2,150 research outputs found
Improving tuberculosis surveillance in Europe is key to controlling the disease.
As underlined by the joint ECDC and World Health Organization Regional Office for Europe TB report, launched on 18 March the importance of good surveillance to stem this trend cannot be underestimated.
Where do we go with surveillance in Europe? Can we do more? How many MDR and XDR TB cases occur because of sub-optimal patient management?
This issue of Eurosurveillance casts light on these important questions with four interesting articles.
The results of the studies reported in this issue of Eurosurveillance allow us to point out some key topics:
\u2022The completeness of reporting information (including treatment outcomes), the proportion of culture-confirmed TB cases reported as well as the proportion of strains on which DST for both first- and second-line drugs is performed and reported are still sub-optimal overall in Europe. The relevance of these pitfalls goes beyond the \u201csimple\u201d surveillance limitation, having the potential to affect other important TB control pillars, e.g. infection control and case-management.
\u2022MDR and XDR TB still persist in Europe. The high proportion of MDR TB identified among new TB cases reported by certain countries indicates that sub-optimal infection control practices are likely to occur, while the high percentage of MDR TB notified among retreatment cases is probably the result of sub-optimal case management in the past decade
Multiresistentse tuberkuloosi ravi kulutulusus ja ravitulemused erinevate ravistrateegiate rakendamisel
JÀrjest laialdasemalt rakendatakse multiresistentse tuberkuloosi haigete raviks DOTS-Plus strateegiat, kasutades teise rea ravimeid, kuid teadmised nende efektiivsuse ja kulutulususe kohta on vÀhesed. Uuringus hinnati alates 2001. a augustist Eestis rakendatud DOTS-Plus strateegia tÔhusust, maksumust ja kulutulusust vÔrreldes 3 alternatiivset ravi strateegiat: DOTS-Plus strateegia, pre-DOTS-plus strateegia ja DOTS-strateegia. Kulud arvutati 2002. a kehtinud hindades, tÔhususe nÀitajateks olid tuberkuloosist pÔhjustatud surmade arv, kaotatud haiguskoormus ja kulutulususe nÀitajaks sÀÀstetud haiguskoormuse maksumus. Saadud andmete alusel vÔib vÀita, et kasutades DOTS-Plus strateegiat, on vÔimalik oluliselt paran dada multiresistentse tuberkuloosi haigete ravitulemusi ning vÔrreldes teiste vÔimalustega on see kulutulusaim.
Eesti Arst 2006; 85 (3): 148â15
Multidrug- and extensively drug-resistant tuberculosis
We evaluated risk factors and treatment outcomes associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004â2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identified as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the former Soviet Union. In patients with XDR TB, hospitalization was longer (mean ± SD 202 ± 130 vs. 123 ± 81 days; p = 0.015) and resistance to all first-line drugs was more frequent (36% vs. 86%; p = 0.013) than in patients with MDR TB. Seventy-four (40%) of these 184 patients received treatment with linezolid. Treatment success rates ranged from 59% for the entire cohort (59% for MDR TB and 57% for XDR TB) to 87% for those with a definitive outcome (n = 125; 89% for MDR TB and 80% for XDR TB). Extensive drug susceptibility testing and availability of second- and third-line drugs under inpatient management conditions permit relatively high treatment success rates in MDR- and XDR TB
Time course of exercise capacity in patients recovering from covid-19-associated pneumonia
Objective: High prevalences of muscle weakness and impaired physical performance in hospitalized patients recovering from COVID-19-associated pneumonia have been reported. Our objective was to determine whether the level of exercise capacity after discharge would affect long-term functional outcomes in these patients. Methods: From three to five weeks after discharge from acute care hospitals (T0), patients underwent a six-minute walk test (6MWT) and were divided into two groups according to the distance walked in percentage of predicted values: <75% group and â„75% group. At T0 and three months later (T1), patients completed the Short Physical Performance Battery and the Euro Quality of Life Visual Analogue Scale, and pulmonary function and respiratory muscle function were assessed. In addition, a repeat 6MWT was also performed at T1. Results: At T0, 6MWD values and Short Physical Performance Battery scores were lower in the <75% group than in the â„75% group. No differences were found in the Euro Quality of Life Visual Analogue Scale scores, pulmonary function variables, respiratory muscle function variables, length of hospital stay, or previous treatment. At T1, both groups improved their exercise capacity, but only the subjects in the <75% group showed significant improvements in dyspnea and lower extremity function. Exercise capacity and functional status values returned to predicted values in all of the patients in both groups. Conclusions: Four weeks after discharge, COVID-19 survivors with exercise limitation showed no significant differences in physiological or clinical characteristics or in perceived health status when compared with patients without exercise limitation. Three months later, those patients recovered their exercise capacity
controlling the disease
Surveillance and outbreak reports Surveillance of extensively drug-resistant tuberculosis in Europe, 2003-2007 15 by I Devaux, D Manissero, K Fernandez de la Hoz, K Kremer, D van Soolingen, on behalf of the EuroTB network Analysis of tuberculosis treatment outcomes in the European Union and European Economic Area: efforts needed towards optimal case management and control 21 by D Manissero, V Hollo, E Huitric, C Ködmön, A Amato-Gauci Risk of developing tuberculosis from a school contact: retrospective cohort study
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