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BACKGROUND: Asynchronous video directly observed therapy (VDOT) may reduce tuberculosis (TB) program costs and the burden on patients. We compared VDOT performance across three cities in the United States, each of which have TB incidence rates above the national average.METHODS: Patients aged ≥18 years who are currently receiving directly observed anti-TB treatment were invited to use VDOT for monitoring treatment. Pre- and post-treatment interviews and medical records were used to assess site differences in treatment adherence and patient characteristics and perceptions.RESULTS: Participants were enrolled in New York City, NY (n = 48), San Diego, CA (n = 52) and San Francisco, CA, USA (n = 49). Overall, the mean age was 41 years (range 18-87); 59% were male; most were Asian (45%) or Hispanic/Latino (30%); and 77% were foreign-born. The median fraction of expected doses observed (FEDO) was 88% (IQR 76-96). At follow-up, 97% thought VDOT was "very or somewhat easy to use" and 95% would recommend VDOT to other TB patients. Age, race/ethnicity, annual income, and country of birth differed by city (P < 0.05), but FEDO and VDOT perceptions did not.CONCLUSIONS: TB programs in three large US cities observed a high FEDO using VDOT while minimizing staff time and travel. Similar findings across sites support VDOT adoption by other large, urban TB programs.

Bushy matgrass (Lippia alba, Verbenaceae) is a promising plant genetic resource, by their active compounds. The present document studied the molecular genetic diversity and spatial genetic structure of two contrasting populations of L. alba in Colombia. Eight RAM, evaluated total DNA of 59 accessions of non-cultivated plants collected in two Colombia regions, Chicamocha and Sumapaz. The expected average heterozygosity (or average heterozygosity genetic diversity of Nei) for the sample had low value (0.0≤He=0.2467≤0.5). The values of molecular diversity (MD) indicated values in the range of 0.1219 to 0.3425 for seven RAM. The frequency of variants is based on an effective number of alleles [Ae] and expected heterozygosity [He], genetic diversity by locus (hj=1-p2-q2) had maximum values (near 0.5) in the primers ACA, AG, CGA, and CEC. RAM suitably analyzed Lippia alba as an endemic genetic resource. A DNA bank composed of 59 Colombian accessions from Lippia alba was set up. The analysis of the spatial global structure shows that the subpopulation Sumapaz is structured, whilst the subpopulation Chicamocha, is in the structuring process. The results suggest in all cases the need for implementing: a) exchange of gene-seed, (b) gene banks with maximum genetic variability and c) induce genetic diversity.

BackgroundAlthough directly observed therapy (DOT) is recommended worldwide for monitoring anti-tuberculosis treatment, transportation and personnel requirements limit its use.ObjectiveTo evaluate the feasibility and acceptability of 'video DOT' (VDOT), which allows patients to record and transmit medication ingestion via videos watched remotely by health care providers to document adherence.MethodsWe conducted a single-arm trial among tuberculosis (TB) patients in San Diego, California, USA, (n = 43) and Tijuana, Mexico (n = 9) to represent high- and low-resource settings. Pre-/post-treatment interviews assessed participant characteristics and experiences. Adherence was defined as the proportion of observed doses to expected doses.ResultsThe mean age was 37 years (range 18-86), 50% were male, and 88% were non-Caucasian. The mean duration of VDOT use was 5.5 months (range 1-11). Adherence was similar in San Diego (93%) and Tijuana (96%). Compared to time on in-person DOT, 92% preferred VDOT, 81% thought VDOT was more confidential, 89% never/rarely had problems recording videos, and 100% would recommend VDOT to others. Seven (13%) participants were returned to in-person DOT and six (12%) additional participants had their phones lost, broken or stolen.ConclusionsVDOT was feasible and acceptable, with high adherence in both high- and low-resource settings. Efficacy and cost-effectiveness studies are needed.

Introduction Haematopoietic stem cell transplantation (HSCT) is a life-saving treatment for a number of haematological diseases. Graft versus host disease (GVHD) is its main complication and hampers survival. There is strong evidence that intestinal microbiota diversity of the recipient may increase the risk of GVHD worsening survival. Antibiotic regimens used during the early phase of the transplant may influence clinical outcomes by reducing intestinal microbiota diversity. Present guidelines of European Conference on Infections in Leukaemia exhort to optimising antibiotic use in haematological patients including HSCT recipients. The present study aims to investigate if, in HSCT recipients, the optimisation of antibacterial use may preserve intestinal microbiota composition reducing the incidence and severity of acute GVHD and improving relevant clinical outcomes.Methods and analysis This is a prospective longitudinal observational study of two cohorts of HSCT recipients: (1) the intervention cohort includes patients treated in centres in which a predefined strategy of antibiotherapy optimisation is implemented, with the objective of optimising and reducing antibiotic administration according to clinical criteria and (2) the control cohort includes patients treated in centres in which a classic permissive strategy of antibiotic prophylaxis and treatment is used. Adult patient receiving a first HSCT as a treatment for any haematological condition are included. Clinical variables are prospectively recorded and up to five faecal samples are collected for microbiota characterisation at prestablished peritransplant time points. Patients are followed since the preconditioning phase throughout 1-year post-transplant and four follow-up visits are scheduled. Faecal microbiota composition and diversity will be compared between both cohorts along with acute GVHD incidence and severity, severe infections rate, mortality and overall and disease-free survival.Ethics and dissemination The study was approved between 2017 and 2018 by the Ethical Committees of participant centres. Study results will be disseminated through peer-reviewed journals and national and international scientific conferences.Trial registration number NCT03727113

Therefore the objective of the present study was to characterize genetically wild and cultivated populations of P. magdalenae, using molecular markers type RAMs in the area of the lower San Jorge, in the Department of Sucre. For this, DNA was extracted and PCR amplified with seven primers RAMs, in a sample of 80 wild specimens from four sites and 40 cultured specimens from two companies the. All primers RAMs were polymorphic with values ranging from 93,33% in the CA primer to 99,17% in AG, this primer had the highest He value (0,469 ± 0,005), while the CCA primer had the lowest value (0,321 ± 0,010). In the wild populations of P. magdalenae the SBA site was the most diverse (He: 0,194 ± 0,028) and the CAI site was the least diverse (0,150 ± 0,029), with an He average of 0,167 ± 0,019, that was lower than the average often cultivated population (He: 0,194 ± 0,002). The analysis of the population structure reflects greater variation within that between the populations with moderate and high FST values, indicating low gene flow between sites and between wild and cultivated populations, that is evidenced in dendrograms. It is concluded that this genetic structure can be due to natural or artificial physiographic barriers and that the greater diversity in the cultivated population can be due to an adequate reproductive management or endogamy effects in the wild population.