scholarly journals Short-course regimens of rifapentine plus isoniazid to treat latent tuberculosis infection in older Chinese patients: a randomised controlled study

2018 ◽  
Vol 52 (6) ◽  
pp. 1801470 ◽  
Author(s):  
Lei Gao ◽  
Haoran Zhang ◽  
Henan Xin ◽  
Jianmin Liu ◽  
Shouguo Pan ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
World Health ◽  
Controlled Study ◽  
Short Course ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Active Disease

Latent tuberculosis infection (LTBI) management is now a critical component of the World Health Organization's End TB Strategy.In this randomised controlled trial (Chinese Clinical Trial Registry identifier ChiCTR-IOR-15007202), two short-course regimens with rifapentine plus isoniazid (a 3-month once-weekly regimen and a 2-month twice-weekly regimen) were initially designed to be evaluated for rural residents aged 50–69 years with LTBI in China.Due to the increasingly rapid growth and unexpected high frequency of adverse effects, the treatments were terminated early (after 8 weeks for the once-weekly regimen and after 6 weeks for the twice-weekly regimen). In the modified intention-to-treat analysis on the completed doses, the cumulative rate of active disease during 2 years of follow-up was 1.21% (14 out of 1155) in the untreated controls, 0.78% (10 out of 1284) in the group that received the 8-week once-weekly regimen and 0.46% (six out of 1299) in the group that received the 6-week twice-weekly regimen. The risk of active disease was decreased, with an adjusted hazard ratio of 0.63 (95% CI 0.27–1.43) and 0.41 (95% CI 0.15–1.09) for the treatments, respectively. No significant difference was found in the occurrence of hepatotoxicity (1.02% (13 out of 1279) versus 1.17% (15 out of 1279); p=0.704).The short regimens tested must be used with caution among the elderly because of the high rates of adverse effects. Further work is necessary to test the ultrashort regimens in younger people with LTBI.

scholarly journals Prevalence of Latent Tuberculosis Infection in the Middle East and North Africa: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Mazin Barry
Keyword(s):  
Systematic Review ◽  
Middle East ◽  
North Africa ◽  
Subgroup Analysis ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
World Health ◽  
Published Data ◽  
Mena Region

Objective. Data on the prevalence of latent tuberculosis infection (LTBI) in Middle Eastern and North African countries are scarce. We aimed to review all relevant published data in countries belonging to this region to determine the overall prevalence of LTBI in the Middle East and North Africa (MENA) region. Methods. In this systematic review PubMed and Google Scholar databases were searched for observational, prospective, retrospective, cross-sectional, and cohort studies providing prevalence data of LTBI in any MENA country. Studies fulfilling the search criteria were incorporated in the review. Overall prevalence of LTBI with 95% confidence intervals (CI) was calculated using the random-effects model; heterogeneity was assessed using I 2 statistics. Gender and age group-based subgroup analyses were performed to evaluate the basis of heterogeneity. Results. The total number of overall LTBI studies identified was 956, of which 31 studies from ten countries within the MENA region were included that represented 12,439 subjects. The overall prevalence was 41.78% (95% CI 31.18% to 52.78%, I 2 = 99.31 % ). By gender-based subgroup analysis, the prevalence of LTBI was 33.12% (95% CI 18.97% to 49.04%, I 2 = 99.25 % ) and 32.65% (95% CI 19.79% to 47%, I 2 = 98.89 % ) in males and females, respectively, while in the age-based subgroup analysis, the prevalence of LTBI was 0.44% (95% CI -0.05% to 0.9%), 3.37% (95% CI 2.23% to 4.74%, I 2 = 0 % ), and 43.81% (95% CI 33.09% to 54.82%, I 2 = 99.18 % ) for children, adolescents, and adults, respectively. Conclusion. This systematic review reveals a high prevalence of LTBI in the MENA region; enhanced LTBI surveillance and prompt infection prevention steps are urgently needed to prevent active tuberculosis, this would help achieve the World Health Organization End TB Strategy 2035, and the United Nations Sustainable Development Goals 2030 target in the MENA region.

scholarly journals Safety of the Rifampin and Pyrazinamide Short-Course Regimen for Treating Latent Tuberculosis Infection

2007 ◽  
Vol 44 (3) ◽  
pp. 464-465 ◽  
Author(s):  
K. Ijaz ◽  
P. D. McElroy ◽  
J. Jereb ◽  
T. R. Navin ◽  
K. G. Castro
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Short Course

scholarly journals Safety and Completion Rate of Short‐Course Therapy for Treatment of Latent Tuberculosis Infection

2006 ◽  
Vol 43 (3) ◽  
pp. 271-275 ◽  
Author(s):  
Paul P. Cook ◽  
Ricardo A. Maldonado ◽  
Connie T. Yarnell ◽  
Don Holbert
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Completion Rate ◽  
Tuberculosis Infection ◽  
Short Course

scholarly journals VITAMIN D AND LATENT TUBERCULOSIS INFECTION IN SCHOOLCHILDREN

2019 ◽  
Vol 22 (6) ◽  
pp. 344-348
Author(s):  
A. D. Petrushina ◽  
Daria M. Slashcheva ◽  
N. S. Brynza ◽  
N. D. Pirogova ◽  
S. V. Sosnovskaya ◽  
...  
Keyword(s):  
Vitamin D ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Preventive Treatment ◽  
Tuberculosis Infection ◽  
World Health ◽  
Skin Tests ◽  
Initial Examination ◽  
Treatment And Prevention ◽  
Vitamin D Levels

The World Health Organization has adopted the global TB strategy for the period of 2016-2035. To achieve its targets, it is necessary to propose and introduce new approaches for the prevention and treatment of latent tuberculosis infection (LTBI) in children and adolescents, as a potential source of active tuberculosis development. In this regard, the use of vitamin D (cholecalciferol) may become promising in combating tuberculosis, since most researchers suppose an adequate level of cholecalciferol to have a positive preventive and therapeutic effect in children with active and latent tuberculosis. So far the use of vitamin D may be appropriate, especially in children not adequately provided with vitamin D. The paper presents the results of the vitamin D levels study before and after prescribing cholecalciferol, as well as the dynamics of the tuberculin skin tests in school-age LTBI children receiving preventive treatment with anti-TB drugs. At the initial examination, a normal level of 25-hydroxycholecalciferol (25(OH)D) was not detected in any child. After 3 months of administration of vitamin D in therapeutic doses, a normal concentration of 25(OH)D was observed in 52% of the children examined repeatedly. Analysis of the tuberculin skin test dynamics showed 47.6% of children to have a negative/doubtful test result after 3 months of treatment with anti-TB drugs and vitamin D. In 9.5% of patients, the size of the papule did not change during treatment. It is important to note that in these children, the 25(OH)D level also did not increase. А vitamin D intake at a therapeutic dosage did not cause hypercalcemia or hypercalciuria in any child. LTBI children are inadequately provided with cholecalciferol. There fore it is necessary to determine the level of vitamin D in the blood, then to prescribe the vitamin D, regardless of the time of year, along with standard therapy for a more effective outcome of LTBI treatment and prevention of active forms of tuberculosis in the future.

scholarly journals Activity of a long-acting injectable bedaquiline formulation in a paucibacillary mouse model of latent tuberculosis infection

2019 ◽  
Author(s):  
Amit Kaushik ◽  
Nicole C. Ammerman ◽  
Sandeep Tyagi ◽  
Vikram Saini ◽  
Iwan Vervoort ◽  
...  
Keyword(s):  
Mouse Model ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Positive Control ◽  
Negative Control ◽  
Tuberculosis Infection ◽  
Sustained Activity ◽  
Short Course ◽  
Long Acting ◽  
Aerosol Infection

ABSTRACTThe potent anti-tuberculosis activity and long half-life of bedaquiline make it an attractive candidate for long-acting/extended release formulations for treatment of latent tuberculosis infection (LTBI). Our objective was to evaluate a long-acting injectable (LAI) bedaquiline formulation in a validated paucibacillary mouse model of LTBI. Following immunization with Mycobacterium bovis rBCG30, BALB/c mice were challenged by aerosol infection with M. tuberculosis H37Rv. Treatment began 13 weeks after challenge infection with one of the following regimens: untreated negative control; positive controls of daily rifampin (10 mg/kg), once-weekly rifapentine (15 mg/kg) and isoniazid (50 mg/kg), or daily bedaquiline (25 mg/kg); test regimens of one, two, or three monthly doses of LAI bedaquiline at 160 mg/dose (BLAI-160); and test regimens of daily bedaquiline at 2.67 (B2.67), 5.33 (B5.33), or 8 (B8) mg/kg to deliver the same total bedaquiline as one, two, or three doses of BLAI-160, respectively. All drugs were administered orally, except for BLAI-160 (intramuscular injection). The primary outcome was the decline in M. tuberculosis lung CFU counts during 12 weeks of treatment. The negative and positive control regimens performed as expected. One, two, and three doses of BLA-160 resulted in decreases of 2.9, 3.2, and 3.5 log10 CFU/lung, respectively by week 12. Daily oral dosing with B2.67, B5.33, and B8 decreased lung CFU counts by 1.6, 2.8, and 4.1 log10, respectively. One dose of BLAI-160 exhibited activity for at least 12 weeks. The sustained activity of BLAI-160 indicates promise as a short-course LTBI treatment requiring few patient encounters to ensure treatment completion.

scholarly journals Systematic review of latent tuberculosis infection research to inform programmatic management in Ireland

2021 ◽  
Author(s):  
James O’Connell ◽  
Eoghan de Barra ◽  
Samuel McConkey
Keyword(s):  
Systematic Review ◽  
Latent Tuberculosis Infection ◽  
Meta Analysis ◽  
Latent Tuberculosis ◽  
Risk Groups ◽  
Tuberculosis Infection ◽  
World Health ◽  
People Living With Hiv ◽  
Knowledge Gaps ◽  
Ltbi Screening

AbstractThe World Health Organisation (WHO) End Tuberculosis (TB) Strategy and the WHO Framework Towards Tuberculosis Elimination in Low Incidence Countries state that latent tuberculosis infection (LTBI) screening and treatment in selected high-risk groups is a priority action to eliminate TB. The European Centre for Disease Prevention and Control (ECDC) advises that this should be done through high-quality programmatic management, which they describe as having six key components. The research aim was to systematically review the literature to identify what is known about the epidemiology of LTBI and the uptake and completion of LTBI screening and treatment in Ireland to inform the programmatic management of LTBI nationally. A systematic literature review was performed according to a review protocol and reported in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Twenty-eight studies were eligible for inclusion and described LTBI screening or treatment performed in one of five contexts, pre-biologic or other immunosuppression screening, people living with HIV, TB case contacts, other vulnerable populations, or healthcare workers. The risk of bias across studies with regard to prevalence of LTBI was generally high. One study reported a complete cascade of LTBI care from screening initiation to treatment completion. This systematic review has described what published research there is on the epidemiology and cascade of LTBI care in Ireland and identified knowledge gaps. A strategy for addressing these knowledge gaps has been proposed.

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