La tuberculose pulmonaire.

Tuberculosis (TB) is a global health problem driven by poverty, HIV infection, etc. In Europe, the problem of multidrug resistance (i.e. resistance to at least rifampin and isoniazid) (MR) develops. The cases come essentially from the former U.S.S.R. In Belgium, the incidence of tuberculosis continues to decline to 9.4/100,000 inhabitants in 2008. The percentage of MR germs is 2.8%. The distribution of cases is not uniform across the country. The incidence is much higher among people recently coming from high prevalence countries than among the Belgian native. The pulmonary forms of TB are more contagious and more common. The clinical signs are frequently non specific. The diagnosis is often mentioned up after performing a chest Xray and must always be confirmed by microbiological examination and culture of several sputum or other respiratory specimens. It is very important to identify the germ, M. tuberculosis complex and to test its sensitivity to anti-TB agents. Standard treatment consists of 4 drugs: isoniazid, rifampin, ethambutol and pyrazinamide for 2 months followed by rifampin and isoniazid for at least 4 additional months. In suspected cases of MR, 5 drugs are prescribed at the outset. Treatment and duration will be adjusted according to the results of susceptibility testing. The potential toxicities of second-line drugs should be well known by the physicians. Compliance of the patient is essential. Screening in the entourage is part of the therapeutic process.English AbstractJournal ArticleSCOPUS: sh.jinfo:eu-repo/semantics/publishe

Pollution intérieure et santé: fonctionnement et bilan de 9 années d’intervention dans l’habitat bruxellois

info:eu-repo/semantics/nonPublishe

Tuberculosis Transmission in a Primary School and a Private Language School. An Estimation of Infectivity

info:eu-repo/semantics/publishe

Characteristics of the 58 MDR-TB patients in strain-clusters and results of epidemiological investigation.

<p>Legend: Y = yes; N = no, U = unknown; − = not applicable.</p

Evolution of the resistance profile of serial isolates obtained from 24 patients.

<p>For these 24 MDR-TB patients out of 37 with multiple isolates, resistance to additional drugs was observed during treatment. Legend: ▪ = Susceptible, ▪ = Resistant, −Test not performed, I: Isoniazid, R: Rifampicin, E: Ethambutol, Z: Pyrazinamid, Rb: Rifabutin, Ofl: Ofloxacin, Amk: Amikacin, Thio: Thioamide, Cap: Capreomycin NA = Not Applicable as less than 2 isolates were FLP profiled, so no conclusion possible.</p

2018 Belgian guidelines for the screening for latent tuberculosis in HIV-infected patients.

To review the current knowledge on screening for latent tuberculosis infection (LTBI) in HIV-infected adults and provide specific guidelines for Belgium. Focus is given to who to test, which testing method to use, timing of screening and choice of LTBI treatment.info:eu-repo/semantics/publishe

Number of MDR with first-line drug resistance only, pre-XDR and XDR isolates in the study cohort.

<p>Number of MDR with first-line drug resistance only, pre-XDR and XDR isolates in the study cohort.</p

Molecular epidemiology of <i>Mycobacterium tuberculosis</i> complex in Brussels, 2010–2013

<div><p>The tuberculosis (TB) incidence rate in Brussels-Capital Region is 3-fold higher than in Belgium as a whole. Eight years after the realization of initial prospective population-based molecular epidemiology investigations in this Region, a similar study over the period 2010–2013 was conducted. TB strains isolated from 945 patients were submitted to genotyping by standardized 24-locus-MIRU-VNTR typing and spoligotyping. The phylogenetic analysis showed that the LAM (16.7%) and Haarlem (15.7%) branches are the two most prevalent TB lineages circulating in Brussels. Analysis of the MDR subgroup showed an association with Beijing strains (39.9%) and patients native of Eastern Europe (40.7%). Genotyping detected 113 clusters involving 321 patients, giving a recent transmission index of 22.9%. Molecular-guided epidemiological investigations and routine surveillance activities revealed family transmission or social contact for patients distributed over 34 clusters. Most of the patients were foreign-born (75.7%). However, cluster analysis revealed only limited trans-national transmission. Comparison with the previous study shows a stable epidemiological situation except for the mean age difference between Belgian-born and foreign-born patients which has disappeared. This study confirms that molecular epidemiology has become an important determinant for TB control programs. However, sufficient financial means need to be available to perform all required epidemiological investigations.</p></div

Repartition of the clusters according to the links identified between the patients.

<p>Clusters are represented by unique identification numbers. Next to the cluster number, the number of patients for who an epidemiological link was detected is indicated (i.e. 2/3: two of the three patients included in the cluster present this link). f: familial link; o: same geographic origin; p: geographic proximity. Clusters in orange contain more than 3 patients and cluster in grey more than 6. The purple boxes indicate the number of clusters belonging to each category (or combination of categories) of links. The blue boxes indicate clusters comprising exclusively Belgian-born patients. The green boxes indicate clusters with strains presenting the 776000000000171 spoligotype (S-family).</p

Characteristics of <i>Mycobacterium tuberculosis</i> complex strains isolated from tuberculosis patients living in Brussels and two subgroups; no-clustered and clustered strains, 2010–2013.

<p>Characteristics of <i>Mycobacterium tuberculosis</i> complex strains isolated from tuberculosis patients living in Brussels and two subgroups; no-clustered and clustered strains, 2010–2013.</p