DV; Onyebujoh PC; Thim S; Goldfeld AE

    Journal of Infectious Diseases. 2007 Aug 15; 196 Suppl 1:S46-S51.

    Currently, there are limited data to guide the management of highly active antiretroviral therapy (HAART) for human immunodeficiency virus type 1 (HIV-1)-infected patients with active tuberculosis (TB), the leading cause of death among individuals with acquired immunodeficiency syndrome (AIDS) in resource-limited areas. Four trials to take place in Southeast Asian, African, and South American countries will address the unresolved question of the optimal timing for initiation of HAART in patients with AIDS and TB: (1) Cambodian Early versus Late Introduction of Antiretrovirals (CAMELIA [ANRS 1295/NIH-CIPRA KH001]), (2) Adult AIDS Clinical Trials Group A5221, (3) START, and (4) a trial sponsored by the World Health Organization/Special Programme for Research and Training in Tropical Diseases. Two other clinical questions regarding patients with TB and HIV-1 coinfection are also undergoing evaluation: (1) the benefits of short-term HAART when CD4 cell counts are > 350 cells/mm3 (PART [NIH 1 R01 AI051219-01A2]) and (2) the efficacy of a once-daily HAART regimen in treatment-naive patients (BKVIR [ANRS 129]). Here, we present an overview of these ongoing or planned clinical studies, which are supported by international agencies. (author's)
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  11. 11
    318625
    Peer Reviewed

    Tuberculosis and HIV infection: The global setting.

    Nunn P; Reid A; De Cock KM

    Journal of Infectious Diseases. 2007 Aug 15; 196 Suppl 1:S5-S14.

    Tuberculosis (TB) and human immunodeficiency virus (HIV) infection make each other's control significantly more difficult. Coordination in addressing this "cursed duet" is insufficient at both global and national levels. However, global policy for TB/HIV coordination has been set, and there is consensus around this policy from both the TB and HIV control communities. The policy aims to provide all necessary care for the prevention and management of HIV-associated TB, but its implementation is hindered by real technical difficulties and shortages of resources. All major global-level institutions involved in HIV care and prevention must include TB control as part of their corporate policy. Country-level decision makers need to work together to expand both TB and HIV services, and civil society and community representatives need to hold those responsible accountable for their delivery. The TB and HIV communities should join forces to address the health-sector weaknesses that confront them both. (author's)
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  12. 12
    318624
    Peer Reviewed

    Tuberculosis and HIV coinfection: Genesis of the supplement and sponsors' contribution.

    Hoxie JA; Miller V; Walker B

    Journal of Infectious Diseases. 2007 Aug; 196 Suppl 1:S4-.

    This supplement to the Journal of Infectious Diseases on tuberculosis (TB)/HIV coinfection came together as a result of a collaboration between the National Institutes of Health (NIH)-funded Centers for AIDS Research (CFARs) at Harvard University and at the University of Pennsylvania, and the Forum for Collaborative HIV Research. It is based on 2 programs addressing TB/HIV coinfection research challenges. A steering committee, consisting of Bruce Walker, Edward Nardell, Megan Murray, and Eric Rubin (Harvard University); Gerald Friedland (Yale University); and James Hoxie (University of Pennsylvania); with the support of the national network of CFARs, organized a symposium entitled "Confronting TB/HIV Co-infection" that was held on 30 June 2005 at Harvard University. The Forum for Collaborative HIV Research, together with the International AIDS Society and the Agence National de Recherches sur le Sida et les Hepatites Virales, with special support from Tibotec, sponsored a special session entitled "HIV/TB: New Visions, New Directions" during the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro on 25 July 2005, followed by a roundtable discussion with representatives from the World Health Organization HIV/ AIDS and Stop TB departments; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the NIH; the Centers for Disease Control and Prevention (CDC); and leaders from the pharmaceutical industry, research networks, and advocacy organizations. (excerpt)
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  13. 13
    316243
    Peer Reviewed

    Barriers to reaching the targets for tuberculosis control: multidrug-resistant tuberculosis.

    Blondal K

    Bulletin of the World Health Organization. 2007 May; 85(5):325-420.

    The development and expansion of WHO's DOTS strategy was successful, with 83% of the world's population living in countries or parts of countries covered by this strategy by the end of 2004. Treatment success in the 2003 DOTS cohort of 1.7 million patients was 82% on average, close to the 85% target. Treatment success was below average in the African Region (72%), which can be partly attributed to occurrence of HIV co-infection, and in the European Region (75%), partly due to drug resistance. Drug resistance, specifically multidrug resistance and extensive drug resistance, is a serious threat to public health in all countries, especially in the Russian Federation, where the highest rates of multidrug resistance are presently accompanied by a rapid increase in HIV infection. Based on the experience of the first projects approved by the Green Light Committee, the treatment success of patients with multidrug-resistant tuberculosis (MDR-TB) is lower than that of drug-susceptible cases, but nevertheless reaches 70%. The collaborative effort of different organizations, professionals and communities is needed to address the development and spread of multidrug resistance and extensive drug resistance, which combined with the epidemic of HIV infection is one of the barriers to dealing effectively with TB. This effort should be directed towards facilitating the diagnosis and treatment of TB patients, in particular by improving access to drug susceptibility testing and strengthening treatment delivery by rigorous adherence to DOTS as outlined by the Stop TB Partnership. (author's)
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  14. 14
    316239
    Peer Reviewed

    Roles of laboratories and laboratory systems in effective tuberculosis programmes.

    Ridderhof JC; van Deun A; Kam KM; Narayanan PR

    Bulletin of the World Health Organization. 2007 May; 85(5):325-420.

    Laboratories and laboratory networks are a fundamental component of tuberculosis (TB) control, providing testing for diagnosis, surveillance and treatment monitoring at every level of the health-care system. New initiatives and resources to strengthen laboratory capacity and implement rapid and new diagnostic tests for TB will require recognition that laboratories are systems that require quality standards, appropriate human resources, and attention to safety in addition to supplies and equipment. To prepare the laboratory networks for new diagnostics and expanded capacity, we need to focus efforts on strengthening quality management systems (QMS) through additional resources for external quality assessment programmes for microscopy, culture, drug susceptibility testing (DST) and molecular diagnostics. QMS should also promote development of accreditation programmes to ensure adherence to standards to improve both the quality and credibility of the laboratory system within TB programmes. Corresponding attention must be given to addressing human resources at every level of the laboratory, with special consideration being given to new programmes for laboratory management and leadership skills. Strengthening laboratory networks will also involve setting up partnerships between TB programmes and those seeking to control other diseases in order to pool resources and to promote advocacy for quality standards, to develop strategies to integrate laboratories' functions and to extend control programme activities to the private sector. Improving the laboratory system will assure that increased resources, in the form of supplies, equipment and facilities, will be invested in networks that are capable of providing effective testing to meet the goals of the Global Plan to Stop TB. (author's)
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  15. 15
    314873

    Emergency Plan for AIDS Relief. Fiscal year 2005 operational plan. June 2005 update.

    United States. Department of State. Office of the United States Global AIDS Coordinator

    Washington, D.C., United States Department of State, Office of the United States Global AIDS Coordinator, 2005 Jun. 184 p. (USAID Development Experience Clearinghouse DocID / Order No. PC-AAB-508)

    This June FY 2005 Operational Plan serves as an update of the February 2005 Operational Plan. The FY 2005 Operational Plan follows "The President's Emergency Plan for AIDS Relief -- U.S. Five-Year Global HIV/AIDS Strategy" and sets out a course to have an immediate impact on people and strengthen the capacity of governments and NGOs to expand programs quickly over the next several years. By the end of FY 2005 the Emergency Plan will provide direct and indirect care and support for approximately 3,500,000 individuals, and will facilitate access to antiretroviral therapy for at least 550,000 individuals. Section III of this document provides information on each country's contribution to the total number of individuals to be receiving care and support and antiretroviral therapy by the end of FY 2005. The country-specific target tables also provide the FY 2008 care and treatment targets for each country. The FY 2008 targets were set at the beginning of the Emergency Plan. The sum of all countries' FY 2008 care/support targets equals the Emergency Plan's goal of ten million individuals receiving care and support by the end of year five. The sum of all countries' FY 2008 treatment targets equals the Emergency Plan's goal of two million people on treatment at the end of year five. (excerpt)
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  16. 16
    314561
    Peer Reviewed

    Stopping tuberculosis proves hard to do.

    Lancet. 2007 Mar 24; 369(9566):965.

    Tuberculosis continues to kill nearly 2 million people every year, most of whom are in the lowest income countries. Since the launch of WHO's new Stop TB Strategy a year ago in this journal, three major threats to tuberculosis control can be identified: the spread of all forms of drug resistance, including extensively drug-resistant tuberculosis (XDR-TB); the challenges of successfully diagnosing and treating HIV-infected patients with tuberculosis; and the failure to attract sufficient funding to put all necessary control measures into place. These threats indicate that global tuberculosis control targets will not be met. The inexorable rise of drug-resistant strains (one in ten new infections is resistant to at least one antituberculosis drug), and the worrying spread of XDR-TB, threaten to undermine tuberculosis control efforts. 35 countries, including all those in the G8, have now confirmed XDRTB cases. But it is in South Africa that XDR-TB poses the greatest threat because of its particularlyhigh mortality in HIV-positive people--most patients will die before the diagnosis of XDR-TB can be confirmed. There are now 269 confirmed XDR-TB cases in South Africa, where it has spread from its place of first discovery last year, the province of KwaZulu Natal, to all parts of the country. There is a real danger that HIV infection will fast track the spread of XDR-TB into a global epidemic. According to Mario Raviglione, director of Stop TB at WHO, an appeal for US$95 million made last October to counter XDR-TB generated little response; WHO now estimates that $650 million is needed for multidrug-resistant tuberculosis and XDR-TB control in 2007 alone. (excerpt)
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  17. 17
    312718

    The Stop TB Partnership in South Africa: a review.

    Barr D; Padarath A; Salt L

    Durban, South Africa, Health Systems Trust, 2004. 61 p.

    This case study presents an overview of the Stop TB Partnership operating in the South African context. It offers an analysis of the activities and impact of the Partnership in South Africa. Its overarching objective is to collect a set of baseline data on the functioning and operational aspects of the Partnership and to assess whether such initiatives contribute to the development of equitable health services in the public health sector. Tuberculosis is a priority disease in South Africa: the cure rate for new patients of 64% is still way below the World Health Organization (WHO) target of 85%. In some provinces, the cure rate is as low as 40%. The estimated incidence of TB per 100 000 population is 526, and an estimated 60% of adults with TB are also HIV positive. South Africa is ranked third in the WHO AFRO region by the number of TB cases, and ninth globally. Funded by WEMOS, this review is part of a multi-country study. It aims to augment the existing body of knowledge on Global Public Private Initiatives in Health (GPPIs) and to generate a body of country-based evidence relating to the effect of GPPIs on health policies and health systems. (excerpt)
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  18. 18
    312576

    WHO training course for TB consultants: RPM Plus drug management sessions in Sondalo, Italy, September 28 - October 1, 2006: trip report.

    Barillas E

    Arlington, Virginia, Management Sciences for Health, Center for Pharmaceutical Management, Rational Pharmaceutical Management Plus, 2006 Oct 18. 26 p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00; USAID Development Experience Clearinghouse DocID / Order No. PN-ACI-323)

    WHO, Stop-TB Partners, and NGOs that support country programs for DOTS implementation and expansion require capable consultants in assessing the capacity of countries to manage TB pharmaceuticals in their programs, developing interventions, and providing direct technical assistance to improve availability and accessibility of quality TB medicines. Beginning in 2001, RPM Plus, in addition to its own formal courses on pharmaceutical management for tuberculosis, has contributed modules and facilitated sessions on specific aspects of pharmaceutical management to the WHO Courses for TB Consultants in Sondalo. The WHO TB Course for TB Consultants was developed and initiated in 2001 by the WHO Collaborating Centre for Tuberculosis and Lung Diseases, the S. Maugeri Foundation, the Morelli Hospital, and TB CTA. The main goal of the course is to increase the pool of international level TB consultants. As of December 2005, over 150 international TB consultants have participated in the training, a majority ofwhom have already been employed in consultancy activities by the WHO and international donors. In 2006 fiscal year RPM Plus received funds from USAID to continue supporting the Sondalo Course, which allowed RPM Plus to facilitate sessions on pharmaceutical management for TB at four courses in May, June, July, and October of 2006. RPM Plus Senior Program Associate, Edgar Barillas, traveled to Sondalo from September 28 to October 1 to facilitate the TB pharmaceutical management session at the WHO course for TB Consultants in Sondalo, Italy. (excerpt)
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  19. 19
    312306

    3...2...1... gone? Failure to call Global Fund Round 6 risks the whole 2010 AIDS treatment target.

    Wright S

    [London, England], ActionAid, 2006 Apr 11. 5 p.

    Global Fund funding rounds are becoming further and further apart due to the failure of donors to commit enough resources for the Fund to do its job. At the April Board meeting, donors will decide whether Round 6 can be held this year. If it is delayed until 2007 or even later, the G8's treatment target will not be helped by one of the main sources of funding. ActionAid calls on the UK Government to continue its leadership on AIDS from 2005 and put pressure on other donors to launch Round 6 and to pay their fair share to the Fund. (excerpt)
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  20. 20
    307507

    XDR-TB -- a global threat [editorial]

    Lancet. 2006 Sep 16; 368(9540):964.

    Following an emergency consultation in Johannesburg on Sept 7 and 8, global health agencies have developed a seven-point plan to combat extensively (or extremely) drug-resistant tuberculosis (XDR-TB). Representatives from several southern African countries have agreed to implement the plan within 3 months. Multidrug-resistant TB (MDR-TB), defined as resistance to at least isoniazid and rifampicin, requires the use of second-line drugs that are less effective, more expensive, and more toxic than first-line regimens based on isoniazid and rifampicin. Recognised earlier this year, XDR-TB is MDR-TB that is also resistant to three or more of the six classes of second-line drugs. Of 17 690 TB isolates taken between 2000 and 2004, 20% were MDR and 2% were XDR. XDR-TB has now been identified in all regions of the world but is most prevalent in Asia and in eastern Europe. (excerpt)
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  21. 21
    306528
    Peer Reviewed

    Multidrug-resistant tuberculosis management in resource-limited settings.

    Nathanson E; Lambregts-van Weezenbeek C; Rich ML; Gupta R; Bayona J

    Emerging Infectious Diseases. 2006 Sep; 12(9):1389-1397.

    Evidence of successful management of multidrugresistant tuberculosis (MDRTB) is mainly generated from referral hospitals in high-income countries. We evaluate the management of MDRTB in 5 resource-limited countries: Estonia, Latvia, Peru, the Philippines, and the Russian Federation. All projects were approved by the Green Light Committee for access to quality-assured second-line drugs provided at reduced price for MDRTB management. Of 1,047 MDRTB patients evaluated, 119 (11%) were new, and 928 (89%) had received treatment previously. More than 50% of previously treated patients had received both first- and second-line drugs, and 65% of all patients had infections that were resistant to both first- and second-line drugs. Treatment was successful in 70% of all patients, but success rate was higher among new (77%) than among previously treated patients (69%). In resource-limited settings, treatment of MDRTB provided through, or in collaboration with, national TB programs can yield results similar to those from wealthier settings. (author's)
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  22. 22
    306526
    Peer Reviewed

    Nosocomial tuberculosis in India.

    Pai M; Kalantri S; Aggarwal AN; Menzies D; Blumberg HM

    Emerging Infectious Diseases. 2006 Sep; 12(9):1311-1318.

    Most high-income countries implement tuberculosis (TB) infection control programs to reduce the risk for nosocomial transmission. However, such control programs are not routinely implemented in India, the country that accounts for the largest number of TB cases in the world. Despite the high prevalence of TB in India and the expected high probability of nosocomial transmission, little is known about nosocomial and occupational TB there. The few available studies suggest that nosocomial TB may be a problem. We review the available data on this topic, describe factors that may facilitate nosocomial transmission in Indian healthcare settings, and consider the feasibility and applicability of various recommended infection control interventions in these settings. Finally, we outline the critical information needed to effectively address the problem of nosocomial transmission of TB in India. (author's)
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  23. 23
    293690

    Fifth round of funding adds $729 to fight against diseases.

    Mera. 2006 Jan; (21):3-4.

    The Global Fund is a unique global public-private partnership dedicated to attracting and disbursing additional resources to prevent and treat HIV/AIDS, tuberculosis and malaria. This partnership between governments, civil society, the private sector and affected communities represents a new approach to international health financing. The Fund works in close collaboration with other bilateral and multilateral organisations to supplement existing efforts dealing with the three diseases. Apart from a high standard of technical quality, the Global Fund attaches no conditions to any of its grants. It is not an implementing agency, instead relying on local ownership and planning to ensure that new resources are directed to programmes on the frontline of this global effort to reach those most in need. Its performance-based approach to grant-making is designed to ensure that funds are used efficiently and create real change for people and communities. (excerpt)
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  24. 24
    296401

    WHO report 2005: TB linked to HIV at alarming levels in Africa.

    Reinhardt E

    UN Chronicle. 2005 Jun-Aug; 42(2):[5] p..

    The battle against tuberculosis (TB) is being successfully fought in most areas of the world, but in Africa the disease has reached alarming proportions with an increasing number of cases and deaths linked to HIV, said the World Health Organization in its WHO Report 2005, Global Tuberculosis Control: Surveillance, Planning, Financing, released on 24 March to coincide with World TB Day. The WHO Report focuses on five principal indicators: incidence, prevalence, deaths, case detection and treatment success. It finds that its prevalence has declined worldwide by more than 20 per cent since 1990 and that incidence rates are falling or stable in all regions except in Africa, where TB rates have tripled since 1990 in countries with high HIV prevalence and continue to rise at 3 to 4 per cent annually. (excerpt)
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  25. 25
    293244

    Towards achieving millennium development goals in the health sector in India [editorial]

    Agarwal SP

    Journal, Indian Academy of Clinical Medicine. 2005 Oct-Dec; 6(4):268-274.

    At the Millennium Summit held at the United Nations (New York) in September 2000, 189 countries reaffirmed their commitment to working towards a world in which sustaining development and eliminating poverty would have the highest priority. Eight Millennium Development Goals (MDG) were adopted by a consensus of experts to measure progress in all the major areas related to the well-being of people. These included extreme poverty, education, health, gender equality, and the environment. All goals are interlinked, and efforts to achieve one goal will have positive spillover effects on several others. 18 Targets and 48 Indicators have been adopted to monitor the Eight Millennium Development Goals. Of these, 8 Targets and 18 Indicators are directly related to health. While many health indicators are "truly health indicators" such as prevalence and death rates associated with malaria and tuberculosis, some are related to critical factors for health such as access to improved water supply or dietary energy consumption (health-related indicators). India is committed to achieve the Targets under the MDGs by 2015. Incidentally, certain targets have been set under the National Population Policy 2000 (NPP-2000), National Health Policy 2002 (NHP-2002), National AIDS Prevention and Control Policy 2004, and the Tenth Five Year Plan. This paper compares goals and targets mentioned in these documents vis-a-vis selected Millennium Development Goals and Targets. This also highlights the current progress towards attaining the MDGs as well as the challenges ahead. (excerpt)
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