TB

Tanzania: TB Cases Reported On the Rise

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The government has explained its strategies for the envisaged expansion of medical treatment services for tuberculosis (TB) following a reported increase in the number of cases.

Tabling his ministry’s budget estimates for the financial year 2014/2015, the Minister for Health and Social Welfare, Dr Seif Rashid, told the National Assembly that data have it that the number of TB patients is on the increase and people above 45 years of age are highly affected. “For the first time the TB Prevalence Survey was conducted last year.

It showed that the disease remains a threat with 295 people affected out of 100,000. People above 45 years of age are highly affected as compared to youths,” he said.

Dr Rashid noted further that the government will continue with efforts to take TB treatment services to lesser hospitals from the Kibong’oto Hospital which is a specialized medical centre for TB treatment.

He added that TB services will be put up in mining areas as the study indicates that miners are in a risky environment when they contact the disease which is airborne.

Dr Rashid noted that Gene-Xpert machines will be distributed around the country to increase hospitals’ capacity of diagnosing TB patients. In another development, the minister said that the ministry’s efforts in collaboration with its stakeholders have managed to reduce HIV/ AIDS prevalence rate to 5.3 per cent in 2012 from 5.8 in 2008.

“This achievement has been registered following various efforts and campaigns geared at counselling and voluntary tests,” he said.

He noted that by December 2013, the number of people who had tested has increased from 11,640 in 2009 to 20,469,241 which is equal to an average of an increase of 2,000,000 per annum.

“The increase in number is a vivid demonstration that the society is highly motivated and informed on the need to understand their health status,” he said.

Dr Rashid noted that 457,901 HIV/AIDS patients were tested for TB out of which 5,413 patients or 1.2 per cent were discovered to have contracted TB and were put into treatment.

Source: All Africa

Caribbean: 1 In 5 Unaware Of TB Diagnosis, Says Health Organisation

The Pan-American Health Organization (PAHO) says one in five people infected with tuberculosis in the Americas, including the Caribbean, remains unaware of the disease.

PAHO said this is due to “failure to access health services or because they are not properly diagnosed.” In 2012, PAHO said regional countries reported 220,000 cases of tuberculosis, and an estimated 19,000 people died from the disease.

But it said an additional 60,000 people are believed to have TB, who have not yet been diagnosed.

“This situation not only endangers their lives, it also facilitates further transmission of TB, producing more disease and generating socioeconomic costs for individuals, families and communities,” PAHO warned.

It issued the statement in commemoration of World TB Day that sought to raise awareness on the tuberculosis burden in the world, as well as the efforts made for its prevention and control.

Throughout the years, PAHO said this commemoration has offered the opportunity to mobilize the political, economic and social commitment for the prevention and control of TB in the countries.

For the 2014 campaign, PAHO said it will follow the worldwide focus on TB diagnosis and case detection of those still not reached, “with emphasis in the Americas on vulnerable populations, social determinants and large cities.”

Source; National news agency of Bernama

Poor diagnosis driving global multidrug-resistant TB, WHO warns

Half a million people fell sick with dangerous superbug strains of tuberculosis (TB) in 2012, but fewer than one in four were diagnosed, putting the rest at risk of dying due to the wrong medicines or no treatment at all.

Latest data from the World Health Organisation (WHO), which says drug-resistant TB is a “global health security risk”, showed a third of the estimated 9 million people who contract TB in any form each year do not get the care they need.

This has led to drug resistance spreading around the world at an alarming rate and has given rise to incurable strains of the bacterial infection – known as totally drug-resistant TB – which cannot be treated with any known medicines.

“Earlier and faster diagnosis of all forms of TB is vital,” said WHO director general Margaret Chan as the U.N. health agency published new TB data on Thursday. “It improves the chances of people getting the right treatment and being cured, and it helps stop spread of drug-resistant disease.”

Last year the WHO called for multidrug-resistant tuberculosis (MDR-TB) to be recognized as a public health crisis. It says the contagious, deadly superbug forms of the disease carry “grave consequences for those affected”.

Treating even regular TB is a long process. Patients need to take a cocktail of antibiotics for six months and many fail to complete the treatment.

This in turn has fuelled the emergence of drug-resistant TB – a man-made problem that has grown in the past decade because people sick with regular TB were either being given the wrong medicines or wrong doses or did not complete their treatment.

HURDLES

Experts say one of the major hurdles to tackling drug-resistant strains effectively is that so many patients who have contracted them do not know it and so continue with the wrong treatments or are not treated at all.

Some of the poorest and most ill-equipped countries have only one central laboratory, which often has limited capacity to diagnose MDR-TB. In other cases, patient samples have to be sent to other countries for testing.

Traditional diagnostic tests can take more than two months to get results, leaving a dangerous gap in which the patient is not getting the right treatment and is putting others at risk of catching the contagious disease.

The WHO says up to 2 million people worldwide may be infected with drug-resistant TB by 2015.

Newer, speedier diagnostic tests have been developed in recent years, but the problem has been getting the technology and know-how to the countries where they are needed most.

However, Chan cited encouraging signs from an international project known as EXPAND-TB (Expanding Access to New Diagnostics for TB), financed by UNITAID, which has helped to triple the number of MDR-TB cases diagnosed in participating countries.

In 2009, UNITAID backed the EXPAND project with $87 million to new TB diagnostic technologies in 27 low- and middle-income countries, which together account for around 40 percent of the global MDR-TB burden.

“The gap in access to TB diagnostics and care is far from filled, but it is narrowing,” said Mario Raviglione, director of WHO’s global TB program. “Increased capacity and reduced prices mean that we can reach more people.”

UNITAID was launched in 2006 by the governments of Britain, Brazil, Chile, France and Norway to give sustainable funding for the fight against HIV/AIDS, malaria and tuberculosis. About 70 percent of its funds come from a levy on airline tickets.

Source: Reuters

China ‘has halved its TB problem,’ survey data suggests

China has more than halved its tuberculosis (TB) prevalence, with rates falling from 170 to 59 per 100,000 population, figures suggest.

The Lancet report says the success is due to a huge expansion of a community-based disease control programme. The World Health Organization says other countries could use a similar approach.

China is a major contributor to the global TB pandemic, accounting for more than one-tenth of cases worldwide. The Lancet report reveals what progress China has made on reducing this burden, based on a 20-year-long analysis of national survey data.

Between 1990 and 2000, levels of TB were reduced in provinces where the WHO-recommended directly observed treatment, short-course (DOTS) programme – rapid detection and cure of infectious tuberculosis patients living in the community – was adopted.

By 2010, TB prevalence in China fell by 57%, tripling the reduction of the previous decade.

The increase of known TB cases treated using DOTS rose from 15% in 2000 to 66% in 2010.

Lead researcher Dr Yu Wang, from the Chinese Centre for Disease Control and Prevention in Beijing, said: “One of the key global TB targets set by the Stop TB Partnership aims to reduce tuberculosis prevalence by 50% between 1990 and 2015.

“This study in China is the first to show the feasibility of achieving such a target, and China achieved this five years earlier than the target date.”

The 2014 World Health Assembly will look at eliminating TB and setting ambitious new targets which could include a 50% reduction in tuberculosis prevalence between 2015 and 2025.

Giovanni Battista Migliori from WHO said: “The results from China show the feasibility of achieving such a target by aggressively scaling up the basic programmatic elements of tuberculosis control both within and outside the public sector.”

He said other countries could learn from China’s example.

TB remains a big issue in many countries, including India, Russia and many African nations. Better diagnostic tools and treatments are still needed.

Aaron Oxley of Stop TB UK said: “China has shown what is possible to achieve when attention and resources are brought to the fight against TB. But nearly 4,000 people still die from TB every day, and 3 million cases go undiagnosed each year. We still have a long way to go.”

Source: BBC news

Vinegar helps fight drug-resistant TB

A new study has found that the active ingredient in vinegar, acetic acid, might be used as an inexpensive and non-toxic disinfectant against drug-resistant tuberculosis (TB) bacteria as well as other stubborn, disinfectant-resistant mycobacteria.

“Mycobacteria are known to cause tuberculosis and leprosy, but non-TB mycobacteria are common in the environment, even in tap water, and are resistant to commonly used disinfectants. When they contaminate the sites of surgery or cosmetic procedures, they cause serious infections. Innately resistant to most antibiotics, they require months of therapy and can leave deforming scars,” senior author on the study, Howard Takiff, from Venezuelan Institute of Scientific Investigation (IVIC) in Caracas, said.

While investigating the ability of non-TB mycobacteria to resist disinfectants and antibiotics, Takiff’s postdoctoral fellow, Claudia Cortesia stumbled upon vinegar’s ability to kill mycobacteria.

Testing a drug that needed to be dissolved in acetic acid, Cortesia found that the control, with acetic acid alone, killed the mycobacteria she wanted to study.

It was found that exposure to 6 percent acetic acid, just slightly more concentrated than supermarket vinegar, for 30 minutes, reduced the numbers of TB mycobacteria from around 100 million to undetectable levels.

The study was published in the journal of the American Society for Microbiology.

Source: Businesss standard

 

Promising class of antibiotics discovered for drug-resistant TB

St Jude Children’s Research Hospital scientists have discovered a promising new class of antibiotics that could aid efforts to overcome drug-resistance in tuberculosis (TB). The drugs increased survival of mice infected with TB and were effective against drug-resistant strains of TB. St Jude led the international research effort, results of which appear in the journal Nature Medicine.

The antibiotics, called spectinamides, were created by changing the chemical structure of an existing antibiotic, spectinomycin, which does not work against TB.

In multiple trials of mice with both active and chronic TB infections, researchers report that one version of the new drug—an analogue known as 1599—was as good as or better than current TB drugs at reducing levels of the bacteria in the lungs of mice. In addition, 1599 caused no serious side effects.

“This study demonstrates how classic antibiotics derived from natural products can be redesigned to create semi-synthetic compounds to overcome drug resistance,” said corresponding author Richard Lee, a member of the St Jude Department of Chemical Biology and Therapeutics. “I hope the result will be drugs that are more effective against tuberculosis and offer a faster route to a cure with fewer side effects.”

TB remains a leading cause of global illness and death. The latest data from the World Health Organization estimates that TB kills 1.3 million persons annually and sickens 8.6 million worldwide. Current treatment requires months of multi-drug therapy to eradicate the slow-growing bacterium, which can lie dormant for years without causing symptoms and results in hard to treat chronic or latent infections. The rise of multi-drug resistant TB, including strains reportedly resistant to all available medications, has further complicated treatment.

This new class of antibiotics works against TB by disrupting the function of a part of the cell known as the ribosome, which is responsible for protein synthesis. To do that, the spectinamides bind to a particular site on ribosomes that is not shared by other TB drugs. That allows the drug to be used in combination with other medications.

For this study, researchers used an approach called structure-based design to re-engineer how spectinomycin binds to the ribosome. To guide their design efforts, scientists used a 3-D model that provided an atomic-level view of spectinomycin bound to the tuberculosis ribosome. The study reinforces the potential of structure-based design as a tool for designing other new agents to block mechanisms TB and other bacteria use to resist current antibiotics, Lee said.

The research reports on the first 20 of the more than 120 spectinomycin derivatives that have resulted from the effort. The list includes 1599 and two other analogues tested against TB in mice.

The three analogues not only bound the ribosome tightly, but they were more successful at avoiding a TB resistance mechanism called efflux. The TB bacteria use efflux pumps as a strategy to remove drugs and other threats from the cell before they can work against the bacteria. Efflux pumps, however, did not protect TB against spectinamides.

The drugs were also effective against multi-drug-resistant strains of TB growing in the laboratory. The strains had been isolated from patients with the disease.

Researchers also found no evidence that 1599 or the two other analogues tested interfered with normal functioning of human cells. Preliminary safety testing on cells grown in the laboratory showed the drugs were not toxic to mammalian cells because they only inhibit the bacterial ribosomes and not mammalian ribosomes.

Work is underway now in mice combining 1599 with new or existing TB drugs. The goal is to identify multi-drug therapy to try in a clinical trial of patients with drug-resistant TB.

Source: India medical Times