This document summarizes the tuberculosis situation globally. It notes that in 2009, there were an estimated 9.4 million cases of TB worldwide, with 1.7 million deaths. Challenges include drug-resistant TB, co-infection with HIV, and low rates of case detection. The Global Plan to Stop TB aims to reduce prevalence and deaths by 50% by 2015 through improved diagnosis, treatment success rates above 85%, and strengthened health systems. However, current declines in TB incidence are less than 1% per year, short of targets. Increased funding, new tools, and full implementation of public health measures are needed to accelerate progress toward global elimination of TB.
Video Directly Observed Therapy for HIV and TB patientsKimberly Schafer
Video-Directly Observed Therapy (V-DOT) is a promising solution for monitoring TB and HIV
treatment adherence for binational patients in the U.S.-Mexico border region.
Video Directly Observed Therapy for HIV and TB patientsKimberly Schafer
Video-Directly Observed Therapy (V-DOT) is a promising solution for monitoring TB and HIV
treatment adherence for binational patients in the U.S.-Mexico border region.
Epidemiology & Control measures for Tuberculosis. AB Rajar
n this Lecture I tried my best to include all essential features about the TB disease. I hope that this will help to undergraduate Medical students for better understanding the Disease.
Bio303 Lecture 2 Two Old Enemies, TB and LeprosyMark Pallen
In this lecture I will focusing on another of the most serious infectious threats to humanity, tuberculosis, outlining its evolutionary origins, impact on human health and wealth and the steps taken to control and treat this infection. I will also discuss a related mycobacterial infection, leprosy and recent progress in its control.
Epidemiology & Control measures for Tuberculosis. AB Rajar
n this Lecture I tried my best to include all essential features about the TB disease. I hope that this will help to undergraduate Medical students for better understanding the Disease.
Bio303 Lecture 2 Two Old Enemies, TB and LeprosyMark Pallen
In this lecture I will focusing on another of the most serious infectious threats to humanity, tuberculosis, outlining its evolutionary origins, impact on human health and wealth and the steps taken to control and treat this infection. I will also discuss a related mycobacterial infection, leprosy and recent progress in its control.
this presentation is based on national health program in india in relation to tuberculosis and malaria as these are mostly occuring disease in india so national program are organised to irradicate the spread of vector borne disease by various methods like controlling the vector (mosquitos) from spreading
role of community pharmacist in educating and monitoring of patients for infection and counselling and educating them regarding the control of malaria and tb.
he WHO Global Tuberculosis Report 2022 provides a comprehensive and up-to-date assessment of the TB epidemic and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels.
www.slideshare.ne www.slideshare.ne Tuberculosis (TB) is fatal
contagious disease that affects the lungs and other part of body which is a public health problem but curable and preventable disease .
Caused organism : bacteria (Mycobacterium tuberculosis
Human : Mycobacterium tuberculosis
Pulmonary TB
Extra pulmonary TB
Animals : Mycobacterium Bovis
Bovine tuberculosis (TB) is a chronic disease of animals caused by a bacteria called Mycobacterium bovis, (M.bovis) which is closely related to the bacteria that cause human
Presentation delivered by Dr Masoud Dara, Programme Manager a.i., Tuberculosis and multidrug-resistant tuberculosis, Division of Communicable Diseases, Health Security and Environment at the 65th session of the WHO Regional Committee for Europe (Vilnius, Lithuania, 14–17 September 2015)
This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
What is greenhouse gasses and how many gasses are there to affect the Earth.moosaasad1975
What are greenhouse gasses how they affect the earth and its environment what is the future of the environment and earth how the weather and the climate effects.
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
1. Tuberculoza o boala de actualitate permanenta
Dr. Cristian Cojocaru
Prof. Dr. Traian Mihaescu
2. Marcus Tullius Cicero 106-43 IC Roman Politician
Cardinal Richelieu 1585-1642 Francez Politician
Alexander Pope 1688-1744 Englez Poet
Luigi Boccherini 1743-1805 Italian Muzician
Johann Wolfgang
von Goethe 1749-1832 German Scriitor
Friedrich Schiller 1759-1805 German Scriitor
Rene Theophile
Hzacinthe Laennec 1781-1826 Francez Medic
Niccolo Paganini 1782-1840 Italian Muzician
Frederic Francois Chopin 1810-1849 Polonez Musician
Emily Bronte 1818-1848 Englez Scriitor
Fyodor Dostoyevsky 1821-1881 Rus Scriitor
Edward Livingston Trudeau1845-1915 American Medic
Anton Cekhov 1860-1904 Rus Scriitor
Mahammed Ali Jinnah 1876-1948 Indian Politician
Igor Stravinsky 1882-1971 Rus Muzician
Franz Kafka 1883-1924 German Scriitor
Eleanor Roosevelt 1884-1962 American Sotia
presedintelui
David Lwrence 1885-1930 Englez Scriitor
George Orwell 1903-1950 Englez Scriitor
Nelson Mandela 1918- Sud African
3. Reversing the tuberculosis upwards trend:
a success story in Romania
C. Marica*, C. Didilescu*, N. Galie*, D. Chiotan*, J.P. Zellweger#, G.
Sotgiu",
L. D’Ambrosio+, R. Centis+, L. Ditiu1 and G.B. Migliori+
Eur Respir J 2009; 33: 168–170
0–24
25–49
50–99
100–299
>300
No estimate
18. Mortalitatea prin tuberculoza, reprezentata in functie de sex si virsta: A. In timpul
perioadelor inalt epidemice; B. In timpul perioadelor intermediare; C. Perioada de
dupa valul epidemic.
19. Situatia actuală si tendintele viitoare ale imbolnavirii prin
tuberculoza
2000 - opt milioane de bolnavi de tuberculoza
1997-2000 crestere cu 1,7%/an
crestere in regiunea sub-Sahariană şi în ţările ex-sovietice
scădere in Europa Centrală si de Vest, America si Orientul
Mijlociu
2000 - 1,8 milioane de decese datorate tuberculozei
20. Estimated
number of cases
Estimated
number of deaths
1.7 million*
(range: 1.5–2.0 million)
9.4 million
(range: 8.9–9.9 million)
440,000
(range: 390,000–510,000)
All forms of TB
Multidrug-
resistant
TB (MDR-TB)
HIV-associated TB 1.1 million (12%)
(range: 1.0–1.2 million)
380,000
(range: 320,000–450,000)
*including deaths among PLHIV
Situatia TB -2009
about 150,000
0–24
25–49
50–99
100–299
300 and higher
No estimate available
22. Impactul HIV la pac cu TB
Notified cases per 100,000 pop. 1980-2008
•79% of all TB/HIV cases world-wide are in Africa
•50% of all TB/HIV cases world-wide in 9 African countries
•23% of the estimated 2 million HIV deaths due to TB
24. Stopping Tuberculosis in England
An Action Plan from the Chief Medical Officer
Action 1: Increased awareness
Aim: Maintain high awareness of TB, particularly among health
professionals , highrisk groups and people who work with them, teachers,
and the public
Five point plan
> Produce multilingual and culturally appropriate public information and
education materials for national and local use and make them widely available
> Ensure that general practitioners and other primary and community care staff
are aware of: the symptoms and signs of the disease; local TB services; and
local
arrangements for referring patients with suspected TB
> Use World TB Day in March each year to increase awareness, particularly
among healthcare professionals and high risk communities, and encourage
relevant
national organisations to do the same
Maintain awareness, including through the media and community groups, and
develop initiatives to support local awarenessraising among high risk groups
Seek greater professional awareness through undergraduate, postgraduate
25. Stopping Tuberculosis in England
An Action Plan from the Chief Medical Officer
Action 2: Strong commitment and leadership
Aim: Create a strongly led, well coordinated and adequately resourced
national TB programme, with all those working to deliver the
programme having a clear focus on what needs to be achieved and
best practice for doing this
26. Stopping Tuberculosis in England
An Action Plan from the Chief Medical Officer
Action 3: High quality surveillance
Aim: Provide the information required at local, national and
international levels to
• identify outbreaks
• monitor trends
• inform policy
• inform development of services, and monitor the
success of the TB programme
27. Stopping Tuberculosis in England
An Action Plan from the Chief Medical Officer
Action 4: Excellence in clinical care
Aim: Provide uniformly high quality, evidence based treatment and
care for patients with suspected and diagnosed TB, with all patients
having their outcome of treatment recorded and at least 85 per cent
successfully completing treatment
28. Stopping Tuberculosis in England
An Action Plan from the Chief Medical Officer
Action 5: Well organised and coordinated patient services
Aim: Provide high quality coordinated services for TB diagnosis,
treatment and continuing care, which also meet the needs of individual
patients
Action 6: First class laboratory services
Aim: Provide laboratory services of consistent high quality which
support clinical and public health needs, in keeping with the overall
pathology modernisation programme
29. Stopping Tuberculosis in England
An Action Plan from the Chief Medical Officer
Action 7: Highly effective disease control at population level
Aim: Increase the evidence base for, and the consistency of application
of public health interventions for TB
Action 8: An expert workforce
Aim: Ensure TB control has an appropriately skilled workforce and that
physicians and nurses with expertise in TB continue to be recruited,
trained and retained
30. Stop TB Strategy & Global Plan
To save lives, prevent suffering,
protect the vulnerable, & promote
human rights
1. Implementarea DOTS
2. TB-HIV, MDR-TB, la
populatiile sarace si
vulnerab ile
3. Intarirea sistemului
de sanatate
4. Sensibilizarea tuturor
funizorilor de
sanatate
5. Sustinerea
persoanelor cu TB
6. Promovarea
31. 2015: Goal 6: Combat HIV/AIDS, malaria and other diseases
Target 6c: to have halted by 2015 and begun to reverse the incidence…
*Indicator 6.9: incidence, prevalence and mortality associated with TB
*Indicator 6.10: proportion of TB cases detected and cured under DOTS
2015: 50% reduction in TB prevalence and deaths by 2015
2050: elimination (<1 case per million population)
Tintele Global TB Control
33. *CPT, cotrimoxazole preventive therapy
ART, antiretroviral therapy
INDICATOR TARGET
Number of countries with ≥1
smear microscopy lab per
100 000 population
149
(All countries
in plan)
Patients notified + treated 6.9 million
Treatment success rate 90%
INDICATOR TARGET
Number of 22 HBCs and 27
MDR-TB HBCs with >1 Cx &
DST lab to cover 0.5-1 M
population
36/36
Previously treated cases tested
for MDR
100%
New cases tested for MDR 20%, all at
high-risk
MDR-TB patients treated
following WHO guidelines
100%, or
~ 270k
INDICATOR TARGET
TB patients tested for HIV 100%
HIV+ TB patients on CPT 100%
HIV+ TB patients enrolled
on ART
100%
DOTS/lab strengthening MDR-TB/lab strengthening
TB/HIV
pp17
10 tinte pentru 2015
34. Realizari pina in prezent
• 41 milloane de patienti vindecati, 1995-2009
• 6 milioane de decese prevenite comparativ
cu standardele din 1995
• Mortalitatea reducsa cu 35% din 1990
• Vindecari >85%, ingijirea/HIV imbunatatita
• But…. TB incidence declining too slowly,
case detection stagnating, and MDR-TB care
only now starting scale-up
35. Estimari globale ale prevalentei si
mortalitatii
2015
Mortalitatea
1990
35
25
15
0
target
Prevalenta
1990
300
200
100
0
2015
target
shaded area = uncertainty band
36. Incidenta globala - scadere <1%/an
Peak in 2004
Incidence (all forms, incl. PLHIV)
TB Notifications
Incidence TB in PLHIV
shaded area = uncertainty band
Notification gap
37. shaded area = uncertainty band
6.7
9.4
3.7
5.8
Notificari (negru)
incidenta estimata (albastru)
TBcases(millions)
Detectia cazurilor gap: 1/3
39. Succesul treatmentului - 86% global
Global WHO Regions
Progres in majoritatea regiunilor, Europeramine in
urma
W. Pacific
SE Asia
EMR
Africa
93
88
80
Americas
77
66
Europe
40. Testarea HIV la pacientii cu TB
Africa
World
Tinta 100% in Global Plan
Citeva tari
inregistreaza rate de
testare f bune
Rwanda: 97%
Kenya: 88%
Tanzania: 88%
Malawi: 86%
Mozambique: 84%
PercentageofTB
41. Provocari pentru 2011
1. Fonduri nesigure
2. slabaDoar 61% din cazuri sunt raportate
3. TB/HIV major impact in Africa
4. MDR-TB in tarile ex-URSS si China
5. Politici slabe de sanatate
6. Practica medicala in afara sistemului de notificare
7. Communitati neinteresate de politicile de sanatate
8. Cercetare
42. Fonduri necesare, Global Plan
Implementation
Plan component US$
billions,
2011–2015
%
total
IMPLEMENTATION 36.9 79%
DOTS 22.6 48%
MDR-TB 7.1 15%
TB/HIV 2.8 6%
Lab strengthening 4.0 8%
Technical
assistance
0.4 1%
R&D 9.8 21%
TOTAL 46.7 100%
PLUS: Target that diagnosis should be free-of-charge or fully reimbursable by
health insurance in all 22 high-burden countries (HBCs)
44. Imbunatatirea controlului TB
1. Remove financial barriers (UHC)
2. Ensure well trained and sufficient human resources
3. Establish a network of labs where rapid tests are also
available
4. Ensure availability of quality drugs
5. Regulate the use of all anti-TB drugs
6. Introduce infection control
7. Establish proper surveillance
8. Promote R&D
9. Mobilize resources domestically and internationally
Document WHA 62.15, 2009
45. •Public and private medical colleges (yellow) diagnose a huge number of cases, but many of them are from outside the city
and need to be refereed for treatment elsewhere.
•The increase in diagnosed cases represents increased notification after medical colleges and other providers started to
report to NTP in a standardised way
Bangalore, 1999-2005
Cresterea numarului de notificari
46. Limitari ale diagnosticului, medicamentelor,
vaccinului
Diagnostics - More than 100 years old
• Detects only half of the cases in patients tested
• Ineffective for diagnosing TB in PLHIV
• Rapid tests for MDR strains available, but not yet in the field
Drugs – Last drug 40 years old
• Four drugs, taken for at least 6 months
• Not compatible with some HIV/AIDS antiretrovirals
• MDR-TB treatment lengthy, with low cure rates, expensive, toxic
Vaccine – Nearly 90 years old
• Unreliable protection against pulmonary TB
• No apparent impact on the TB epidemic
47. 1
10
100
1000
10000
2000 2010 2020 2030 2040 2050
Year
Incidence/million/yr
Elimination 16%/yr
Global Plan 6%/yr
Current trajectory 1%/yr
Implementarea completa a Global Plan
Elimination
target: 1 /
million / year
by 2050
TB incidence 10x
lower than today,
but >100x higher
than elimination
target in 2050
Current rate
of decline
48.
49. Impactul potential al unui nou vaccin, test si
medicament in SE Asia
Source:L.AbuRaddadetal,PNAS2009
Add. Effects = effects also on latency
and infectiousness of cases in vaccinated
•Led & NAAT at microscopy lab level
•Dipstick at point of care
•Regimen 1 = 4-month, no effect on DR
•Regimen 2 = 2-month, 90% effective in M/XDR
•Regimen 3 = 10-day, 90% effective in M/XDR
50. Eliminarea TB in 2050 interventii
sinergice
DyeC&WilliamsBG,J.R.Soc.Interface2007
NOT by preventing
infection & treating active
TB
(both act on cutting
transmission)
But by treating latent infection and active TB or
by preventing and treating latent infection (cutting transmission and reactivation)
51. 1. Declin din 2015
2. acces universal la resurse
3. Cercetare si dezvoltare
Concluzii
Editor's Notes
Regarding the big challenge of TB/HIV, on the left are the case notifications of selected African countries.
These curves show that, when HIV began to spread in the mid-1980s, TB started increasing fast, reaching many times the original rate.
One can easily imagine the impact on already weak services and realise why TB is the number one killer of PLHIV.
On the right, the pie tells you where the HIV-associated TB cases are: 85% in Africa and 15% in other continents.
We do have interventions that are effective to prevent the burden of TB on HIV and that of HIV on TB. We need the GF to promote their use in a bolder way than today.
This slide that contains all essential numbers
WHO estimates that worldwide in 2007 over 9 million TB cases occurred (and of those, 4 million infectious, sputum-smear (+)).
1.65 million people died of TB, which means 4500 every day.
WHO estimates, based on surveys conducted in over 110 settings in the last decade, that nearly half a million cases are multi-drug resistant, and 130,000 of them lethal
WHO estimates that XDR-TB cases, which are resistant to all most potent first-line and second-line, reserve drugs, were about 50,000, the majority of which are lethal.
Finally, well over 700,000 cases of the 9 million are linked with HIV/AIDS. This is slightly less than 10%. In Africa, this % is much higher, up to50%. In the rest of the world, however, the vast majority of TB cases are not due to HIV.
This slide that contains all essential numbers
WHO estimates that worldwide in 2007 over 9 million TB cases occurred (and of those, 4 million infectious, sputum-smear (+)).
1.65 million people died of TB, which means 4500 every day.
WHO estimates, based on surveys conducted in over 110 settings in the last decade, that nearly half a million cases are multi-drug resistant, and 130,000 of them lethal
WHO estimates that XDR-TB cases, which are resistant to all most potent first-line and second-line, reserve drugs, were about 50,000, the majority of which are lethal.
Finally, well over 700,000 cases of the 9 million are linked with HIV/AIDS. This is slightly less than 10%. In Africa, this % is much higher, up to50%. In the rest of the world, however, the vast majority of TB cases are not due to HIV.
However,
Even at maximum DOTS coverage, case detection seems to remain below the 70% target level in most settings (Dye et al 2002)
So we need innovative approaches to case detection.
The DEWG is a mechanism to do whatever it needs to be done
We need to ensure we make good use of it.
The 2nd ad hoc Committee produced some recommendations for action, the DEWG is a tool to facilitate/implement some of them.