Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Menzies HJ[original query] |
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The disconnect between a national tuberculosis drug resistance survey and treatment outcomes: a lost opportunity
Click ES , Chirenda J , Kibias S , Menzies HJ , Oeltmann JE , Sentle C , Muribe T , Lere TD , Makombe R , Bamrah S , Moore BK , Cain KP . Int J Tuberc Lung Dis 2014 18 (11) 1319-22 We linked results from the Fourth Botswana National Drug Resistance Survey (DRS), 2007-2008, to patient records from the national Electronic Tuberculosis Registry to determine treatment outcomes. Of 915 new patients, 651 (71%) had treatment data available. Completion or cure was achieved for 10/15 (67%, 95%CI 42-85) with isoniazid monoresistance, (6/16, 38%, 95%CI 18-61) with multidrug resistance, while 73% (391/537, 95%CI 69-76) were susceptible to first-line drugs. The analysis was limited because of unavailable treatment records and undocumented outcomes. Prospective analyses following DRSs should be considered to ensure adequate outcome data. |
Increase in anti-tuberculosis drug resistance in Botswana: results from the fourth National Drug Resistance Survey
Menzies HJ , Moalosi G , Anisimova V , Gammino V , Sentle C , Bachhuber MA , Bile E , Radisowa K , Kachuwaire O , Basotli J , Maribe T , Makombe R , Shepherd J , Kim B , Samandari T , El-Halabi S , Chirenda J , Cain KP . Int J Tuberc Lung Dis 2014 18 (9) 1026-33 SETTING: Although approximately 0.5 million cases of multidrug-resistant tuberculosis (MDR-TB) occur globally each year, surveillance data are limited. Botswana is one of the few high TB burden countries to have carried out multiple anti-tuberculosis drug resistance surveys (in 1995-1996, 1999 and 2002). OBJECTIVE: In 2007-2008, we conducted the fourth national survey of anti-tuberculosis drug resistance in Botswana to assess anti-tuberculosis drug resistance, including trends over time. In the previous survey, 0.8% (95% CI 0.4-1.5) of new patients and 10.4% (95%CI 5.6-17.3) of previously treated patients had MDR-TB. DESIGN: During the survey period, eligible specimens from all new sputum-smear positive TB patients and from all TB patients with history of previous anti-tuberculosis treatment underwent mycobacterial culture and anti-tuberculosis drug susceptibility testing (DST). RESULTS: Of 924 new TB patients and 137 with previous anti-tuberculosis treatment with DST results, respectively 23 (2.5%, 95% CI 1.6-3.7) and 9 (6.6%, 95% CI 3.3-11.7) had MDR-TB. The proportion of new TB patients with MDR-TB has tripled in Botswana since the previous survey. CONCLUSION: Combatting drug-resistant TB will require the scale-up of MDR-TB diagnosis and treatment to prevent the transmission of MDR-TB and strengthening of general TB control to prevent the emergence of resistance. |
Importance of tuberculosis control to address child survival
Graham SM , Sismanidis C , Menzies HJ , Marais BJ , Detjen AK , Black RE . Lancet 2014 383 (9928) 1605-7 Tuberculosis commonly affects young children (<5 years) in countries that have high rates of child mortality.1 The global public health focus to control tuberculosis has traditionally aimed to reduce transmission through early case-finding and effective treatment of the most infectious cases. Young children have historically been excluded from this focus, since their contribution to tuberculosis transmission is believed to be small. In the past decade, national tuberculosis programmes in high-burden settings have given increased attention to the challenges of childhood tuberculosis.2 In 2012, World TB Day focused on children for the first time. This attention is likely to increase further as the WHO Global Tuberculosis Programme’s ambitious post-2015 tuberculosis control strategy seeks to engage the entire health sector, including maternal and child health. | Within the Millennium Developmental Goal (MDG) framework, tuberculosis control and its related targets are framed within MDG 6, and yet are also relevant to MDGs 4 and 5 (child and maternal mortality) and MDG 1 (undernutrition). Improvement of child survival is a major global health priority but tuberculosis is not regarded as important in that context. However, we believe that the relevance of tuberculosis to child survival will become increasingly apparent over the next decade, especially in countries where tuberculosis control remains difficult and high rates of Mycobacterium tuberculosis transmission are sustained. Recognition of the relevance and challenges of tuberculosis to child survival is growing.3 |
Pediatric and adolescent tuberculosis in the United States, 2008-2010
Winston CA , Menzies HJ . Pediatrics 2012 130 (6) e1425-32 OBJECTIVE: We examined heterogeneity among children and adolescents diagnosed with tuberculosis (TB) in the United States, and we investigated potential international TB exposure risk. METHODS: We analyzed demographic and clinical characteristics by origin of birth for persons <18 years with verified case of incident TB disease reported to National TB Surveillance System from 2008 to 2010. We describe newly available data on parent or guardian countries of origin and history of having lived internationally for pediatric patients with TB (<15 years of age). RESULTS: Of 2660 children and adolescents diagnosed with TB during 2008-2010, 822 (31%) were foreign-born; Mexico was the most frequently reported country of foreign birth. Over half (52%) of foreign-born patients diagnosed with TB were adolescents aged 13 to 17 years who had lived in the United States on average >3 years before TB diagnosis. Foreign-born pediatric patients with foreign-born parents were older (mean, 7.8 years) than foreign-born patients with US-born parents (4.2 years) or US-born patients (3.6 years). Among US-born pediatric patients, 66% had at least 1 foreign-born parent, which is >3 times the proportion in the general population. Only 25% of pediatric patients with TB diagnosed in the United States had no known international connection through family or residence history. CONCLUSIONS: Three-quarters of pediatric patients with TB in the United States have potential TB exposures through foreign-born parents or residence outside the United States. Missed opportunities to prevent TB disease may occur if clinicians fail to assess all potential TB exposures during routine clinic visits. |
Evaluation of tuberculosis diagnostics in children: 2. Methodological issues for conducting and reporting research evaluations of tuberculosis diagnostics for intrathoracic tuberculosis in children. Consensus from an expert panel
Cuevas LE , Browning R , Bossuyt P , Casenghi M , Cotton MF , Cruz AT , Dodd LE , Drobniewski F , Gale M , Graham SM , Grzemska M , Heinrich N , Hesseling AC , Huebner R , Jean-Philippe P , Kabra SK , Kampmann B , Lewinsohn D , Li M , Lienhardt C , Mandalakas AM , Marais BJ , Menzies HJ , Montepiedra G , Mwansambo C , Oberhelman R , Palumbo P , Russek-Cohen E , Shapiro DE , Smith B , Soto-Castellares G , Starke JR , Swaminathan S , Wingfield C , Worrell C . J Infect Dis 2012 205 Suppl 2 S209-15 Confirming the diagnosis of childhood tuberculosis is a major challenge. However, research on childhood tuberculosis as it relates to better diagnostics is often neglected because of technical difficulties, such as the slow growth in culture, the difficulty of obtaining specimens, and the diverse and relatively nonspecific clinical presentation of tuberculosis in this age group. Researchers often use individually designed criteria for enrollment, diagnostic classifications, and reference standards, thereby hindering the interpretation and comparability of their findings. The development of standardized research approaches and definitions is therefore needed to strengthen the evaluation of new diagnostics for detection and confirmation of tuberculosis in children. In this article we present consensus statements on methodological issues for conducting research of Tuberculosis diagnostics among children, with a focus on intrathoracic tuberculosis. The statements are complementary to a clinical research case definition presented in an accompanying publication and suggest a phased approach to diagnostics evaluation; entry criteria for enrollment; methods for classification of disease certainty, including the rational use of culture within the case definition; age categories and comorbidities for reporting results; and the need to use standard operating procedures. Special consideration is given to the performance of microbiological culture in children and we also recommend for alternative methodological approaches to report findings in a standardized manner to overcome these limitations are made. This consensus statement is an important step toward ensuring greater rigor and comparability of pediatric tuberculosis diagnostic research, with the aim of realizing the full potential of better tests for children. |
Epidemiology of tuberculosis among US- and foreign-born children and adolescents in the United States, 1994-2007
Menzies HJ , Winston CA , Holtz TH , Cain KP , MacKenzie WR . Am J Public Health 2010 100 (9) 1724-9 OBJECTIVES: We examined trends in tuberculosis (TB) cases and case rates among US- and foreign-born children and adolescents and analyzed the potential effect of changes to overseas screening of applicants for immigration to theUnited States. METHODS: We analyzed TB case data from the National Tuberculosis Surveillance System for 1994 to 2007. RESULTS: Foreign-born children and adolescents accounted for 31% of 18659 reported TB cases in persons younger than age 18 years from 1994 to 2007. TB rates declined 44% among foreign-born children and adolescents (20.3 per 10000 to 11.4 per 100000 population) and 48% (2.1 per 100000 to 1.1 per 100000) among those who were born in the United States. Rates were nearly 20 times as high among foreign-born as among US-born adolescents. Among foreign-born children and adolescents with known month of US entry (88%), more than 20% were diagnosed with TB within 3 months of entry. CONCLUSIONS: Marked disparities in TB morbidity persist between foreign- and US-born children and adolescents. These disparities and the high proportion of TB cases diagnosed shortly after US entry suggest a need for enhanced pre- and postimmigration screening. |
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