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TB-Related News and Journal Items Weekly Update

Week of January 16 to January 22, 2011

CDC provides the TB-Related News and Journal Items Weekly Update as a public service only.

This update is a compilation of TB-related articles published for the benefit and information of

people interested in TB, and we do not confirm the accuracy of the data in the articles that are

abstracted. Providing synopses of key scientific articles and lay media reports on TB does not

constitute CDC endorsement. This update may also include information from CDC and other

government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR)

articles, fact sheets, press releases, and announcements. Reproduction of this text is

encouraged; however, copies may not be sold. For those items reproduced from the first section

of the TB weekly update, the CDC HIV/Hepatitis/STD/TB Prevention News Update should be

cited. For any other items in the TB weekly update, you may cite the CDC TB-Related News

and Journal Items Weekly Update.





This Week's Contents

TB-Related Announcements

News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News Update

Headlines

Journal Articles

Job Announcements

Upcoming Conferences, Trainings, and Other Events





TB-Related Announcements

1. ―Asking the Right Questions: A Visual Guide to Tuberculosis Case

Management for Nurses‖ now available online





The Francis J. Curry National TB Center announces a new online educational

toolkit: Asking the Right Questions: A Visual Guide to Tuberculosis Case

Management for Nurses (http://www.nationaltbcenter.ucsf.edu/arq/index.cfm) .





The primary target audience is nurses in the public and private health sectors,

but the toolkit materials are also useful for TB outreach workers, health care

workers in facilities where TB cases are found, and community-based providers

who may identify TB suspects or help to treat patients with TB.





Learners can use the toolkit to:





Prompt critical thinking about TB case management

Find relevant basic national training materials and guidelines

Get an overview of the full TB case management timeline

The toolkit can be used for self-paced learning or for mixed classroom and self-

paced learning. It has three components:





(1)The Visual Guide (poster) presents a timeline of the full TB case management

process and suggests critical questions to ask throughout the process to ensure

full assessment of TB suspects and completion of safe, effective treatment for

TB disease.





(2) The Reference Guide takes the critical questions another level deeper and

offers short topics that briefly explain relevant concepts, and provides

hyperlinks to training materials from the CDC and Regional Training and Medical

Consultation Centers and to current national guidelines and selected

publications.





(3) The Web Guide offers several features for exploring questions and concepts.

These features include: an interactive exploration of critical questions linking to

Reference Guide topics and hyperlinks, a presentation about the TB case

management timeline that is part of the Visual Guide, an online glossary, and

downloadable learning guides with suggested curricula.





To put these materials to use, two learning guides suggest training curricula for

self-paced learning and for a combination of self-paced and classroom-based

learning, adaptable to the needs of your jurisdiction or agency. The Facilitator’s

Guide offers suggestions for presenting a curriculum that combines self-paced

study with classroom discussion and activities. The Self-Paced Learning Guide

outlines a learning curriculum that can be completed by the learner at his or her

own pace.









2. TB REACH Launches Call for Proposals for Wave 2 Funding

Stop TB Partnership, December 1, 2010





TB REACH is accepting proposals for the second wave of funding for projects

that promote early and increased case detection of TB cases and ensure their

timely treatment, while maintaining high cure rates within national TB programs.

TB REACH encourages the development and application of innovative, ground-

breaking, and efficient approaches, interventions, and activities that result in

increased TB case detection, reduced transmission, and prevention of the

emergence of drug-resistant forms of TB. As suggested by its name, TB REACH

focuses on reaching vulnerable people, people from poverty areas, and people

who have limited or no access to TB services.





Eligibility criteria, examples of suitable interventions, technical guidance, the

application form, and instructions for applicants are available on the TB REACH

website.





The deadline for submitting proposals for Wave 2 is February 28, 2011.





Eligible applications will be reviewed by the Proposal Review Committee, an

independent group of experts, during March 2011. All proposals recommended

for funding will be presented for approval to the Stop TB Partnership

Coordinating Board at its next meeting. The final results of the review are likely

to be made available to all applicants by May 2011.





TB REACH was launched officially on January 25, 2010. Thirty projects in 19

eligible countries, which aimed to detect and treat an additional 40,000 new

smear-positive TB cases, received funding under Wave 1. The TB REACH

initiative receives support from the Canadian International Development Agency

(CIDA).

News Item(s) From the CDC HIV/Hepatitis/STD/TB Prevention News Update

1. West Fargo Students Warned of Possible Exposure to Tuberculosis

WDAY.com (Fargo), January 13, 2011





Parents of 75 students who attend a school in West Fargo, North Dakota, have

been notified that their children likely have had direct contact with a student who

has symptoms of active TB, although that diagnosis has not been confirmed.

The only students potentially at risk are those whose parents received the

letters, said Dr. John Baird, health officer. The students who undergo testing will

be tested again in eight to 10 weeks, Baird said.

Headlines

1. New Executive Secretary to Head the Stop TB Partnership (Switzerland)

Stop TB Partnership, www.stoptb.org, January 19, 2011

The Stop TB Partnership announced the appointment of Dr. Lucica Ditiu as its

Executive Secretary, replacing Dr. Marcos Espinal, who stepped down in August

of 2010. Dr. Ditiu is a physician and researcher who has focused on improving

the lives of people living in communities heavily burdened by TB. She joined the

Stop TB Partnership in Geneva in January of 2010 to lead the TB REACH

initiative. She began working with the World Health Organization (WHO) in

January of 2000 as a medical officer for TB in Albania, Kosovo, and Macedonia

within the disaster and preparedness unit of the WHO European Regional Office.

Dr. Ditiu is a 1992 graduate of the University of Medicine and Pharmacy in

Bucharest, and completed a specialty in pulmonology in a joint program with the

Romanian National Institute of Lung Disease. In 1999, she received a certificate

in International Public Health from the George Washington University in

Washington, DC, where she completed a fellowship in the epidemiology of lung

disease in TB control and program management and evaluation.









2. Stop TB Partnership Global Drug Facility (GDF) Working to Mitigate Shortage

of Quality-Assured Streptomycin (Switzerland)

Stop TB Partnership, www.stoptb.org, January 17, 2011





The Global Drug Facility (GDF) will resume streptomycin delivery in the first

quarter of 2011 in limited supply until at least mid-2011. Allocation of stocks to

existing GDF orders will be prioritized by date the order was received and

countries’ stock levels, but multiple shipments may be needed to complete the

order. New orders through GDF may be subject to substantial delay, with

delivery unlikely before the end of 2011. In November, GDF warned of an

anticipated temporary shortage of quality-assured streptomycin, which is used

to treat multidrug-resistant (MDR) TB, and countries were advised to consider

different temporary solutions. Since then, GDF has identified manufacturers that

produce streptomycin according to GDF’s quality assurance policy, but the

production capacity of these producers is limited, and production costs are high.

The shortage was related to quality issues of the active pharmaceutical

ingredient source used by one of the main suppliers of streptomycin, as well as

more stringent quality assurance policies adopted by major donors and

technical agencies. GDF is working with industry in various countries and with

World Health Organization experts. Together, they are working on quality and

safety of drugs to facilitate the inspections and product assessments required

for alternative manufactures to become eligible for supplying GDF drugs. GDF

will maintain contact with countries to collect information on stock levels and

notify them of the status of their streptomycin orders.









3. DOH Turns Over Microscopes for TB Program to 6 Aklan Towns (The

Philippines)

Stop TB Citizen News, http://stoptb.citizen-news.org, January 18, 2011, by Venus

G. Villaneuva PIA News





The Philippine Department of Health recently provided microscopes to six Aklan

towns. The microscopes were received by Aklan Governor Carlito, S. Marques,

from Dr. Ariel Valencia, Regional Director DOH-6, and will be distributed to the

municipalities Lezo, Libacao, Ibajay, Batan, New Washington and Makato. These

microscopes are to be used for implementation of Aklan’s programs to fight TB,

and will be used by medical technologists on duty in rural health units.









4. Nunavut Health Officials to TB: ―Taima‖ (Canada)

NunatsiaqOnline, www.nunatsiaqonline.ca, January 13, 2011, by Chris Windeyer





Nunavut public health officials are launching Taima TB (Stop TB) in Inuktitut, a

combination of public education, social media outreach, and door-to-door

screening and treatment. The project raises awareness through town hall

meetings and social media such as Facebook. Teams will help people with latent

TB infection (LTBI) get treatment. The program will boost screening for TB and

urge people with active TB disease to get treatment. The federal government has

provided an $800,000 grant for Taima TB. Taima TB’s approach has the backing

of high-ranking Nunavut officials. The approach was designed with the past in

mind, when many Inuit were taken south for TB treatment in the 1950s and 60s.

Many died or never returned north, and this resulted in much pain and heartache

for the families.









5. Tuberculosis Confirmed in Two Inmates at Prison in Wilkesboro: Hundreds

Tested (United States)

Winston-Salem Journal, www.journalnow.com, January 12, 2011, by Monte

Mitchell, mmitchell@wsjournal.com





About 238 inmates of Wilkes Correctional Center in North Carolina, 56 staff

members, and some outside contacts have been tested for TB, after the disease

was diagnosed in two inmates. According to Wilkes County health officials, the

first case was diagnosed in early November, and testing and notifications began

immediately. The two patients are being treated in Raleigh, and no additional

cases have been confirmed. Wilkes Correctional Center is a minimum-security

state prison, where inmates live in dormitory-style housing, and many are

eligible for work-release programs. Officials are working to notify any contacts,

but health officials believe the potential for exposure is limited, and no one is at

immediate risk. There was one TB case in Wilkes County in 2009, and there were

two in 2008.









6. Technology for Early Diagnosis of TB to Be Piloted in Pakistan (Pakistan)

The News, www.thenews.com, January 15, 2011, by Shahina Maqbool





In 2011, Pakistan’s National TB Control Program (NTP) will begin using

GeneXpert, a rapid diagnostic test that detects TB and rifampin drug resistance.

A $1 million grant from the US State Department will support the pilot project at

15 sites across Pakistan. GeneXpert, which was endorsed by the World Health

Organization, gives results in less than two hours using untreated sputum. Also,

the NTP has received $173 million from the Global Fund to Fight AIDS, TB, and

Malaria, which will be used over the next five years to prevent MDR TB and

manage 17,000 MDR TB cases. Pakistan reports having approximately 15,000

MDR TB patients per year. The grant will provide food and travel allowances for

TB patients and will enable the NTP to upgrade its laboratories for MDR TB

diagnosis. NTP has engaged the private sector in 60 districts to improve MDR TB

prevention, and has piloted the public-private mix approach at hospitals and

health services in different areas of the country. Free drugs are being provided

to all hospitals working to prevent MDR TB. In addition to the National Reference

Laboratory at the National Institute of Health, four laboratories will be

established in the provinces. Pakistan ranks 8th on the WHO list of tuberculosis

high-burden countries in the world. Each year an estimated 300,000 people in

Pakistan develop TB. The country’s case detection rate has risen from 70

percent to 74 percent, and the treatment success rate from 88 percent to 91

percent in the last two years.









7. Additional TB Unit to Come Up in Bhagalpur (India)

The Times of India, http://timesofindia.indiatimes.com, January 19, 2011, by

Kumar Rajesh





The health department in Bhagalpur, India, plans to add a TB unit to the Bihpur

primary health center, as well as adding infrastructure for examining TB patients

to existing primary health centers. In the last six years, the number of TB

patients has increased, despite the use of DOTS, which is recommended by the

World Health Organization. In 2006, there were 2,613 TB patients; in 2007, 3,876;

in 2008, 3,965; and in 2009, 3,915. In response to the steady rise in TB patients,

the health department has decided to decentralize TB treatment, and determine

the number of patients at the primary health centers in the district based on

sputum results. In addition to the TB unit at Bihpur, laboratories will be opened

in eight primary health centers. These laboratories will assist in early detection

of the disease and provide free antituberculosis drugs to patients. According to

Dr. Madhukar Prasad, District TB Program Officer, the additional TB units and

laboratories will help the health department control the disease by providing

early diagnosis and treatment.

Journal Articles

1. AIDS. 2010 Nov; Volume 24 Suppl 5:S37-44. 'Team up against TB': Promoting

Involvement in Thibela TB, a Trial of Community-Wide Tuberculosis Preventive

Therapy; Grant, A.D., Coetzee, L., Fielding, K.L., Lewis, J.J., et al.





Click here for PubMed abstract: PubMed





This study describes a program of community education and mobilization to

promote uptake in a cluster-randomized trial of TB preventive therapy offered to

all members of intervention clusters. The intervention took place in the gold

mines in South Africa, where TB incidence is extremely high, despite

conventional control measures. All employees in intervention clusters (mine

shaft and associated hostel) were invited to enroll. The main outcome measure

was cumulative enrolment in the study in intervention clusters. Key steps in

communicating information relevant to the study included extensive

consultation with key stakeholders; working with a communication company to

develop a project 'brand'; developing a communication strategy tailored to each

intervention site; and involving actors from a popular television comedy series

to help inform communities about the study. One-to-one communications used

peer educators along with study staff, and participant advisory groups facilitated

two-way communication between study staff and participants. By contrast,

treatment 'buddies' and text messaging to promote adherence proved less

successful. Mean cumulative enrolment in the first four intervention clusters was

61.9%, increasing to 83.0% in the final four clusters. It is concluded that a

tailored communication strategy can facilitate a high level of enrollment in a

community health intervention.









2. AIDS. 2010 Nov; Volume 24 Suppl 5:S19-27. Symptom and Chest Radiographic

Screening for Infectious Tuberculosis Prior to Starting Isoniazid Preventive

Therapy: Yield and Proportion Missed at Screening; Churchyard, G.J., Fielding,

K.L., Lewis, J.J., Chihota, V.N., et al.





Click here for PubMed abstract: PubMed





This study describes the prevalence of and risk factors for TB at screening prior

to isoniazid preventive therapy (IPT), the additional yield of TB using chest

radiography versus symptoms alone, and risk factors for TB missed by

screening. A cross-sectional analysis of a trial of community-wide IPT was

conducted in the South African gold mines. Participants were screened for TB

prior to starting IPT using symptoms (cough >2 weeks, weight loss, night

sweats) and chest radiography. TB suspects had sputum collected for

mycobacterial investigations. Those with a positive smear or culture with no

speciation or culture identified as Mycobacterium tuberculosis were classified as

having probable or definite TB, respectively. Among participants who were

dispensed IPT, the researchers defined a 'missed' case of active TB as one

identified within 90 days of the enrollment screen. Between July 2006 and

December 2008, among 23,286 participants with complete data, the prevalence of

undiagnosed TB [definite (284) and probable (31)] was high (315/23 286; 1.4%).

The addition of chest radiography to symptom screening increased the number

of definite TB cases detected by 2.5-fold (113 to 281 cases). Among 19,609

individuals correctly screened for TB who started IPT and had more than 90 days

of follow-up, only 39 (0.2%) active TB cases were missed. Risk factors for TB

missed by screening included increasing age [adjusted odds ratio (aOR) 1.66/10

year increase, 95% confidence interval (CI) 1.07-2.56], non-South African, in HIV

care (aOR 4.80, 95% CI 1.63-14.1), lower weight (aOR 2.07/10 kg decrease, 95% CI

1.23-3.49) and alcohol use (aOR 2.52, 95% CI 1.31-4.86), which were similar to

risk factors for TB detected by screening. TB screening prior to IPT detects a

substantial burden of TB and misses very few cases. Chest radiography

significantly increased the yield of TB cases detected.









3. Bull World Health Organ. 2010 Dec 1;88(12):937-942. Epub 2010 Sep 29.

Engaging Hospitals to meet Tuberculosis Control Targets in China: Using the

Internet as a Tool to Put Policy into Practice; Wang, L., Liu, X., Huang, F., Hennig,

C., et al.





Click here for PubMed abstract: PubMed





TB services in China are provided through a large network of TB dispensaries.

Even though hospitals are not as well placed to follow recommended standards

of TB care, a significant proportion of people with TB symptoms seek care from

hospitals. In spite of having a policy and mandate in place, the Ministry of Health

had little success in encouraging hospitals to refer suspected TB cases to

dispensaries. Following the epidemic of severe acute respiratory syndrome in

2003, the government set up a nationwide Internet-based communicable

diseases reporting system. This achieved productive collaboration between

hospitals and TB dispensaries. From 2004 to 2007, the percentage of TB

suspects and patients needing referral from hospitals who arrived in TB

dispensaries increased substantially from 58.7% to 77.8% and the contribution of

hospitals to diagnosing sputum smear-positive TB cases doubled from 16.3% to

32.9%. Using the Internet-based reporting system, hospitals in China contributed

to finding about one third of all sputum smear-positive TB cases and helped

meet the global TB control target of detecting 70% of such cases. Based on the

data available from routine surveillance facilitated by this Internet-based system,

this paper details the process and outcomes of strengthening collaboration

between hospitals and TB dispensaries using the Internet as a tool and its

potential application to other country settings.

4. Drugs. 2010 Dec 3; Volume 70, Number 17: 2201-14. doi: 10.2165/11538170-

000000000-00000. Drugs in Development for Tuberculosis; Ginsberg, A.M.





Click here for PubMed abstract: PubMed





TB drug research and development efforts have resurged in the past 10 years to

meet urgent medical needs, but enormous challenges remain. These urgent

needs are largely driven by the current long and arduous multidrug regimens,

which have significant safety, tolerability, and compliance issues; rising and

disturbing rates of multidrug- and extensively drug-resistant TB; the existence of

approximately 2 billion individuals already latently infected with Mycobacterium

tuberculosis, the causative pathogen of TB; and a global TB-HIV co-epidemic.

Stakeholders in TB drug development are moving to enable and streamline

development and registration of novel, multidrug treatment regimens, comprised

of multiple new chemical entities with novel mechanisms of action that do not

demonstrate cross-resistance to current first- and second-line TB drugs. Ideally,

these new regimens will ultimately provide a short, simple treatment suitable for

essentially all TB patients, whether sensitive or resistant to the current anti-TB

agents, whether HIV-infected or HIV-non-infected, and irrespective of patient age.

This article reviews the challenges faced by those trying to develop these novel

regimens and the key agents currently in clinical testing for TB; the latter are

organized for discussion into three categories: (i) novel drugs (TMC207, SQ109,

sudoterb [LL3858]); (ii) present first-line TB drugs being re-evaluated to optimize

their efficacy (rifampicin, rifapentine); and (iii) currently licensed drugs for other

indications and 'next-generation' compounds of the same chemical class being

repurposed for TB (gatifloxacin and moxifloxacin; linezolid, PNU100480 and

AZD5847; metronidazole, OPC-67683 and PA-824).









5. Ethiopian Medical Journal. 2010 Jul; Volume 48, Number 3: 203-10.

Identification of Drug Susceptibility Pattern and Mycobacterial Species in

Sputum Smear Positive Pulmonary Tuberculosis Patients with and without HIV

Co-Infection in North West Ethiopia; Mekonen, M., Abate, E., Aseffa, A., Anagaw,

B., et al.





Click here for PubMed abstract: PubMed

Ethiopia is among the high-burden countries of TB in the world. Since

mycobacterial culture and susceptibility testing are not routinely performed in

Ethiopia, recent data on susceptibility patterns and the mycobacterial species

cultured from sputum smear positive patients are limited. This study determined

first line anti-TB drug susceptibility of Mycobacterium tuberculosis isolates

obtained from consecutive newly diagnosed smear positive pulmonary TB

patients in northwest Ethiopia. A retrospective cross sectional study was

conducted using previously collected sputum samples (n=180) kept at the

referral hospital of the University of Gondar at -20 degrees C. Sputum samples

were cultured on Lowenstein Jensen (LJ) medium. Conventional polymerase

chain reaction (PCR), using RD4 primers to identify the M. tuberculosis complex,

was performed on cultured isolates. Ninety eight (84.4%) of the 116 isolates

identified as M. tuberculosis were tested for their drug susceptibility pattern

using the proportion method. Clinical baseline data including body mass index,

body temperature, clinical symptoms, and erythrocyte sedimentation rate were

obtained. The culture retrieval rate of previously frozen sputum samples was

64.4% (116/180). All the isolated mycobacterial species (n=116) were confirmed

as belonging to the M. tuberculosis complex by PCR. Of 98 isolates for which the

drug susceptibility test was done, 15.3% (15/98) were found to be resistant to one

or more antimycobacterial drugs, and resistance to isoniazid and streptomycin

was most common with 8.2% (8/98) and 6.1% (6/98) respectively. TB patients co

infected with HIV had increased erythrocyte sedimentation rate, higher age, and

lower sputum smear grade than HIV negative TB patients. No mycobacteria other

than M. tuberculosis were detected in sputum smear positive TB-patients.

Although no multi drug resistant strain was observed, relatively high rates of INH

resistance were found in this region. Culture facilities are urgently needed in

regional centers to increase diagnostic sensitivity and monitor developing

trends of drug resistance in Ethiopia.









6. Ethiopian Medical Journal. 2010 Jul; Volume 48, Number 3: 195-202. Quality of

Tuberculosis Care in Six Health Facilities of Afar Region, Ethiopia; Girma, A.,

H/Mariam, D., Deribe, K.





Click here for PubMed abstract: PubMed

Quality TB care plays an important role in the status of TB control, treatment

completion, and adherence. Nonetheless, very little is known about the quality of

TB care in public health facilities in Ethiopia. In this study the researchers

assessed the quality of TB care delivery in Afar Region of Ethiopia. A descriptive

cross sectional health institution based survey with both semi-structured and

structured questionnaires was employed. A mix of complementary techniques

was administered. Data were collected between 5th February and 10th March

2007 from six health institutions. Records were reviewed for 270 patients, exit

interviews were made for 209 patients, six providers were interviewed, and 49

patients were observed. Data were collected by trained nurses and analyzed

using SPSS 11.0 statistical software. The study showed that delivery of

materials, drugs, and supplies for TB control activities were fairly good. Staffing

qualities were poor, and patterns of supervision were weak. A relatively higher

proportion of patients were dissatisfied with the appropriateness and adequacy

of working hours (63.6%) and waiting time (70.3%). Statistically significant

correlation was observed between process quality and output quality (clients'

satisfaction) parameters (p < 0.001). Continued quality improvement mechanisms

to improve the different aspects of the program and adherence to the National

Tuberculosis and Leprosy Control Program guideline could be important

interventions to enhance the quality of care delivery. An expanded community-

based study to better guide quality DOTS program in pastoral communities is

crucial.









7. The European Respiratory Journal. 2010 Dec; Volume 36, Number 6: 1242-

1247. Challenges and Perspectives for Improved Management of

HIV/Mycobacterium tuberculosis Co-Infection; Sester, M., Giehl, C., McNerney,

R., Kampmann, B., et al.





Click here for PubMed abstract: PubMed





HIV and Mycobacterium tuberculosis (MTB) are two widespread and highly

successful microbes whose synergy in pathogenesis has created a significant

threat for human health globally. In acknowledgement of this fact, the European

Union (EU) has funded a multinational support action, the European Network for

global cooperation in the field of AIDS and TB (EUCO-Net), which brings together

experts from Europe and those regions that bear the highest burden of HIV/MTB

co-infection. In this article, the authors summarize the main outcome of the

EUCO-Net project derived from an expert group meeting that took place in

Stellenbosch (South Africa) (AIDS/TB Workshop on Research Challenges and

Opportunities for Future Collaboration) and the subsequent discussions, and

propose priority areas for research and concerted actions that will have impact

on future EU calls.









8. Future Microbiology. 2010 Oct; Volume 5:1581-97. Protein Export Systems of

Mycobacterium tuberculosis: Novel Targets for Drug Development? Feltcher,

M.E., Sullivan, J.T., Braunstein, M.





Click here for PubMed abstract: PubMed





Protein export is essential in all bacteria and many bacterial pathogens depend

on specialized protein export systems for virulence. In Mycobacterium

tuberculosis, the etiological agent of the disease TB, the conserved general

secretion (Sec) and twin-arginine translocation (Tat) pathways perform the bulk

of protein export and are both essential. M. tuberculosis also has specialized

export pathways that transport specific subsets of proteins. One such pathway

is the accessory SecA2 system, which is important for M. tuberculosis virulence.

There are also specialized ESX export systems that function in virulence (ESX-1)

or essential physiologic processes (ESX-3). The increasing prevalence of drug-

resistant M. tuberculosis strains makes the development of novel drugs for TB

an urgent priority. In this article, the researchers discuss their current

understanding of the protein export systems of M. tuberculosis and consider the

potential of these pathways to be novel targets for TB drugs.









9. The Indian Journal of Tuberculosis. 2010 Apr; Volume 57, Number 2: 75-9. Can

Cord Formation in BACTEC MGIT 960 Medium be Used as a Presumptive Method

for Identification of M. tuberculosis Complex? Kadam, M., Govekar, A., Shenai,

S., Sadani, M., et al.





Click here for PubMed abstract: PubMed

Serpentine cord formation in BACTEC MGIT 960 medium was evaluated as a

rapid method for the presumptive identification of M. tuberculosis complex

(MTBC). A total of 2,527 samples were processed for AFB culture using MGIT 960

TB system over a period of three months. AFB smears were prepared from 1000

MGIT tubes flagged positive by the MGIT instrument and stained by ZN method

to examine presence or absence of serpentine cording. The cord formation was

compared with PNBA [p-nitro benzoic acid] test on MGIT system and all

controversial cases were further evaluated by NAP [p-nitro-a-acetylamino-

phydroxypropiophenone] test on BACTEC 460 TB system. Of the 1,000 culture

positives, 904 (90.4%) were identified as mycobacteria, of which 869 (96%)

showed cording by smear microscopy. One (0.1%) was identified as nocardia. In

the remaining 95 (9.5%) cases, primary smear made from MGIT vial was negative.

Of 869 cultures showing serpentine cord formation, 842 were confirmed as

MTBC and 27 as NTM by PNBA assay on MGIT 960 TB system. The sensitivity,

specificity, positive and negative predictive values are found to be 99.6%, 54%,

96%, and 91% respectively. An average detection time for PNBA assay was

found to be eight days whereas cording results were available on the same day

of culture positivity. Though highly sensitive it is not very specific and hence

cannot be the only test for presumptive diagnosis of MTBC.









10. The Indian Journal of Tuberculosis. 2010 Apr; Volume 57, Number 2: 67-74.

Detection of Circulating Free and Immune-Complexed Antigen in Pulmonary

Tuberculosis Using Cocktail of Antibodies to Mycobacterium tuberculosis

Excretory Secretory Antigens by Peroxidase Enzyme Immunoassay; Majumdar,

A., Kamble, P.D., Harinath, B.C.





Click here for PubMed abstract: PubMed





Decreased sensitivity has been a limiting factor of antigen assay for detection of

TB. Assay of more than one antigen may improve sensitivity of an assay. To

develop a simple, rapid and less-expensive serodiagnostic method compared to

culture method for Pulmonary Tuberculosis. A cocktail of affinity purified

antibodies against Mycobacterium tuberculosis H37Ra antigens (SEVA TB ES-

31, ES-43 and EST-6) was explored for detection of circulating free and immune-

complexed (IC) cocktail antigen by microtiter plate peroxidase sandwich ELISA.

The assay was evaluated in 27 clinical sera of sputum acid fast bacilli (AFB)

positive and 10 AFB negative, but anti-tuberculosis therapy responded to

pulmonary TB patients and 20 normal sera as controls. Assay of cocktail antigen

showed marginal improvement in sensitivity compared to assay of ES-31 antigen

alone. The assay for circulating free cocktail antigen showed a sensitivity of

77.7% for AFB positive cases and 70% for AFB negative cases compared to

assay of ES-31 antigen with sensitivity of 74% and 70% respectively. The assay

for IC-cocktail antigen showed sensitivity of 77.7% for AFB positive and 80% for

AFB negative cases compared to assay of ICES-31 antigen with sensitivity of

77% and 70% respectively. Specificity of antigen assay was found to be 90%.

Detection of IC-antigen as adjunct assay improved the sensitivity of detection in

AFB-ve but ATT responded cases. Peroxidase enzyme immunoassay of cocktail

antigen showed a sensitivity of detection of 0.25 microg/ml and levels of free and

IC cocktail antigens were 1.70 +/- 1.04 and 1.13 +/- 0.047 microg/ml in AFB

positive patients' sera. Peroxidase enzyme immunoassay for circulating antigen

was found to be a useful serodiagnostic assay and in particular in AFB-ve cases

responding to ATT.









11. Japanese Journal of Infectious Diseases. 2010 Nov; Volume 63, Number 6:

433-6. Is the T-Cell-Based Interferon-Gamma Releasing Assay Feasible for

Diagnosis of Latent Tuberculosis Infection in an Intermediate Tuberculosis-

Burden Country? Gorek Dilektasli, A., Erdem, E., Durukan, E., Oner Eyüboğlu, F.





Click here for PubMed abstract: PubMed





The diagnosis of active and latent TB infection (LTBI) remains a challenge,

especially in light of the fact that the tuberculin skin test (TST), which has been

used to diagnose LTBI for over a century, has many well-known drawbacks. This

study compared the diagnostic performance of the T-cell-based interferon-

gamma releasing assay (IGRA) T-SPOT.TB with the TST for the diagnosis of LTBI

in an intermediate TB-burden country with high BCG coverage. For this purpose,

a total of 91 participants, including culture-confirmed TB patients, healthy

contacts known to have been exposed to Mycobacterium tuberculosis, and

healthy volunteers, selected from a BCG-vaccinated population were recruited.

The sensitivities of the T-SPOT.TB and TST were 79.3 and 25.8%, and the

specificities were 75.9 and 56.7%, respectively. The negative- and positive-

predictive values for T-SPOT.TB and TST were 78.6 and 76.7% and 42.5 and

38.1%, respectively. The diagnostic performance of the TST in LTBI diagnosis is

therefore severely diminished in BCG-vaccinated populations, with the

sensitivity and specificity of the T-SPOT.TB assay being markedly higher. IGRAs

have been reported to have higher diagnostic sensitivity and specificity in low

TB-incidence settings than those seen here. Further larger scale studies in high

and intermediate TB-incidence settings are therefore warranted.









12. Journal of Acquired Immune Deficiency Syndromes. 2010 Dec 1; Volume 55,

Number 4: 446-50. Causes of Early Mortality in HIV-Infected TB Suspects in an

East African Referral Hospital; Kyeyune, R., den Boon, S., Cattamanchi, A.,

Davis, J.L., et al.





Click here for PubMed abstract: PubMed





Respiratory infections are a leading cause of death in Africa, especially among

HIV-infected patients. Data on the etiology of fatal respiratory diseases are

largely based on autopsy studies. The researchers evaluated causes of

pneumonia associated with early mortality among hospitalized HIV-infected

patients in Kampala, Uganda. Prospective cohort study of HIV-infected patients

admitted to Mulago Hospital, Kampala, with at least 2 weeks of cough.

Consecutively enrolled patients with negative Ziehl Neelsen sputum smears for

acid-fast bacilli underwent bronchoscopy with bronchoalveolar lavage and

examination for mycobacteria (smear, solid culture), Pneumocystis jirovecii

(Giemsa stain), and fungi (KOH mount, India ink stain, Sabouraud culture). Early

mortality was defined as death before the 2-month follow-up visit. Follow-up

data were available for 353 (87%) of 407 patients enrolled. Of participants with

follow-up data, 112 (32%) died within 2 months. Among patients with early

mortality, a diagnosis was confirmed in 74 (66%), including TB (56%),

cryptococcal pneumonia (1%), Pneumocystis pneumonia (3%), pulmonary

Kaposi sarcoma (4%), and pneumonia caused by 2 or more disease processes

(3%). Mortality in HIV-infected TB suspects is high, with TB associated with the

largest proportion of deaths. A significant proportion of patients die without a

confirmed diagnosis.

13. The Journal of the Egyptian Public Health Association. 2010; Volume 85,

Number 1-2: 61-71. Prevalence of Latent TB among Health Care Workers in Four

Major Tertiary Care Hospitals in Riyadh, Saudi Arabia; Abbas, M.A., Alhamdan,

N.A., Fiala, L.A., Elenezy, A.K., et al.





Click here for PubMed abstract: PubMed





TB infection represents a global health problem and a great risk to health care

workers (HCWs). Identifying individuals, particularly HCWs with latent TB

infection (LTBI) will support TB control through chemoprophylaxis and prevent

cross-infection. This study identified prevalence of LTBI among a group of two-

year new hires of HCWs in 4 major tertiary care hospitals in Riyadh, Saudi

Arabia. 2,650 recently-hired (2-years) HCWs were screened for LTBI using the

Tuberculin Skin Test (TST). Data were collected from January 2008 to December

2009. Induration due to TST equal to or more than 10 mm. within 48-72 hours was

considered positive. The results of TST were correlated with other variables such

as age group, gender, job category, country of origin. As an overall rate,

291(11%) out of 2,650 were positive for TST, with the highest significant positive

rates among physicians (14.9%) and nurses (12.9%) compared to students as a

reference group. No statistically significant difference was detected between

both sexes. The highest significant positive TST rates were found among HCWs

in the age group of 50 years and older (32.6%) compared to 10-19 years age

group as a reference group, and among HCWs coming from sub-Saharan

countries (61.1%) compared to Saudi HCWs with the lowest positive rates (5%)

as a reference group. LTBI is prevalent among newly-hired HCWs in Riyadh

tertiary hospitals. Standard programs for detection and treatment of LTBI should

be encouraged.









14. Journal of Microbiology, Immunology, and Infection. 2010 Oct; Volume 43,

Number 5: 395-400. Abdominal Tuberculosis in Adult: 10-year Experience in a

Teaching Hospital in Central Taiwan; Chou, C.H., Ho, M.W., Ho, C.M., Lin, P.C., et

al.





Click here for PubMed abstract: PubMed

TB is an important communicable disease worldwide. The clinical presentation

of abdominal TB often mimics various gastrointestinal disorders and may delay

accurate diagnosis. In this study, the researchers conducted a 10-year

retrospective study to investigate the clinical manifestations, treatment

responses, and outcomes of abdominal TB. This retrospective study recruited

patients presenting between January 1998 and December 2007; all patients ≥ 18

years of age with a diagnosis of abdominal TB were enrolled. Patient charts were

thoroughly reviewed and clinical specimens were processed in the laboratory

using the BBL MycoPrep System and BACTEC MGIT 960 Mycobacterial

Detection System. Mycobacterium tuberculosis complex was confirmed by acid

fast stain and the BD ProbeTec ET System. During the study period, 34 patients

were diagnosed with abdominal TB. The mean age was 55+18 years. Fourteen

patients (41%) had no risk factors; however, 20 patients (59%) had at least one

risk factor. Abdominal pain (94.1%), abdominal fullness (91.2%), anorexia

(88.2%), and ascites (76.5%) were the most common presenting symptoms. The

peritoneum (88%) was the most commonly involved site. Patients with risk

factors such as liver cirrhosis, end-stage renal disease, and diabetes mellitus

had a higher positive rate of acid-fast stain and mycobacterial culture from

abdominal specimens (p = 0.02 and 0.05, respectively). The crude mortality rate

was 9% and the attributed mortality rate was 3%. In an endemic area like Taiwan,

regardless of whether a patient has risk factors for TB, abdominal TB should be

seriously considered as a differential diagnosis when a patient presents with

gastrointestinal symptoms and unexplained ascites.









15. Journal of Microbiology, Immunology, and Infection. 2010 Oct; Volume 43,

Number 5: 386-94. Does Radiographic Evidence of Prior Pulmonary Tubercular

Infection Influence the Choice of Empiric Antibiotics for Community-Acquired

Pneumonia in a Tuberculosis-Endemic Area? Jeng, Y.Y., Lin, Y.T., Huang, L.J.,

Chen, T.L., et al.





Click here for PubMed abstract: PubMed





Recent medical literature suggests that use of fluoroquinolones (FQs) might be

associated with the delayed diagnosis of pulmonary TB. This study assessed the

impact of radiographic evidence of prior pulmonary TB infection on empiric

antibiotic choice in cases of community-acquired pneumonia (CAP), as well as

the effect of antibiotic regimens on clinical outcome. A total of 280 patients with

CAP between 1 May and 31 December 2007 were included in the study and their

medical records were retrospectively reviewed. Patients were divided into two

groups: those receiving FQs (FQ group) or those receiving β-lactam-based

regimens (β-lactam group). Their demographic data, underlying diseases, clinical

features, diseases severity, and outcomes were compared. Radiographic

evidence of a previous pulmonary TB infection (odds ratio = 3.507, 95%

confidence interval = 1.422-8.645; p = 0.006) was an independent factor

associated with β-lactam-based regimens. Patients with a modified pneumonia

severity index (mPSI) category V were more likely to receive FQ therapy (odds

ratio = 2.53, 95% confidence interval = 1.140-5.615; p = 0.022). Of the patients

with mPSI category V, the 14-day mortality rate of those in the β-lactam group

was significantly lower than that of those in the FQ group (0%vs. 23%,

respectively; p = 0.044). Radiographic evidence of a previous pulmonary TB

infection and a lower mPSI score increases the probability of the selection of a β-

lactam-based regimen for the treatment of CAP.

Job Announcements

All job announcements will be posted for two months. Please notify us if a job is

filled before the end of the two-month posting period, and we will remove the job

announcement. Thank you.









1. Stop TB Advocacy Officer - Washington (DC)-based NEW

Sponsors: RESULTS Educational Fund; Stop TB Partnership Secretariat





Location: Washington, DC





The Stop TB Partnership (TBP) Coordinating Board endorsed the enhancement

of the TBP’s advocacy influence, including strategy, coordination,

communications, support, and leadership engagement. The Board mandated

TBP to clearly define the responsibilities and the budget implications of a

Washington-based position, and to open discussions with partners regarding the

creation of such a position within their organization.





These discussions have resulted in the proposed grant to RESULTS Educational

Fund (REF) as partial funding for a Stop TB Advocacy Officer—additional to the

staff currently working at REF on TB advocacy—to be hosted at their offices in

Washington, DC. The grant will be for an initial period of 1 year. Subject to

results achieved and availability of funds, a similar arrangement may be

considered subsequently.





For more information, including the objectives of this position, duties,

qualifications, experience, and skills, interested applicants should e-mail

action_jobs@results.org. Applications will be reviewed on a rolling basis, so

early submission is recommended. No phone calls please, qualified candidates

will be contacted.









2. Training and Consultation Specialist

Sponsor: New Jersey Medical School Global Tuberculosis Institute

Job Number: 10NS963549





Location: Newark, New Jersey





The New Jersey Medical School Global TB Institute is currently accepting

applications for a Training and Consultation Specialist.





The primary purpose of the Training and Consultation Specialist position is to

develop, implement, and evaluate educational programs and materials related to

TB to meet the needs of health care professionals and TB patients. These

activities will be consistent with the goals and objectives of the CDC funded

Regional Training and Medical Consultation Centers initiative, or with other

national or international TB control projects. These programs may include

training courses, lectures, symposia, preceptorships, and enduring materials,

including curricula and self study materials. Responsibilities will include

developing and implementing training courses for TB Program staff and

developing patient and provider educational materials for use in domestic and

international settings. Previous experience in international TB training and

education is desired.





More information and an online application are available at:

http://umdnj.hodesiq.com/job_detail.asp?JobID=2194623&user_id=

3. Director, Tuberculosis Programs (Tracking code 4307)

Sponsor: PATH





Location: Hanoi, Vietnam





PATH seeks a dynamic and experienced public health professional to lead and

manage its increasingly large and complex portfolio of TB Control projects;

represent PATH to donors, partners, and government agencies;, and serve as a

member of PATH Vietnam’s senior management team.





With support from the Global Fund to Fight AIDS, TB and Malaria and the United

States Agency for International Development (USAID) and in partnership with the

National TB Program, PATH is expanding its TB control program in Vietnam with

two major initiatives. The Global Fund project is designed to scale up technical

components and partnerships to increase TB control impact while the USAID-

funded project will reduce diagnostic delays, increase case detection, and

improve adherence to TB treatment through strengthened stakeholder

involvement in TB control activities at the district, provincial, and national levels.

The Global Fund project will implement a public-private partnership model for TB

case detection, and both projects will strengthen capacity for advocacy,

communication, and social mobilization toward the goal of eliminating TB as a

public health threat. Reporting to the Country Program Leader, the incumbent

will oversee a combined budget of nearly nine million USD and 24 staff, including

six direct reports.





Specific responsibilities include:

(1) Project Leadership, Management and Oversight:





- Assume strategic leadership and direct planning, implementation, and

management for Global Fund project and oversight for USAID TB project,

including strategic support for program objectives, key interventions, and

evaluation strategies.

- Liaise with Global TB program staff integrating TB work in Vietnam with overall

PATH strategy for TB Control.

- Oversee rapid start-up of project activities for each initiative: hiring staff and

initiating and building relationships with key stakeholders.

- Develop and coordinate the annual budgeting process for each project; ensure

prudent management of project funds; coordinate each project’s accounting,

monitoring, and reporting systems, including establishing internal control

systems in accordance with PATH’s standard operating procedures.

- Represent PATH to donors, partners, and government agencies, and oversee

coordination activities with the National TB Program.

- Support the Country Program Leader in managing all donor-related compliance

matters, ensuring that project teams achieve project goals and objectives

according to donor expectations and within approved project budgets.

- Work with staff to develop strategy for each project and identify

issues/challenges for effective implementation of work plan activities.

- Oversee preparation of required reports to Headquarters and donors.

- Maintain updated technical knowledge in TB and related public health topics to

be able to provide vision and input to strategy development and technical

assistance to project staff.





(2) PATH Representation:





- On delegation, serve as the PATH representative to donors, collaboration

institutions, other potential clients and partners, and the press.

- Serve as a member of the senior management team contributing to strategic

policy and program directions and decisions.

- Represent PATH on national working groups and task forces as appropriate

and maintain contacts with other organizations engaged in TB control activities.

- Identify and participate in new business opportunities and activities for PATH

including proposal writing.





If interested, forward resume to Sue Wallace. E-mail swallace@path.org, or

apply online at http://www.path.org.

Upcoming Conferences, Trainings, and Other Events

Find up-to-date information on TB-related conferences, US training

opportunities, and other events at the DTBE Monthly Calendar.









1. TB Cohort Review NEW

Sponsor: Heartland National TB Center

Dates: February 24, 2011

Location: San Antonio, Texas





Registration deadline: February 18, 2011





The goal of this training is to introduce health care workers to the TB Cohort

Review process through CDC guidelines, case examples, and group exercises.

Using interactive lectures as well as case presentations and group exercises,

participants will be able to list elements of a cohort review, identify key

participants and their role, prepare for and conduct a practice cohort review,

demonstrate an actual cohort review, and analyze the data to understand

outcomes and programmatic follow-up.





There is no charge to attend this workshop, but pre-registration is mandatory.

Space is limited to 25 participants. Register at

http://www.heartlandntbc.org/training.asp . Continuing education credits are

available.





For more information, contact Jessica Quintero. E-mail

Jessica.quintero@uthct.edu;

telephone (210) 531-4568; or access the Web site at

http://www.heartlandntbc.org/training/brochure_san_antonio_TX_24_feb_2011.p

df.









2. TB in Corrections NEW

Sponsor: Heartland National TB Center

Date: March 24, 2011

Location: Phoenix, Arizona





Registration deadline: March 10, 2011





This course is designed for the registered nurse and other health care

professionals who are tasked with the management of TB in correctional

facilities at the local, state, and federal level. The goal of this training is to

enhance the knowledge of TB prevention and control measures within the

correctional setting.

There is no charge to attend this workshop, but pre-registration is mandatory.

Space is limited to 35 participants. Register at

http://www.heartlandntbc.org/training.asp . Continuing education credits are

available.





For more information, contact Jessica Quintero. E-mail

Jessica.quintero@uthct.edu;

telephone (210) 531-4568; or access the Web site at

http://www.heartlandntbc.org/training/brochure_phoenix_az_24_mar_2011.pdf.









3. Strategic Planning and Innovation NEW

Dates: August 15 – 20, 2011

Sponsor: International Union Against Tuberculosis and Lung Disease (The

Union)

Location: Singapore





Application deadline: July 10, 2011





Leading teams that work within critical areas of health care is a considerable

challenge for any national TB program manager who is expected to develop and

adhere to strategies for a country’s health projects. Participants in this course

will learn to foresee potential difficulties and confidently meet them by

developing successful health program strategies. This course will help them to

become stronger leaders within their health organizations The course focuses

on creating a learning organization that has the capacity to identify key issues

blocking organizational progress – whether operational, strategic, or policy-

related. Key topics the course addresses: (1) learning how to lead a participative

strategic planning activity within your TB program, (2) developing a focused

approach to strategy implementation, (3) expanding your operations by

creatively using simple tools and techniques, and (4) strengthening health

systems through exploration of innovative and creative practices.





Late applications accepted on a space-available basis. To register, e-mail

imdp@theunion.org.

For more information, e-mail technical-courses@theunion.org; or visit the Web

site at http://www.union-imdp.org/courses/strategic-planning-innovation.









4. Targeted Testing and Treatment of Latent TB Infection: An Online Presentation

(60 minutes)

Sponsor: The Francis J. Curry National Tuberculosis Center





This slide presentation is presented by L. Masae Kawamura, M.D., TB Controller

of the San Francisco Department of Public Health and co-principal investigator

of the Francis J. Curry National TB Center/UCSF. Dr. Kawamura explores the

diagnosis and treatment of LTBI, including: the rationale for TB screening and

what is meant by "targeted testing," risk factors for TB, the tuberculin skin test

and new interferon gamma release assays (IGRAs), current LTBI treatment

guidelines, and how to counsel and motivate patients. This slide presentation

with streaming audio provides information on how to effectively target test for

TB as well as how to treat latent TB infection (LTBI). A question and answer

guide, a printable PowerPoint slide file, and other useful resources are also

included as supplemental materials.





For more information, visit http://www.nationaltbcenter.ucsf.edu/testing_ltbi/ .









5. Practical Solutions for TB Infection Control: Infectiousness and Isolation

Sponsor: Francis J. Curry National Tuberculosis Center

Location: Online Course

Length: 60 minutes





This 60-minute Flash presentation with streaming audio provides information on

how to determine whether a TB patient is infectious and demonstrates practical

ways to prevent TB transmission in the clinic, in transit, and in the patient's

home. Throughout the training, interactive questions allow participants to test

and apply what has been learned. At the end of the presentation, there is a list of

additional resources that includes links to further written information as well as

links to the Regional Training and Medical Consultation Centers (RTMCCs).

For further assistance, contact Francis J. Curry National Tuberculosis Center. E-

mail tbcenter@nationaltbcenter.ucsf.edu; telephone (415) 502-4600; or fax (415)

502-4620.





For a course description, visit http://www.nationaltbcenter.ucsf.edu/tbicweb/ .









6. Medical Management of Tuberculosis: An Online Presentation

Sponsor: Francis J. Curry National Tuberculosis Center

Length: 30 minutes

Credit: 0.5 contact hour CME/CNE





This slide presentation with streaming audio will provide information on how to

manage treatment of TB. A question and answer guide, a printable PowerPoint

slide file, and other useful resources are also included as supplemental reading

materials. This 30-minute lecture, conducted by Dr. Karen Smith, covers the

general principles of TB treatment, the drugs used to cure TB, alternative

regimens, monitoring, and potential adverse reactions to therapy. It targets

audiences of clinicians and health care professionals.





For a course description or to receive continuing medical education (CME) or

continuing nursing education (CNE) contact hours, please visit

http://www.nationaltbcenter.edu/med_mgmt/ .









7. Legal Interventions in TB Control: A Web-Based Seminar

Sponsor: New Jersey Medical School Global Tuberculosis Institute

Location: Web-Based Seminar





This web-based seminar, presented by the Global TB Institute, was originally

held on September 11, 2007 and explored successful and innovative approaches

to implementing legal interventions in TB control programs in the US. Experts

shared legal and ethical considerations, as well as hands-on experiences,

practical steps, and legal tools that can be used to improve outcomes of case

management, treatment outcomes, and contact investigations. Points were

illustrated using lectures and case presentations

Please follow the link below to view this web-based seminar:

http://www.umdnj.edu/globaltb/audioarchives/legal.htm .









8. Arresting TB: Best Practices for Controlling TB in Corrections

Sponsor: Southeastern National Tuberculosis Center (SNTC)

Date: January 27, 2011

Location: Forsyth, Georgia





This course highlights best practices for recognizing and controlling TB in

correctional settings and is designed to enhance communication and

collaboration between the local health department and correctional facility staff.

Presented in an interactive case-based lecture format, attendees join in group

discussions and actively participate in exercises designed to foster skills for

managing TB in correctional settings.





Enrollment is limited to 50 participants from the southeastern region.

Registration is free; online pre-registration is required by January 15, 2011.

Continuing education credits are available.





For more information, contact the SNTC. E-mail Ellen.murray@medicine.ufl.edu;

phone (352) 273-9385 or toll free (888) 265-7682; fax (352) 273-9275; or access the

Web site at http://sntc.medicine.ufl.edu/Training.aspx?Id=9242.









9. Webinar: Understanding Mycobacterium bovis

Sponsor: Heartland National TB Center

Date: February 2, 2011

Location: Nationwide, US





Registration deadline: January 31, 2011





This webinar will describe the epidemiologic risk factors and transmission of

Mycobacterium bovis, discuss the differences between Mycobacterium bovis

and Mycobacterium tuberculosis, and identify case management best practices

during treatment of Mycobacterium bovis.

Participants from the Heartland region will be given priority registration.

Continuing education credits are available.





For more information contact the Heartland National TB Center, Email:

Jessica.quintero@uthct.edu; Phone: (800)839-5864; or download the brochure at:

http://www.heartlandntbc.org/training/webinars/20110202/brochure.pdf.









10. Best Practices in TB Control #3: TB Cohort Review in Action: Putting It All

Together

Sponsor: NJMS Global Tuberculosis Institute

Date: February 10, 2011

Location: Nationwide, USA





This web-based seminar will present the entire picture of a cohort review from

start to finish. The format features a simulated cohort review session including

case presentations, feedback, and comments by a program director and medical

reviewer; analysis and summary of outcomes by an epidemiologist; and plans

for each person to follow up on the findings. Presenters are experienced

practitioners from programs in Columbus OH, Philadelphia PA, Washington DC,

and Washington State.





Please register online at:

https://www323.livemeeting.com/lrs/8001122164/Registration.aspx?pageName=q

hn3cwj8q27qnt1s . There is no limit to the number of participants at one location

viewing from one room and computer. However, each site must identify a contact

person to receive conference information, submit the sign-in sheet, and share

the link to the online conference evaluation after the seminar.





Contact: For more information contact Bill Bower, E-mail: blb3@columbia.edu;

Phone: (646) 448-0945; or access the Web site:

http://www.umdnj.edu/globaltb/courses/brochures/2011/cohortreview3.html .









11. Management, Finance and Logistics

Sponsor: International Union Against Tuberculosis and Lung Disease (The

Union)

Dates: February 14 – 26, 2011

Location: Bangkok, Thailand





This course will cover the basics of managing a national health program.

Participants in this course will build financial comprehension, learn how to

communicate more effectively, practice multi-party negotiation, and develop

fundamental budgeting skills. Key topics of the course address: Learning to

develop and understand budgets, Working with financial concepts in order to

make more confident decisions in health projects, Improving procurement of

drug supplies and logistics management through quality assurance and supply-

chain management, and Assessing leadership strengths and building managerial

skills. Combining practical exercises, in-class discussions, presentations, and

lectures, participants will gain a greater understanding of proven and effective

management methods and how they can be directly applied to public health.





This course is also offered in French. Continuing education credits are

available.





For more information, Email: technical-courses@theunion.org; or visit the Web

site: http://www.union-imdp.org/courses/management-finance-logistics .









12. Tuberculosis Clinical Intensive

Sponsor: The Francis J. Curry National Tuberculosis Center (CNTC)

Dates: February 15 – 17, 2011

Location: San Francisco, California





This three-day course is designed for physicians and other licensed medical

professionals who diagnose and treat TB. The course will cover: diagnosis,

management, and treatment of active TB and latent TB infection; TB

transmission and pathogenesis; pediatric TB; drug-resistant TB; TB and HIV

coinfection; and more.





Enrollment is limited and pre-registration is required. There is no fee for this

course. Continuing education credits are available.

For a complete course description and application information, visit:

http://www.nationaltbcenter.ucsf.edu/training/tb_clinical_intensive.cfm.









13. 15th Annual Conference of the Union - North American Region (IUATLD-NAR)

Sponsor: British Columbia Lung Association; International Union Against TB

and Lung Disease (IUATLD) - North American Region

Dates: February 24 – 26, 2011

Location: Vancouver, BC, Canada





This year's theme, "Engaging Vulnerable Populations: Tools and Strategies to

Halt TB," highlights the crucial importance of developing effective partnerships

with those most impacted by TB. The keynote speakers are both internationally

recognized experts in their fields. Dr. Anthony Harries, the George Comstock

lecturer, and Sharon Venne, Beyond TB lecturer, will open the conference by

addressing two global populations who have been the most impacted by TB.

Plenary sessions will focus on several of the region's most at risk for TB,

including indigenous, migrant and immigrant populations, and those affected by

diabetes.





Registration fee (Canadian $): Physicians/PhDs: $500/Non-member,

$450/Member; Nurses and Allied Health Care professionals: $450/Non-member,

$400/Member; Students/Fellows: $250/Non-Member. Continuing education

credits are available.





For more information, contact Menn Biagtan, MD, MPH, British Columbia Lung

Association. E-mail biagtan@bc.lung.ca; phone (604) 731-5864; fax (604) 731-

5810; or access the Web site at

http://www.bc.lung.ca/association_and_services/union.html .









14. TB Case Management and Contact Investigation Intensive

Sponsor: Francis J. Curry National Tuberculosis Center

Dates: March 15 – 18, 2011

Location: San Francisco, California

This course is intended for physicians, nurses, and other licensed medical care

providers who manage patients with TB or who are at risk for TB. Topics covered

include: Epidemiology of TB; Fundamentals of TB case management;

Completion of care; TB contact investigation; The role of the laboratory; Medical

management of TB; Quality assurance in TB control programs; Targeted testing

for TB; Treatment of latent TB infection (LTBI); Culture, community, and TB care;

Working with special populations; and Interviewing skills.





There is no fee for this course. Enrollment is limited, and pre-registration is

required.





For more information, contact Jennifer Kanouse, Program Manager. E-mail

tbcmci@nationaltbcenter.ucsf.edu; phone (415) 502-2712; or access the Web site

at

http://www.nationaltbcenter.ucsf.edu/training/tbcmcimar11.cfm.









15. Mass Media and Communications

Sponsor: International Union Against Tuberculosis and Lung Disease (The

Union)

Dates: March 21 – 25, 2011

Location: Singapore





Application deadline: February 21, 2011





Communication exchange has never been so easily accessible and so critical to

the success of a national health program. Gain a greater understanding of how

effective communications strategies can help promote TB and HIV programs and

further disseminate important health messages to the public. During this course

participants will receive training on how to write a professional press release,

develop useful promotional tools, conduct media outreach, and discover how to

build positive public awareness around an organization’s work. Learning directly

from experts working in mass communications, participants will engage in class

exercises, discussions, and real-life simulations that demonstrate how skillful

use of the media and communications can propel any health program to

excellence.

To register or receive more information, email imdp@theunion.org or visit

http://www.union-imdp.org/courses/mass-media-communications . Late

applications accepted on a space-available basis.









16. Critical Care and Pulmonary Medicine: An Update and Review

Sponsor: American Medical Seminars, Inc.

Dates: March 28 – April 1, 2011

Location: Sarasota, Florida





Following this course, the participant should be able to assess the common

presentation and patient complaints for the various pulmonary disorders

described; implement a diagnostic work-up appropriate for each presented

disorder, considering a practical and cost-effective approach; employ a cost-

effective method of treatment, follow-up, and long-term care when indicated.

This activity is expected to result in improved competence in making an

appropriate diagnosis and providing effective treatment and referral or follow-up

care with the overall goal of improving patient outcomes. The emphasis will be

on aligning physician behavior with current guidelines and evidence-based

medicine, as indicated within each topic’s specific objectives, with a focus on

diagnosis, treatment, and when to refer.





To receive regular registration rate, fees must be received or postmarked at least

30 days prior to program start date. Registration fee: Regular - $745/Physician;

$645/Non Physician; Late - $795/Physician; $695/Non Physician. Continuing

education credits are available.





For more information contact the American Medical Seminars, Inc., E-Mail:

mail@ams4cme.com; Phone: (941) 388-1766; Toll Free: (866) ams4cme (866-267-

4263); Fax: (941) 365-7073; or access the Web site:

http://www.ams4cme.com/www/LiveSeminars/SEMLA-2520110328.aspx .









17. The Denver TB Course

Sponsor: National Jewish Health

Dates: April 13 – 16, 2011

Location: Denver, Colorado

The purpose of this course is to present knowledge about the management of TB

to general internists, public health workers, infectious diseases and chest

specialists, registered nurses, and other healthcare providers who will be

responsible for the management and care of patients with TB. This event

includes the following course highlights: Transmission and pathogenesis of

adult and pediatric TB; MDR TB and XDR TB; Screening for and treatment of

latent TB infection; Factors influencing infections of TB; Planning TB control

programs with particular emphasis on organization of outpatient chemotherapy;

TB and HIV co-infection; and Mycobacteriology Laboratory Tour.





Continuing education credits are available.





For more information contact Nicole Austin Ross, National Jewish Health, E-

mail: rossn@njhealth.org;

Phone: (303) 398-1110; Fax: (303) 270-2239; or access the Web site:

http://www.njhealth.org/TBCourse.









18. Influencing, Networking and Collaboration

Sponsor: International Union Against Tuberculosis and Lung Disease (The

Union)

Dates: April 25 – 30, 2011

Location: Singapore





Application deadline: March 25, 2011





Creating partnerships and networks is an important element to the success of a

TB program. Participants in this course will learn how relationship building and

developing strong partnerships can boost health program results. The course

will address the following key topics: Creating empowered teams and moving

away from the command and control structure, facilitating large stakeholders

meeting and managing conflict, negotiating and partnering with stakeholders

within health programs, and building consensus within large groups of distinct

and diverse personalities.

Application deadline: March 25, 2011. Late applications accepted on a space-

available basis. To register, email imdp@theunion.org .





For more information, Email: technical-courses@theunion.org; or visit the Web

site: http://www.union-imdp.org/courses/influencing-networking-collaboration .









19. Leading Management Teams

Sponsor: International Union Against Tuberculosis and Lung Disease (The

Union)

Dates: June 27 – July 9, 2011

Location: Bangkok, Thailand





Application deadline: May 25, 2011





Bringing measurable changes within a TB program requires a comprehensive

approach to performance management. Participants in this course will learn how

to more effectively guide groups of personnel through advanced management

training by examining their own leadership styles. Key topics the course

addresses include: (1) Creating measurable results in a TB program through

long-term planning; (2) Leading changes in a health organization that build

greater staff commitment, competence, and confidence; (3) Achieving higher

success rates through enhanced team performance; and (4) Developing team

members through coaching and mentoring.





Late applications accepted on a space-available basis. To register, E-mail

imdp@theunion.org.





For more information, E-mail: technical-courses@theunion.org; or visit the Web

site: http://www.union-imdp.org/courses/leading-management-teams.









20. The Denver TB Course

Sponsor: National Jewish Health

Dates: October 12 – 15, 2011

Location: Denver, Colorado

The purpose of this course is to present knowledge about the management of TB

to general internists, public health workers, infectious diseases and chest

specialists, registered nurses, and other healthcare providers who will be

responsible for the management and care of patients with TB. This event

includes the following course highlights: Transmission and pathogenesis of

adult and pediatric TB; MDR TB and XDR TB; Screening for and treatment of

latent TB infection; Factors influencing TB infections; Planning TB control

programs with particular emphasis on organization of outpatient chemotherapy;

TB and HIV co-infection; and Mycobacteriology Laboratory Tour.





Continuing education credits are available.





For more information contact Nicole Austin Ross, National Jewish Health, E-

mail: rossn@njhealth.org;

Phone: (303) 398-1110; Fax: (303) 270-2239; or access the Web site:

http://www.njhealth.org/TBCourse.



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