The update of the ESTC was conducted as a joint endeavour with ERS, consulting experts from international societies and organisations, national TB programmes, civil society and affected communities. The second edition of the ESTC includes 21 standar
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ds in the areas of diagnosis, treatment, HIV and co-morbidities and public health and prevention. The ESTC is a user-friendly guide for clinicians and public health workers to help them achieve optimal diagnosis, treatment and prevention of TB
Available in 25 languages: https://ecdc.europa.eu/en/all-topics-ztuberculosisprevention-and-control/european-union-standards-tuberculosis-care
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6 July 2021. Three new nucleic acid amplification test (NAAT) classes are endorsed by WHO and included.
The latest operational handbook includes the new classes recommended by WHO. It aims at facilitating the implementation of the WHO recommendations by the Member States, technical partners, and ot
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hers involved in managing patients with TB and DR-TB. The operational handbook provides practical information on existing and new tests recommended by WHO, step-by-step advice on implementing and scale-up testing to achieve local and national impact and lastly, model diagnostic algorithms, which are updated to incorporate the latest recommendations. An overview of budgetary considerations and information sheets on each of the newly recommended tests is provided.
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Despite being a curable and preventable disease, tuberculosis (TB) remains as one of the major challenges for health systems, globally. Every year, TB affects more than 10 million people and kills m
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ore than 1.4 million people. WHO’s Digital Health for the End TB Strategy – an Agenda for Action outlines a conceptual framework in which advantageously positioned digital health solutions are matched to the most urgent needs of TB programmes. Video-supported treatment is a component of one of the four core functions of this framework, the Patient Care domain, and primarily supports the first pillar of the End TB Strategy. This quick guide provides information on the solutions available for asynchronous modes of video communication and how these can be of use to TB programmes.
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Meeting Report 27-29 October 2020
The overall goal of the meeting was to discuss recent changes in treatment regimens and diagnostics for drug-resistant TB and to determine how these impact on the definition of XDR-
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TB, with a view to revising this definition. The pre-existing definition of XDR-TB was formulated in 2006 at a meeting of the Global Taskforce on XDR-TB, convened by WHO, and has been in use for clinical and surveillance purposes, since this time.
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Tuberculosis cases, TB deaths
The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB
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. The WHO Operational Handbook on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact.
The operational handbook provides practical information and tools that complement the recommendations in the guidelines. The strategies described in the operational handbook are based on the latest WHO recommendations which were formulated by Guideline Development Groups using the GRADE approach. In many cases however, the recommendations in their current form lacked sufficient clinical and programmatic detail, which is important for implementation. This operational handbook complements the guidelines with practical advice based on best practices and knowledge from the fields such as pharmacokinetics, pharmacodynamics, microbiology, pharmacovigilance and clinical and programmatic management.
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This Rapid Communication aims to inform national TB programmes and other stakeholders about the key implications of the latest evidence on the use of specific molecular assays as initial diagnostic tests of pulmonary and extrapulmonary
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TB and RR-TB, in adults and children.
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Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with drug-resistant
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TB have a high prevalence of symptoms; hence, staff caring for these patients should have some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible
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TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delamanid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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The practical guidance in the operational handbook aims to inform the development or revision of national policies and related implementation guidance on the management of TB in children and adolescents under programmatic circumstances and at differ
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ent levels of the health system. The operational handbook can also help countries adequately plan for the uptake of interventions to better address the specific needs of children and adolescents with or at risk of TB. It can contribute to national efforts to build capacity among national and subnational programme managers and among health workers at all levels of the health care system.
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7 April 2022. Aimed at national policymakers, public health and healthcare planners, staff working in reception centres, and healthcare staff caring for displaced persons, the information note concludes that universal testing of incoming refugees from Ukraine for tuberculosis (
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TB) infection is not recommended. Specific groups, such as household contacts of bacteriologically confirmed pulmonary cases, or those who are immunocompromised should however be considered for TB infection testing.
Available in Czech, Hungarian, Polish, Romanian, Slovakian, Ukranian
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This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This
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is followed by key figures for the region, the role of WHO in country support and, recognizing the importance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
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Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and
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recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP), which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes.
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Guidance
Second Edition
Monitoring and Evaluation
Module 5
Monitoring and Evaluation
October 2018
Module 5: Monitoring and evaluation. This module is for people responsible for monitoring Pr
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EP programmes at the national and site levels. It provides information on how to monitor PrEP for safety and effectiveness, suggesting core and additional indicators for site-level, national and global reporting.
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2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing
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TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and they have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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These guidelines group all recommendations on TB care and support in one document and are complemented by an operational handbook. The guidelines are to be used primarily by national TB program
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mes, or their equivalents in Ministries of Health, stakeholders and technical organizations working on TB care in the public and private sectors and in the community.
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Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo util
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izando los datos del programa nacional de TB de los años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
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Screening programmes for tuberculosis (TB) among immigrants rarely consider the heterogeneity of
risk related to migrants’ country of origin. We assess the performance of a large screening programme in asylum seekers by analysing (i) the differen
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ce in yield and numbers needed to screen (NNS) by country and WHO-reported TB burden, (ii) the possible impact of screening thresholds on sensitivity, and (iii) the value of WHO-estimated TB burden to improve the prediction accuracy of screening yield.
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Rev Panam Salud Publica. 2021;45:e74.
Some characteristics of patients and healthcare providers influence treatment success in MDR-TB cases. Physicians’ and nurses’ knowledge about MDR-TB must
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be improved, and follow-up of MDR-TB patients who are living with HIV and of those affiliated with the subsidized health insurance scheme in Colombia must be strengthened, as these patients have a lower likelihood of a successful treatment outcome.
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