The role of the laboratory in the prevention and control of multidrug-resistant tuberculosis

1997 ◽  
Vol 8 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Edward P. Desmond
2005 ◽  
Vol 13 (2) ◽  
pp. 172-174 ◽  
Author(s):  
Rishen Naidoo ◽  
Anu Reddi

The emergence of multidrug-resistant tuberculosis poses a serious challenge to traditional drug therapy. In view of the relapse rate of up to 50% following medical management, there has been renewed interest in the role of surgery for this problem. We report our experience with lung resection for this condition. Over a 5-year period, resection was performed in 23 patients who were diagnosed with multidrug resistance after completing a course of standard chemotherapy and at least 3 months of second-line therapy. Pneumonectomy was performed in 17 patients and lobectomy in 6. There was no operative or postoperative mortality. Major complications developed in 4 patients (17.4%): 2 had post-pneumonectomy empyema and 2 underwent rethoracotomy for bleeding. Ten patients were sputum positive preoperatively, and only 1 remained positive after surgery. The patients were put on appropriate chemotherapy and followed up for 18 months. The cure rate was 95.6%. Pulmonary resection can be considered as an important adjunct to medical therapy in carefully selected patients: those who have localized disease with adequate pulmonary reserve, or who have multiple previous relapses, or whose sputum remains positive after 4 to 6 months of appropriate medical treatment. Surgery offers high cure rates with acceptable morbidity and mortality.


2015 ◽  
Vol 61 (6) ◽  
pp. 1029-1030 ◽  
Author(s):  
Abed Zahedi Bialvaei ◽  
Hossein Samadi Kafil ◽  
Mohammad Asgharzadeh

2017 ◽  
Vol 8 (3) ◽  
pp. 11 ◽  
Author(s):  
Sean O'Brien ◽  
Jacy Downey

Objectives: The primary objective is to investigate the public’s perception about the role of the community pharmacist in Peru’s directly observed treatment, short course (DOTS) program. The secondary objective is to assess perceived barriers that would prevent the public from utilizing community pharmacists in order to identify future opportunities for community pharmacists to increase adherence to multidrug-resistant tuberculosis (MDR-TB) therapy. Design: Qualitative study comprised of an 8 close-ended survey questionnaire. Setting: Healthcare clinics established by a medical mission group in Lima and surrounding communities, Peru, from July 13 to July 27, 2015. Participants: Patients 15 years of age and over who sought healthcare at the clinics. Main outcome measures: Public’s perception about the role of the community pharmacist in Peru and barriers that would prevent the public from seeking a community pharmacist. Results: Out of the 445 patients approached, 438 patients completed the survey, resulting in a 98% response rate. More than half (52%) of the respondents were likely to seek a community pharmacist to assist them in completing a MDR-TB medication regimen. Almost half (48%) of the respondents felt comfortable with assistance of a community pharmacist in completing an MDR-TB regimen. The physician was the first health care professional that was contacted for all medical situations, including drug-related questions (61%). Lack of privacy in the pharmacy (53%) and busyness of the pharmacists (52%) were the top perceived barriers for asking community pharmacists questions. Conclusion: This study highlights the need for pharmacist participation in Peru’s DOTS program. Furthermore, this investigation has identified several issues of concern related to current community pharmacy practice in Peru. Therefore, future efforts may be necessary to address these identified areas of opportunity to promote the community pharmacist’s role in health screening, drug therapy monitoring, and counseling to decrease the public health burden of MDR-TB. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents or royalties.   Type: Original Research


2008 ◽  
Vol 13 (23) ◽  
Author(s):  
I Abubakar ◽  
K Fernandez de la Hoz

Air travel has increased over the last few decades resulting in greater risk of the spread of infectious diseases carried by infectious travellers. The risk of transmission of pathogens is particularly important for airborne organisms raising concern among public health agencies and the public. Despite limited research on the risk of tuberculosis associated with air travel, several reports have published evidence of the transmission of tuberculosis infection, including multidrug-resistant tuberculosis (MDR-TB) [1, 2].


2021 ◽  
Vol 8 (1) ◽  
pp. 12-20
Author(s):  
Murwanti Murwanti

Background: Tuberculosis is an infectious disease if the patient does not complete therapeutic treatment can cause multidrug-resistant tuberculosis (MDR-TB). The role of the environment is needed to support treatment.The study aims to explore more deeply the family's support for medication adherence in patients with multidrug-resistant tuberculosis (TBC-MDR). Method: This type of research is qualitative using a descriptive phenomenological approach, in-depth interviews of 5 participants based on purposive sampling technique. Results: The results of the study found the role of the family towards TB-MDR patients manifested in emotional, physical, instrumental, and spiritual support. emotional support consists of positive and negative emotional. Community involvement after counseling was supportive but there were some who could not accept even families of MDR-TB sufferers were also shunned. The role of health services is to convey information, prepare medicines, supervise, motivate treatment, remind check schedules, refer to more complete facilities when needed, visit homes and ensure patients take medication if unable to come to the public health service. Conclusion: This study found 3 main themes, namely the role of comprehensive family, community involvement and the role of health services in mentoring TB-MDR patients.


Pharmaceutics ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 1132
Author(s):  
Antonella Obinu ◽  
Elena Piera Porcu ◽  
Sandra Piras ◽  
Roberta Ibba ◽  
Antonio Carta ◽  
...  

The role of mycobacterial efflux pumps in drug-resistant tuberculosis has been widely reported. Recently, a new compound, named SS13, has been synthesized, and its activity as a potential efflux inhibitor has been demonstrated. In this work, the chemical–physical properties of the SS13 were investigated; furthermore, a formulative study aimed to develop a formulation suitable for oral administration was performed. SS13 shows nonintrinsic antitubercular activity, but it increases the antitubercular activity of all the tested drugs on several strains. SS13 is insoluble in different simulated gastrointestinal media; thus, its oral absorption could be limited. Solid lipid nanoparticles (SLNs) were, therefore, developed by using two different lipids, Witepsol and/or Gelucire. Nanoparticles, having a particle size (range of 200–450 nm with regards to the formulation composition) suitable for intestinal absorption, are able to load SS13 and to improve its permeation through the intestinal mucosa compared to the pure compound. The cytotoxicity is influenced by the concentration of nanoparticles administered. These promising results support the potential application of these nanocarriers for increasing the oral permeation of SS13 in multidrug-resistant tuberculosis management.


Author(s):  
Nizam Damani

This section discusses the role of hospital support services in the prevention and control of infection. It examines the role and responsibilities of the occupational health department which include pre-employment assessment and provision of guidance on how to manage healthcare workers who are exposed and/or infected with various communicable diseases and multidrug-resistant pathogens. It outlines the importance of infections spread by contaminated environment and provides practical advice on the environmental cleaning. Advice on the management of clinical waste, kitchen and catering services, linen and laundry services, and pest control is also provided.


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