46 research outputs found
Screening for tuberculosis and testing for human immunodeficiency virus in Zambian prisons
Objective: To improve the Zambia Prisons Service's implementation of tuberculosis screening and human immunodeficiency virus (HIV) testing.
Methods: For both tuberculosis and HIV, we implemented mass screening of inmates and community-based screening of those residing in encampments adjacent to prisons. We also established routine systems – with inmates as peer educators – for the screening of newly entered or symptomatic inmates. We improved infection control measures, increased diagnostic capacity and promoted awareness of tuberculosis in Zambia's prisons.
Findings: In a period of 9 months, we screened 7638 individuals and diagnosed 409 new patients with tuberculosis. We tested 4879 individuals for HIV and diagnosed 564 cases of infection. An additional 625 individuals had previously been found to be HIV-positive. Including those already on tuberculosis treatment at the time of screening, the prevalence of tuberculosis recorded in the prisons and adjacent encampments – 6.4% (6428/100 000) – is 18 times the national prevalence estimate of 0.35%. Overall, 22.9% of the inmates and 13.8% of the encampment residents were HIV-positive.
Conclusion: Both tuberculosis and HIV infection are common within Zambian prisons. We enhanced tuberculosis screening and improved the detection of tuberculosis and HIV in this setting. Our observations should be useful in the development of prison-based programmes for tuberculosis and HIV elsewhere
Co-infection with Pansensitive and Multidrug-Resistant Strains of Mycobacterium tuberculosis
We report a case of a 23-year-old HIV-negative man with multidrug-resistant Mycobacterium tuberculosis that became evident while he was being treated for M. tuberculosis that was sensitive to all first-line drugs. This case should alert clinicians to consider co-infection as a possible cause of recrudescent disease
Buruli Ulcer Recurrence, Benin
Access to high-quality treatment prevents Buruli ulcer recurrence
Clusters of Multidrug-Resistant Mycobacterium tuberculosis Cases, Europe
These case investigations may help identify routes of transmission
Worldwide Emergence of Extensively Drug-resistant Tuberculosis
Mycobacterium tuberculosis strains are becoming resistant to not only the most powerful first-line drugs but also many second-line drugs
Drug-resistant Mycobacterium tuberculosis in Estonia
Tuberculosis (TB) infection and disease patterns among different
populations are extremely heterogeneous. This thesis explores mainly by
microbiological methods the epidemiology of TB in Estonia.
Through the work high rates of drug resistance were found. The first
countrywide study carried out in 1994 ascertained that drug resistant TB,
and particularly multidrugresistant TB (MDR-TB) is a serious problem for
Estonia. Initial resistance to one or more of the drugs tested was 28%,
with 10% being initially multidrug-resistant. Molecular typing with IS6110
RFLP has revealed that 29% of Estonian M. tuberculosis isolates belonged
to the genetically closely related group of strains with a predominant IS6110
banding pattern. This isolates were classified by spoligotyping as
Beijing genotype strains, widely found in Asia. The majority (87.5%) of
all multidrug-resistant isolates and two thirds (67.2%) of all isolates
with any drug resistance belonged to Beijing genotype family.
The incidence of TB among health care workers (HCW) in Estonia was 1.5 to
3 times higher (mean 91/100 000/year) than in the general population. In
a chest hospital the incidence was 30 to 90 times higher. The highest
rate was observed among physicians. In addition, this work shows that
nosocomial isolates of M. tuberculosis can often be MDR after MDR-TB
becomes more common in the general population. More than one third (38%)
of all M. tuberculosis isolates obtained from HCW were
multidrug-resistant.
The investigation of means by which drug resistance evolves among
drugsusceptible M. tuberculosis strains during antiT13 treatment revealed
that initially drugsusceptible M. tuberculosis does not always evolve
drug resistance despite highly irregular and prolonged therapy. Yet, the
remained susceptibility of M. tuberculosis does not grant treatment
success. When advanced method of molecular typing is not employed,
exogenous re-infection with drug resistant M. tuberculosis may be
misinterpreted as creation of drug resistance.
This work also encompass of our experience and knowledge on testing drug
susceptibility of MDR M. tuberculosis isolates to second-line and
alternative drugs. In Estonia, a standardized treatment regimen with up
to 6 second-line drugs can be suggested for 2/3 of MDR-TB patients; for
the remaining cases additional testing of an extended panel of drugs is
required.
The MDR M. tuberculosis clinical isolates with unusual
kanamycin-resistant but arnikacin- susceptible phenotype were
characterized by identification of mutations with-in the rrs gene.
Mutation possible related to intermediate level of resistance to
kanamycin, showing a thymine for cytosine substitution at the 16S rRNA
position 516, has not previously been associated with kanamycin
resistance in M. tuberculosis. To date, genetic methods fail to detect
all clinically relevant levels of drug resistance to aminoglycosides.
Consequently it is important to test antimicrobial susceptibility of
resistant clinical isolates of M. tuberculosis by culture
Creating Streetscapes as a Component of Tartu Green Network
Bachelor’s thesis
Curriculum of Environmental Planning and Landscape DesignThe aim is to create a sustainable, holistic solution for two sites on the banks of the river
“Emajõgi” in Tartu. To harness the potential of urban space and contribute to the creation
of a better green corridor. The work is based on interviews and analyses that provide the
basis for the design proposal concept and the final solution. The result of the work will
be a design proposal for two complex streetscapes in the city of Tartu. The resulting
solution can be the basis for a real design project.Eesmärk on luua jätkusuutlik, terviklik lahendus kahele alale Tartu Emajõe kaldal.
Kasutada linnaruumis olevat potentsiaali ja aidata kaasa sidusamate rohekoridoride
tekkimisele. Töö aluseks on intervjuud ja analüüsid, mis annavad aluse disainiettepaneku
kontseptsioonile ja lõplikule lahendusele. Töö tulemuseks on disainiettepanek kahe
taskupargi rajamiseks Tartu kesklinna. Leitud lahendused on linnal edasise idee-arenduse
käigus võimalik tänavate ümberehituse aluseks võtta
Tartu Ülikooli-Jaani kogudus aastatel 1995–2016: ajalugu ja inimesed
Töö eesmärgiks oli uurida Tartu Ülikooli-Jaani koguduse ajalugu ja koguduses valitsevat vaimsust aastatel 1995–2016. Uurimistöös kasutati mitmesuguseid allikaid, sealhulgas arhiivimaterjale, erialakirjandust, perioodikat ja empiiriliselt kogutud materjali. Uurimistöös käsitles autor järgmisi aspekte: koguduste taasavamine ja ülesehitamine; koguduste jumalateenistused, ühinemisprotsess, õhustik ja usuline elu, kirikuruumi tajumine; kirikuhoone restaureerimine; tegevused, millesse koguduse liikmed olid kaasatud; põhjused, miks on inimesed kogudusega liitunud ja kogudusse jäänud; vaimuliku roll koguduse elus; koguduse juhtorganite roll koguduse elus; kultuurielu Tartu Jaani kirikus