Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Sarita Shah N[original query] |
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Global progress and gaps in tuberculosis screening and treatment among people with HIV: experience from 32 countries
Peterson M , Sarita Shah N , Smith-Jeffcoat SE , Nichols C , Fukunaga R , Al-Samarrai T , MacNeil A . AIDS 2021 35 (7) 1154-1156 Tuberculosis (TB) is responsible for roughly one-third of HIV-associated deaths among people with HIV (PWH). Despite the known risk among this population, only 56% (456 385) of an estimated 815 000 people with TB/HIV globally received a TB diagnosis and were reported in 2019 [1]. To close this gap, the WHO recommends screening PWH at every clinical encounter for cough of any duration, fever, weight loss and night sweats, followed by sputum testing with a WHO-recommended rapid diagnostic test when symptoms are present. Ruling out active disease is also crucial for safely initiating TB preventive treatment (TPT), which is a critical component of care for PWH. The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the world's largest HIV programme that provides antiretroviral therapy (ART) to 17·4 million people (roughly 65% of all PWH receiving ART), aligns with WHO guidance regarding TB screening [1,2]. We assess TB screening among ART patients in PEPFAR-supported sites and review existing literature on TB screening among PWH. |
Extensively drug-resistant tuberculosis in South Africa: genomic evidence supporting transmission in communities.
Auld SC , Sarita Shah N , Mathema B , Brown TS , Ismail N , Omar SV , Brust JCM , Nelson KN , Allana S , Campbell A , Mlisana K , Moodley P , Gandhi NR . Eur Respir J 2018 52 (4) ![]() Background: Despite evidence that transmission is driving an extensively drug-resistant (XDR) tuberculosis epidemic, our understanding of where and between whom transmission occurs is limited. We sought to determine whether there was genomic evidence of transmission between individuals without an epidemiologic connection.Methods: We conducted a prospective study of XDR tuberculosis patients in KwaZulu-Natal, South Africa, during 2011-2014. We collected sociodemographic and clinical data, and identified epidemiologic links based on person-to-person or hospital-based connections. We performed whole-genome sequencing on the Mycobacterium tuberculosis isolates and determined pairwise single nucleotide polymorphism (SNP) differences.Findings: Among 404 participants, 123 (30%) had person-to-person or hospital-based links, leaving 281 (70%) epidemiologically unlinked. The median SNP difference between participants with person-to-person and hospital-based links was 10 (IQR 8-24) and 16 (IQR 10-23), respectively. The median SNP difference between unlinked participants and their closest genomic link was 5 (IQR 3-9); half of unlinked participants were within 7 SNPs of at least five participants.Conclusions: The majority of epidemiologically unlinked XDR tuberculosis patients had low pairwise SNP differences, consistent with transmission, with at least one other participant. These data suggest that much of transmission may result from casual contact in community settings between individuals not known to one another. |
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