Tuberculosis: A Comprehensive Clinical Reference

Cover......Page 1
Copyright
......Page 2
Foreword......Page 3
Preface......Page 4
Contributors......Page 6
Dedication......Page 15
Acknowledgements......Page 16
Abbreviations......Page 17
World History......Page 21
Discovery of the Cause......Page 23
Chemotherapy......Page 24
Challenges......Page 25
References......Page 26
Introduction and Historical Perspective......Page 28
Epidemiological Data on the Determinants of Tuberculosis Transmission......Page 30
Human Source Factors......Page 31
Mycobacterial Factors, Strain Differences, and Interactions with Source, Environment, and Host......Page 32
Mathematical Modelling of M. Tuberculosis Transmission......Page 33
References......Page 35
Risk Factors......Page 37
Population attributable fractions......Page 38
Global and Regional Burden and Trends......Page 39
Trends......Page 41
Quality Management System and Network Requirements......Page 42
Achieving the Millennium Development Goals by 2015......Page 43
Eliminating Tuberculosis in the Twenty-First Century......Page 44
Conclusions......Page 45
References......Page 46
The Genome of M. Tuberculosis and Regions of Epidemiological Significance......Page 48
IS6110 RFLP Analysis......Page 49
Spoligotyping......Page 50
Genomic Deletion Analysis......Page 52
Bars, Pubs, and Restaurants......Page 53
Drug Resistance......Page 54
Phenotypic Variation between M. Tuberculosis Strains and Host-Pathogen Compatibility......Page 55
References......Page 56
Imaging findings......Page 58
Tuberculin Skin Test Surveys......Page 59
Population at Risk......Page 60
Drug resistance......Page 61
References......Page 62
The Mycobacteria and the Tubercle Bacillus - An Historical Introduction......Page 64
The Ecology of Mycobacteria......Page 65
Growth Characteristics and Metabolism of Mycobacteria......Page 66
Antigenic Structure of Mycobacteria......Page 67
Macromolecular Structure of Mycobacteria......Page 68
Definition of the M. tuberculosis Complex......Page 69
The Genome of M. tuberculosis and other Mycobacteria......Page 71
Age and duration of diabetes......Page 72
Human Resources......Page 73
The Evolution and Devolution of the M. tuberculosis Complex......Page 74
Determinants of Virulence and Pathogenicity......Page 75
Persistence, Latency, and Dormancy......Page 76
References......Page 77
DOTS Services......Page 80
Isolation of Mycobacteria......Page 81
Mycobacterial Identification......Page 82
Drug Susceptibility Testing......Page 85
Complications of Tuberculosis......Page 86
Lymphadenitis......Page 87
Background and Epidemiology......Page 88
Active versus Inactive Tuberculosis......Page 89
Mycobacterium kansasii......Page 90
Treatment of Skin, Soft-Tissue and Bone/Joint Infections......Page 91
References......Page 92
Phagocytosis by macrophages......Page 95
Dendritic cells......Page 96
Phagosomal Maturation and Antigen Processing......Page 97
MHC Class I Antigen Presentation......Page 99
IL-18......Page 100
Tumour Necrosis Factor-alpha......Page 101
CD1-Restricted T-Lymphocytes......Page 102
Chemokines, Adhesion Molecules and Cellular Migration......Page 103
Differential Diagnosis......Page 104
References......Page 105
IFN-gamma and IFN-gammaR......Page 107
Second-Line Susceptibility Testing......Page 108
Mannose-binding lectin......Page 109
Slc11a1 (formerly Nramp1)......Page 110
The effects of stress......Page 111
Th2 Responses......Page 112
References......Page 113
Clinico-radiological Data......Page 116
Histopathological Data......Page 117
Impact on CD4 T Cells......Page 118
Impact on the Tuberculosis Granuloma......Page 119
Epidemiology......Page 120
Differential Diagnosis and Investigation......Page 121
HIV-1 proviral transcription......Page 122
Symptoms and Signs......Page 123
References......Page 124
Leading Candidate Tuberculosis Vaccines......Page 127
Clinical studies......Page 128
Preclinical studies......Page 130
Bone and Joint Pains......Page 131
The Need for Phase III Trial Sites......Page 133
Epidemiology......Page 134
Epidemiology......Page 137
Lymphocytes......Page 138
Determinant of IRIS......Page 139
Segmental tuberculosis......Page 140
Rupture into pulmonary artery......Page 141
Management......Page 142
Local complications of secondary pulmonary tuberculosis......Page 143
The Effect of HIV on Tuberculosis......Page 144
The Effect of HIV on Granulomatous Inflammation......Page 145
Destruction of Tissue......Page 146
References......Page 147
Risk of infection......Page 149
Comment......Page 834
Symptoms and Signs......Page 199
Planning Care......Page 732
Outcomes of Primary Infection......Page 150
Recurrent tuberculosis......Page 151
References......Page 152
Exposure to Infection......Page 153
'Time-Table of Childhood TB'......Page 156
Pulmonary Infection......Page 158
Ghon Focus with/without Cavitation......Page 160
With effusion......Page 161
Dynamic Balance......Page 162
Case Definition......Page 163
Disease Diversity......Page 164
References......Page 165
Tuberculosis in Cattle and Other Mammals......Page 166
Rapid liquid culture systems for DST......Page 167
Pathogenesis and Clinical Features of Zoonotic Tuberculosis......Page 168
Changing Trends in the Occurrence of Zoonotic Tuberculosis in the Industrially Developed Nations......Page 169
Human-to-Animal Transmission......Page 170
Conclusions......Page 171
References......Page 172
Age and Clinical Presentation......Page 174
Persistent cough......Page 175
Night sweats......Page 176
Clinical Examination......Page 177
Radiological Findings......Page 178
Scoring Systems......Page 179
Diagnostic Aspects......Page 180
Management Approach......Page 181
References......Page 182
Further Reading......Page 183
The Clinical Features of Tuberculosis......Page 184
Tuberculosis meningitis......Page 185
Developed Countries......Page 186
Conclusion......Page 187
References......Page 188
Specimen Collection, Storage, and Transport......Page 189
Microscopy......Page 190
Specimen Preparation......Page 191
Liquid media......Page 192
Tuberculosis in the skeletal system......Page 193
Conventional (Phenotypic) Susceptibility Testing......Page 194
Tuberculous Osteomyelitis......Page 195
Microscopic Observation Drug Susceptibility (Mods)......Page 196
References......Page 197
Adverse reactions......Page 200
False-positive tests: non-tuberculous mycobacteria......Page 201
Magnetic Resonance Imaging (MRI)......Page 320
Boosting - from two-step tuberculin testing......Page 202
Development of IGRAs......Page 205
Special Groups and Situations......Page 820
Liver, spleen and gallbladder......Page 324
Summary of Published Research Evidence on IGRA Performance......Page 206
Unresolved Issues and Directions for Future Research......Page 208
Serological Diagnosis of Smear-Positive Pulmonary Tuberculosis......Page 209
Serological Diagnosis of Extrapulmonary Tuberculosis......Page 211
References......Page 360
Synthesis......Page 212
References......Page 380
Commercial Assays: FDA-Approved......Page 217
In-House Assays......Page 218
The Use of NAATs for the Diagnosis of Extrapulmonary Tuberculosis......Page 219
NAATs for Tuberculous Pleuritis and Meningitis......Page 220
Line Probe Assays......Page 221
References......Page 222
Interpretation......Page 225
Standardized Treatment with Supervision and Support......Page 226
Tertiary syphilis......Page 227
Hypersensitivity pneumonitis......Page 228
Sputum......Page 229
Temporary regimen before reintroduction of original antituberculosis drugs......Page 230
Cysts......Page 231
Cytomorphology......Page 232
References......Page 234
Induced sputum......Page 236
Other specimens......Page 237
Staining and Microscopic Examination......Page 238
Line-probe assays......Page 239
Interpretation of the TST......Page 240
Haematology and Acute-Phase Reactants......Page 241
IFN-gamma assays in the diagnosis of tuberculosis effusions......Page 242
Ultrasonography......Page 243
Conclusion......Page 244
References......Page 245
Current State of Tuberculosis Diagnostic Testing and Laboratory Facilities......Page 247
The Need for Better Tuberculosis Diagnostics......Page 248
Generation of New Technologies......Page 249
Prioritization of Tuberculosis Diagnostic Test Development......Page 250
Mycobacterial Growth Detection......Page 251
Nucleic Acid Amplification Testing (NAAT)......Page 252
Detection of Tuberculosis-Specific Organic Compounds......Page 253
References......Page 254
Initial Presentation and Diagnosis of Tuberculosis at Health Facilities......Page 257
Human immunodeficiency virus......Page 696
Diagnosis of Pericardial Effusion......Page 372
Postprimary (Reactivation) Tuberculosis......Page 262
Support for Patients on Treatment......Page 618
Radiographic Manifestations of Surgical Treatment for Tuberculosis......Page 269
Pathogenesis......Page 362
Surveillance......Page 809
Management......Page 271
Dermatological Side Effects......Page 596
Future Strategies Remaining to be Investigated......Page 717
Tuberculosis in the gastrointestinal system......Page 272
Tuberculosis in the Immunocompromised Patient......Page 274
Non-Tuberculous Mycobacteria......Page 276
Prevention......Page 475
Looking for Nodes......Page 282
Community Participation in Tuberculosis Care......Page 288
Imaging Abdominal Tuberculosis......Page 289
Looking at Focal Lesions: Tuberculomas, Tuberculosis Abscesses, Localized Meningitis......Page 291
Looking at More Diffuse Disease: Meningitis and its Complications......Page 293
Imaging Tuberculosis of the Musculoskeletal System......Page 294
Spinal Tuberculosis......Page 311
Bone Tuberculosis (Tuberculous Osteitis)......Page 313
Conclusion......Page 314
References......Page 316
Postprimary Pulmonary Tuberculosis or Phtysis......Page 317
Tracheobronchial tuberculosis......Page 319
Quality Assurance, Quality Control and External Quality Assessment......Page 321
Tuberculous lymphadenopathy......Page 323
Renal......Page 325
Female genital tuberculosis......Page 326
Differential diagnosis of vertebral tuberculosis......Page 327
Management......Page 328
Tuberculosis of the Central Nervous System......Page 329
Tuberculous leptomeningitis......Page 330
Parenchymal tuberculomas......Page 331
Positron Emission Tomography in Pulmonary and Extrapulmonary Tuberculosis......Page 333
References......Page 334
Pulmonary Tuberculosis in Adults......Page 336
Prognosis......Page 337
Algorithms for the Management of Tuberculosis in HIV-Infected Patients Under Care......Page 338
References......Page 342
Exposure to Infection......Page 343
Screening for Disease......Page 344
Type of ART and immunovirological change at time of IRIS......Page 346
From Pilot Phase to Auto-pilot......Page 348
Treatment......Page 349
Standard Treatment......Page 350
References......Page 351
Epidemiology......Page 352
Postprimary Pulmonary Tuberculosis......Page 353
HIV......Page 354
Investigations......Page 355
Chest Radiography......Page 356
Trial of Antibiotics......Page 357
Health Sector Reform and Weak Health Systems......Page 358
Prevention......Page 359
Diagnostic Tests......Page 363
Biochemical Tests......Page 364
Microbiological Examination......Page 365
Diagnostic Approach in Resource-Constrained Settings......Page 366
Acknowledgements......Page 367
References......Page 368
Pathology......Page 371
Diagnosis of Pericardial Constriction......Page 373
Direct Methods for the Diagnosis of a Tuberculous Aetiology......Page 374
Differential Diagnosis of Congestive Pericarditis......Page 376
Tuberculous Pericardial Effusion......Page 377
Drug challenging after skin reaction......Page 378
Differential Diagnosis......Page 379
Clinical Picture......Page 381
Radiology......Page 382
References......Page 383
Introduction, Background......Page 384
Bronchoscopy findings......Page 385
Medical Management......Page 386
Surgical Management......Page 387
Clinical Presentation......Page 388
Chest Radiographic Features......Page 389
Management......Page 390
Diagnosis......Page 391
Clinical Presentation......Page 392
Laryngeal Tuberculosis......Page 393
Management......Page 394
References......Page 395
Introduction......Page 397
HIV and Extrapulmonary Tuberculosis......Page 398
Paradoxical Reactions and Immune Restoration Disease......Page 399
Tuberculous Lymphadenitis......Page 400
Tuberculous Pericarditis......Page 401
Abdominal Tuberculosis......Page 402
Female genitourinary tuberculosis......Page 403
Tuberculosis of the Central Nervous System......Page 404
Other Adjuvant Immunotherapy......Page 405
Cutaneous Tuberculosis......Page 406
Miscellaneous Conditions......Page 407
References......Page 408
Pathogenesis......Page 411
Clinical Findings and Diagnosis......Page 412
HIV Infection......Page 413
Clinical Findings and Diagnosis......Page 414
References......Page 415
Further Reading......Page 416
Mediastinal Tuberculous Lymphadenopathy......Page 417
Treatment of Tuberculous Lymphadenitis......Page 418
References......Page 419
Recommended Treatment Regimens......Page 421
Central Nervous System Tuberculosis and HIV Coinfection......Page 422
Clinical diagnostic methods......Page 423
The chest radiograph and brain imaging......Page 424
Cerebral Tuberculomas......Page 425
Pathology and Pathogenesis......Page 426
Antituberculosis Chemotherapy......Page 427
Central Nervous System Tuberculosis Caused by Drug-Resistant Mycobacterium Tuberculosis......Page 428
Tuberculous meningitis......Page 429
Response to Treatment and Complications......Page 430
References......Page 431
Clinical Features......Page 433
Motor paralyses......Page 434
Special Investigations......Page 435
The Management of Tuberculous Meningitis......Page 436
The Management of Raised Intracranial Pressure and Tuberculous Hydrocephalus......Page 437
Prognosis in Tuberculous Meningitis......Page 438
The Final Report on Progress against the Targets for 2005......Page 441
References......Page 442
Type and Site of Involvement......Page 444
Issues Related to Compliance of Treatment......Page 445
Barium enema......Page 446
Colonoscopy......Page 447
Magnetic Resonance Enteroclysis......Page 448
Differentiating Intestinal Tuberculosis from Crohn's Disease......Page 449
References......Page 450
Intestine......Page 452
Clinical Presentation......Page 453
Diagnosis......Page 454
Steroids......Page 455
References......Page 456
'Classical' Urinary Tract Tuberculosis......Page 458
Tuberculous Interstitial Nephritis......Page 459
Transplant Patients......Page 460
Imaging......Page 461
Pathology......Page 464
Lower Urinary Tract Involvement......Page 465
Treatment......Page 467
References......Page 468
Alcohol and Substance Abuse......Page 470
Supporting Operational, Programmatic, and Implementation Research......Page 471
Pathophysiology......Page 472
Medical......Page 473
Gastrointestinal Upset......Page 476
Diagnosis......Page 477
Pathology......Page 478
Endometrial Tuberculosis......Page 479
Tuberculosis of the Fallopian Tubes and Infertility......Page 480
Treatment......Page 481
References......Page 482
Laryngeal Tuberculosis......Page 483
Tuberculous Cervical Lymphadenopathy......Page 484
Nasopharyngeal Tuberculosis......Page 485
Skeletal Tuberculosis......Page 486
CD4 cell count before ART initiation......Page 487
References......Page 488
Nodular tuberculous mastitis......Page 489
Clinical Features......Page 490
Pathogenesis......Page 491
Adherence to treatment as one of the keys to successful treatment......Page 492
Polymerase Chain Reaction (PCR)......Page 493
References......Page 494
Aetiopathogenesis of Ocular Tuberculosis......Page 496
Unresolved Issues on the Nature of Mycobacterium Tuberculosis Latent Bacilli......Page 497
Posterior Uveitis (Choroidal Tuberculosis)......Page 498
Retinal vascular disease......Page 499
Neuro-Ophthalmological Aspects......Page 500
Ocular Investigations......Page 501
Antituberculosis Therapy......Page 502
References......Page 503
Introduction......Page 504
Nucleic acid amplification tests (NAATs)......Page 759
Pathogenesis and Morphology......Page 505
Primary Cutaneous Tuberculosis......Page 506
Secondary Tuberculosis from Endogenous Source......Page 507
Progression of Tuberculosis in Pregnancy......Page 508
Adjunctive Treatment for HIV Infection......Page 902
Diagnosis......Page 509
Treatment......Page 511
Conclusion......Page 512
References......Page 513
Investigations......Page 514
Clinical Presentation......Page 515
Time of ART initiation......Page 516
Other available investigations......Page 517
Deformity......Page 519
Relative indications......Page 520
HIV-Infected Patients......Page 521
Prevention......Page 522
Disability grants......Page 625
References......Page 523
Differential Diagnosis......Page 524
Complications......Page 526
Shelters......Page 607
References......Page 542
Clinical Monitoring of Patients on Treatment......Page 546
Differential Diagnosis......Page 527
Individualized treatment regimens......Page 664
Epidemiology......Page 528
Research to develop new diagnostics, drugs and vaccines......Page 965
Management......Page 529
Epidemiology......Page 530
Epidemiology......Page 531
Investigations......Page 532
References......Page 533
Pulmonary Manifestations......Page 535
Empyema......Page 537
Risk Assessment......Page 539
Abdominal Tuberculosis......Page 540
Precautions for the Surgical Staff......Page 541
HIV and Multidrug-Resistant Tuberculosis......Page 544
Investigations for Tuberculosis in HIV-Infected Individuals......Page 545
Clinical Features of Tuberculosis in Diabetes Patients......Page 580
Empirical Antituberculous Therapy......Page 548
What are the barriers that exist to getting a quick tuberculosis diagnosis after first seeking care?......Page 932
References......Page 549
Previously Treated (Acquired) Resistance in Children......Page 552
Case Detection of MDR-TB in Children......Page 553
MDR-TB Regimens for Children......Page 554
Nutrition......Page 555
Conclusions and Implications......Page 556
References......Page 557
Epidemiology......Page 559
Assisted Living Situations......Page 562
The Potential for Mass Benefit......Page 760
Policy guidance......Page 563
TB/HIV Linkages......Page 694
Extrapulmonary Drug-Resistant Tuberculosis......Page 565
Surgical Management......Page 566
References......Page 567
Distribution of Extensively Drug-Resistant Tuberculosis Worldwide......Page 571
Origin of Tuberculosis Drug Resistance......Page 572
Infection Control and Extensively Drug-Resistant Tuberculosis......Page 573
Clinical Presentation and Diagnosis of Extensively Drug-Resistant Tuberculosis
......Page 574
The basic principles used in formulating an extensively drug-resistant tuberculosis treatment regimen......Page 575
Guidelines for selecting the four core drugs for an extensively drug-resistant tuberculosis regimen......Page 576
Cure Rates for Extensively Drug-Resistant Tuberculosis......Page 577
References......Page 578
Suggested Further Reading/Resources......Page 579
Comment......Page 904
Immunopathogenesis and Vaccine Studies......Page 773
Advocacy, Communication and Social Mobilization (ACSM) Including Community Participation and Patient Charter......Page 819
Progress in Implementing the Dots Strategy......Page 581
Tuberculosis in Patients with Renal Failure......Page 582
Tuberculosis drug therapy in renal failure......Page 583
Clinical Presentation and Diagnosis of Tuberculosis in Patients with Malignancies......Page 584
Differential Diagnosis......Page 585
Epidemiology......Page 586
Isoniazid Prophylaxis in Solid Organ Transplantation......Page 587
Infliximab......Page 588
Tuberculosis Chemoprophylaxis for Patients Receiving Anti-TNF-alpha Therapy......Page 589
References......Page 590
Vertical Transmission of Tuberculosis......Page 592
Clinical Features of Tuberculosis in the Neonatal Period......Page 593
Risk of Tuberculosis in HIV-Infected Individuals......Page 782
Clinical Features of Tuberculosis in Pregnant Women......Page 594
Obstetric, Perinatal, and Neonatal Outcomes......Page 595
Acknowledgement......Page 993
Breastfeeding......Page 597
Management of Tuberculosis in the HIV-Infected Women Where There is a Need Only to use Antiretroviral Therapy for Prevention of Mother-to-Child Transmission of Tuberculosis......Page 598
References......Page 599
Healthcare Settings......Page 601
Prisons and Jails......Page 605
Case Study......Page 733
Regular Congregate Settings......Page 608
Occasional Congregate Settings......Page 609
Automobiles......Page 610
Local BCG Reactions......Page 784
References......Page 612
Introduction......Page 615
The Era before Chemotherapy......Page 616
Community Involvement in Healthcare: Essential Terminology......Page 681
Two months......Page 619
Private Practitioners and Tuberculosis Treatment......Page 623
Antiretroviral treatment (ART)......Page 624
Contacts of Tuberculosis Patients......Page 626
References......Page 627
Annual Risk of Infection with Mycobacterium Tuberculosis......Page 628
The Optimal Regimen for Multidrug-Resistant Tuberculosis: Standardized vs Individualized......Page 630
Pyrazinamide......Page 631
Streptomycin......Page 632
Ethionamide......Page 633
Thioacetazone......Page 634
New Drugs......Page 635
References......Page 636
Mechanisms of Drug-Drug Interactions......Page 638
Cytosolic Drug-Metabolizing Enzymes......Page 639
Effect of Rifampicin on Efavirenz......Page 640
Effects of Rifampicin......Page 641
The Effects of Rifamycins on Concentrations of Drugs Used to Prevent or Treat Opportunistic Infections......Page 643
Complications......Page 644
References......Page 645
Recommended First-Line Drug Dosages in Children......Page 647
Controversies in the Treatment of Pulmonary Tuberculosis......Page 648
Other Types of Extrapulmonary Tuberculosis......Page 650
Multidrug Resistance (MDR-TB)......Page 651
Cotrimoxazole......Page 652
Overlapping drug toxicities......Page 653
Adherence to multiple medications......Page 654
Chemoprophylaxis for Children Exposed to, or Infected by, Infectious Pulmonary Tuberculosis Source Cases (Treatment of Latent Tuberculosis Infection)......Page 655
References......Page 656
Principles of Chemotherapy......Page 658
New Cases......Page 659
Previously Treated Cases......Page 660
Pregnancy and breastfeeding......Page 661
Differential Diagnosis......Page 662
Hepatic disease......Page 665
References......Page 666
Introduction......Page 669
IRIS Definition......Page 670
Diabetes......Page 671
The doses of anti-TB drugs used should conform to international recommendations. Fixed-dose combinations of two (isoniazid and rifampicin), three (isoniazid.........Page 672
Standard 9: To foster and assess adherence, a patient-centred approach to administration of drug treatment, based on the patient’s needs and mutual respect.........Page 673
Standard 11: A written record of all medications given, bacteriological response and adverse reactions should be maintained for all patients......Page 674
Standard 14: An assessment of the likelihood of drug resistance, based on history of prior treatment, exposure to a possible source case having drugresistant.........Page 675
Standard 16: All providers of care for patients with TB should ensure that persons (especially children under 5 years of age and persons with HIV infection).........Page 676
References......Page 677
hellipand Tuberculosis Control Programmes......Page 680
Principles and Strategy for Communicable Disease Control: The Case of Tuberculosis......Page 808
Defining Core Elements of Community Involvement and of a Right-Based Approach......Page 684
Capacity building......Page 685
Clinical Course at Tertiary Referral Hospital......Page 848
References......Page 686
Functional Public Health System: Ensuring Long-Term Sustainable Political, Administrative, and Financial Commitment......Page 688
Case Detection Through Quality-Assured Sputum Microscopy......Page 689
Treatment......Page 846
Compliance......Page 691
Supervision and Monitoring......Page 693
References......Page 695
Conclusion......Page 821
Monitoring Tuberculosis Prophylactic Treatment......Page 802
Drugs Management: Interaction, Cross Side Effects......Page 876
The Second Revolution - The Development of the Styblo Model......Page 697
Adapting the DOTS strategy......Page 953
Management......Page 699
Monitoring and reviewing progress......Page 925
Complications......Page 700
Detailed Timeline......Page 938
Investigations......Page 701
Management......Page 702
Management......Page 703
Differential Diagnosis......Page 704
Investigations......Page 705
Orange or Red Discoloration of Body Fluids......Page 706
Management of Side Effects Using Fixed-Dose Combination Antituberculosis Drugs......Page 707
Epidemiology......Page 709
Tuberculosis Preventive Treatment: Programme Aspects......Page 803
Planning and Budgeting Tuberculosis Control Activities......Page 817
Tuberculosis dissemination......Page 715
Tuberculin skin test......Page 716
HIV preventive methods......Page 828
Pathology......Page 718
Prevention......Page 719
Tuberculosis Infection Control Plan: Risk Management......Page 721
Tuberculosis Infection Prevention and Control Plan......Page 722
Prioritizing Control Measures......Page 723
Identification of potentially infectious patients......Page 724
Isolation of infectious cases......Page 725
Pre- and on-employment measures......Page 726
HCWs in employment......Page 727
Ultraviolet germicidal irradiation......Page 728
Summary......Page 729
References......Page 730
Nursing Diagnoses......Page 731
References......Page 737
Cytokine Regulation of Macrophage Activation......Page 738
Treatment and Testing Strategies......Page 739
Interferon......Page 740
GM-CSF......Page 741
Thalidomide......Page 742
Therapeutic Vaccines......Page 743
Conclusions......Page 744
References......Page 745
Introduction......Page 747
Relating Risk of Infection to Burden of Disease......Page 748
Background information......Page 792
Current Controversies and Unresolved Issues in the Diagnosis of Tuberculosis......Page 749
Administration and Logistics......Page 942
Failure in Developing Countries......Page 952
Working Together to Control Tuberculosis......Page 1001
Contribution of Surgery to the Treatment of Multidrug-Resistant Tuberculosis Patients......Page 751
Cost-Effectiveness of Tuberculosis Control Strategies Among Immigrants and Refugees......Page 753
The Dream of a Vaccine Against Tuberculosis. New Vaccines: Improving or Replacing BCG?......Page 755
References......Page 756
Introduction......Page 758
Drug-drug interactions......Page 903
Comments......Page 849
Research......Page 763
Conclusion......Page 764
Improved Diagnostics for Tuberculosis......Page 766
Optimizing Current Treatment Outcomes: Improving Clinical Management of Tuberculosis in HIV-Infected and -Uninfected Individuals......Page 770
Eliminating persisters......Page 771
Antiretroviral and Antituberculosis Therapy for People Living with HIV/AIDS Who have Tuberculosis......Page 772
Preventive Therapy for Tuberculosis......Page 774
Operational and Implementation Research......Page 775
Effects of Gender on Disease Risk, Disease Severity and Case Detection......Page 776
Acknowledgements......Page 777
References......Page 778
History of BCG Vaccines......Page 779
Genetics of BCG Vaccines......Page 780
Efficacy of BCG Vaccines......Page 781
BCG Safety in the Context of HIV Infection: BCG Adverse Events......Page 783
Regional BCG Disease (BCG Adenitis)......Page 785
Disseminated BCG disease (BCG-osis)......Page 787
Summary......Page 788
References......Page 789
Background Epidemiology......Page 791
Assigning Priorities to Contacts......Page 793
Medical Evaluation of Contacts......Page 795
New Technologies......Page 796
The Importance of Ensuring Curative and Preventive Treatment Completion in Contacts......Page 797
References......Page 798
Target Groups for Tuberculosis Preventive Treatment......Page 800
Tuberculosis Preventive Treatment Regimens......Page 801
Tuberculosis Prevention in the Era of Highly Active Antiretroviral Treatment......Page 804
References......Page 805
Theory of Communicable Disease and its Relation to Tuberculosis......Page 806
The host......Page 807
Research, development, and innovation......Page 810
Critical Issues in Current Global Tuberculosis Control Activities......Page 811
Variations in Transmission Dynamics......Page 812
References......Page 813
Historical Aspects......Page 815
Organization of National Tuberculosis Control Programmes (NTP)
......Page 816
Coordination of Activities Undertaken by Different Programmes and Partners......Page 818
References......Page 822
The Programmatic Response......Page 824
Programmatic Approach......Page 825
Joint TB/HIV planning......Page 826
Tuberculosis preventive therapy......Page 827
Antiretroviral therapy......Page 829
Women of Reproductive Age......Page 830
References......Page 831
Case 5: The Security Guard......Page 836
Case 6: The Unemployed Shack Dweller......Page 837
References......Page 838
Case 2: The Depressed HIV-Infected Mother......Page 839
Case 4: The Young Man with Previous Tuberculosis......Page 840
Comment......Page 841
References......Page 842
Treatment and Outcome......Page 843
References......Page 845
Discussion......Page 847
Reference......Page 850
Summary and Clinical Lessons......Page 851
Investigations......Page 852
Differential Diagnosis and Management......Page 853
References......Page 854
Discussion......Page 855
References......Page 856
Case Report......Page 857
Comments......Page 858
Dermatology case report: Papulonecrotic tuberculosis......Page 859
Discussion......Page 861
Epidemiology......Page 863
References......Page 864
Case Report......Page 865
Discussion......Page 868
Clinical Progress of the Newborn......Page 870
Recommendations......Page 871
Discussion......Page 872
References......Page 873
Second Episode of IRIS......Page 874
Diagnosis of IRIS......Page 875
References......Page 877
Mimicking a Brain Tumour......Page 878
Paradoxical Response to Antituberculosis Treatment......Page 881
Cervical Spine Tuberculosis......Page 882
Extradural Abscess......Page 883
Spina Ventosa......Page 884
Tuberculosis of the Long Bones......Page 885
Tuberculosis of the Ankle Joint and Foot......Page 886
Calvarial Tuberculosis......Page 887
Adult-Type Post-Primary Tuberculosis Cavitation in a Child......Page 888
Oesophageal Perforation by Tuberculous Lymphadenopathy......Page 889
References......Page 890
Case Presentation......Page 891
Discussion......Page 892
What Causes Sarcoidosis?......Page 894
Diagnosis......Page 895
Treatment......Page 896
Did this patient have both sarcoidosis and tuberculosis or only tuberculosis?......Page 897
Conclusion......Page 898
References......Page 899
Cotrimoxazole preventive therapy (CPT)......Page 900
Comment......Page 901
References......Page 905
Gender Disparities, HIV Infection and Regional Variations......Page 906
Tuberculosis Infection, Disease and Gender......Page 907
Health-Seeking Behaviour and Gender......Page 908
Treatment Adherence and Social Consequences of Tuberculosis......Page 909
Acknowledgements......Page 910
References......Page 911
Human Migration......Page 912
Migrants and Tuberculosis Disease in Low-Burden Countries......Page 916
Migrants and Tuberculosis Disease in High-Burden Countries......Page 917
Conclusions......Page 918
References......Page 919
Economic and Social Implications of Tuberculosis in the Workplace......Page 921
High-Risk Workplaces......Page 922
Infection-Control Strategies in Healthcare Facilities to Reduce Risk to Healthcare Workers......Page 923
The Employment Sector's Role in Tuberculosis Control......Page 924
Guaranteeing an uninterrupted supply of good quality antituberculous drugs......Page 926
References......Page 927
Essential Concepts......Page 928
Understanding Poverty......Page 929
Analysis of poverty based on areas......Page 930
Conclusion for Step 1......Page 931
Involve Informal Health Providers and Community Structures, Including Patients, in Tuberculosis Control......Page 933
Conclusion......Page 934
References......Page 935
Randomization and Blinding......Page 936
The Trial Protocol......Page 937
Main Aspects of GCP......Page 939
The role of the sponsor......Page 940
Trial Management and Coordination......Page 941
Conclusion......Page 943
References......Page 944
Class, Race and Death in the Twentieth Century......Page 945
Global Poverty and the 'New' Tuberculosis......Page 947
References......Page 948
Trials and Tribulations - The Early Development of Combination Chemotherapy......Page 950
Who put the DOT in the DOTS strategy?......Page 954
The Development of the Strategy......Page 955
Implementing the Strategy......Page 956
Conclusion......Page 957
References......Page 959
Challenges and Opportunities......Page 960
Case detection through quality-assured bacteriology......Page 962
Prevent and control multidrug-resistant tuberculosis......Page 963
Public-public and public-private mix (PPM) approaches......Page 964
Implementing the Strategy: Progress and Challenges......Page 966
References......Page 968
The First Global Plan to Stop TB (2001-2005)......Page 969
Regional and Global Scenarios for Impact and Costs of Planned Activities......Page 970
Results of Global Planning......Page 971
Funding Gap......Page 974
References......Page 975
Conversion of units for laboratory results......Page 977
Individual Drug Profiles......Page 978
Drug-Drug Interactions......Page 983
Sources of Information......Page 991
Prevent and Control Multidrug-Resistant Tuberculosis......Page 992
Tuberculosis research funding......Page 994
Conclusions......Page 995
Learning from the Past......Page 998
Resurgence of Interest in Tuberculosis......Page 999
Tuberculosis Elimination: What's to Stop us?......Page 1000
References......Page 1002
A......Page 1003
B......Page 1005
C......Page 1006
D......Page 1010
E......Page 1012
G......Page 1014
H......Page 1015
I......Page 1017
K......Page 1019
L......Page 1020
M......Page 1021
N......Page 1024
O......Page 1025
P......Page 1026
R......Page 1028
S......Page 1030
T......Page 1032
U......Page 1033
Z......Page 1034