16 results on '"Chee CB"'
Search Results
2. Ministry of Health Clinical Practice Guidelines: Prevention, Diagnosis and Management of Tuberculosis
- Author
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Wang, YT, primary, Chee, CB, additional, Hsu, LY, additional, Jagadesan, R, additional, Kaw, GJ, additional, Kong, PM, additional, Lew, YJ, additional, Lim, CS, additional, Lim, TT, additional, Lu, KF, additional, Ooi, PL, additional, Sng, LH, additional, and Thoon, KC, additional
- Published
- 2016
- Full Text
- View/download PDF
3. Outcome of a grocery voucher incentive scheme for low-income tuberculosis patients on directly observed therapy in Singapore
- Author
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Chua, AP, primary, Lim, LK, additional, Ng, H, additional, Chee, CB, additional, and Wang, YT, additional
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- 2015
- Full Text
- View/download PDF
4. Doxycycline host-directed therapy in human pulmonary tuberculosis.
- Author
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Miow QH, Vallejo AF, Wang Y, Hong JM, Bai C, Teo FS, Wang AD, Loh HR, Tan TZ, Ding Y, She HW, Gan SH, Paton NI, Lum J, Tay A, Chee CB, Tambyah PA, Polak ME, Wang YT, Singhal A, Elkington PT, Friedland JS, and Ong CW
- Subjects
- Adult, Double-Blind Method, Female, Humans, Male, Middle Aged, Collagenases biosynthesis, Doxycycline administration & dosage, Gene Expression Regulation, Enzymologic drug effects, RNA-Seq, Tuberculosis, Pulmonary drug therapy, Tuberculosis, Pulmonary enzymology
- Abstract
BACKGROUNDMatrix metalloproteinases (MMPs) are key regulators of tissue destruction in tuberculosis (TB) and may be targets for host-directed therapy. We conducted a phase II double-blind, randomized, controlled trial investigating doxycycline, a licensed broad-spectrum MMP inhibitor, in patients with pulmonary TB.METHODSThirty patients with pulmonary TB were enrolled within 7 days of initiating anti-TB treatment and randomly assigned to receive either 100 mg doxycycline or placebo twice a day for 14 days, in addition to standard care.RESULTSWhole blood RNA-sequencing demonstrated that doxycycline accelerated restoration of dysregulated gene expression in TB towards normality, rapidly down-regulating type I and II interferon and innate immune response genes, and up-regulating B-cell modules relative to placebo. The effects persisted for 6 weeks after doxycycline discontinuation, concurrent with suppressed plasma MMP-1. Doxycycline significantly reduced sputum MMP-1, -8, -9, -12 and -13, suppressed type I collagen and elastin destruction, reduced pulmonary cavity volume without altering sputum mycobacterial loads, and was safe.CONCLUSIONAdjunctive doxycycline with standard anti-TB treatment suppressed pathological MMPs in PTB patients. Larger studies on adjunctive doxycycline to limit TB immunopathology are merited.TRIAL REGISTRATIONClinicalTrials.gov NCT02774993.FUNDINGSingapore National Medical Research Council (NMRC/CNIG/1120/2014, NMRC/Seedfunding/0010/2014, NMRC/CISSP/2015/009a); the Singapore Infectious Diseases Initiative (SIDI/2013/013); National University Health System (PFFR-28 January 14, NUHSRO/2014/039/BSL3-SeedFunding/Jul/01); the Singapore Immunology Network Immunomonitoring platform (BMRC/IAF/311006, H16/99/b0/011, NRF2017_SISFP09); an ExxonMobil Research Fellowship, NUHS Clinician Scientist Program (NMRC/TA/0042/2015, CSAINV17nov014); the UK Medical Research Council (MR/P023754/1, MR/N006631/1); a NUS Postdoctoral Fellowship (NUHSRO/2017/073/PDF/03); The Royal Society Challenge Grant (CHG\R1\170084); the Sir Henry Dale Fellowship, Wellcome Trust (109377/Z/15/Z); and A*STAR.
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- 2021
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5. Cross-sectional study of prevalence and risk factors, and a cost-effectiveness evaluation of screening and preventive treatment strategies for latent tuberculosis among migrants in Singapore.
- Author
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Lim VW, Wee HL, Lee P, Lin Y, Tan YR, Tan MX, Lin LW, Yap P, Chee CB, Barkham T, Lee V, Chen M, and Ong RT
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- Adult, Cost-Benefit Analysis, Cross-Sectional Studies, Humans, Mass Screening, Middle Aged, Prevalence, Risk Factors, Singapore epidemiology, Tuberculin Test, Young Adult, Latent Tuberculosis diagnosis, Latent Tuberculosis drug therapy, Latent Tuberculosis epidemiology, Transients and Migrants
- Abstract
Objectives: WHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective., Design: Cross-sectional study and cost-effectiveness analysis., Setting: Migrants in Singapore., Participants: 3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited., Primary and Secondary Outcome Measures: Costs, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted., Results: Of 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort's length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing., Conclusions: For LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2021
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6. Brief Smoking Cessation Interventions on Tuberculosis Contacts Receiving Preventive Therapy.
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Tay MZ, Galamay L, Bhoopalan S, Khin Mar KW, Wang YT, and Chee CB
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- Adult, Contact Tracing, Female, Humans, Latent Tuberculosis drug therapy, Male, Multivariate Analysis, Odds Ratio, Practice Patterns, Nurses', Prospective Studies, Singapore, Antitubercular Agents therapeutic use, Counseling, Latent Tuberculosis prevention & control, Pamphlets, Smoking Cessation methods
- Published
- 2019
7. The role of chronic viral hepatitis on tuberculosis treatment interruption.
- Author
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Chua AP, Lim LK, Gan SH, Chee CB, and Wang YT
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- Adult, Aged, Antitubercular Agents adverse effects, Chemical and Drug Induced Liver Injury diagnosis, Chemical and Drug Induced Liver Injury epidemiology, Directly Observed Therapy, Female, Hepatitis B diagnosis, Hepatitis C diagnosis, Humans, Liver Function Tests, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prevalence, Risk Assessment, Risk Factors, Singapore epidemiology, Time Factors, Tuberculosis epidemiology, Coinfection, Hepatitis B epidemiology, Hepatitis C epidemiology, Tuberculosis drug therapy
- Abstract
Background: Tuberculosis (TB) drug-induced liver injury (TB-DILI) usually occurs within 8 weeks of anti-tuberculosis drug initiation. In Singapore, we suspected that the onset of TB drug-induced transaminitis may be confounded with hepatitis C virus (HCV) and hepatitis B (HBV) virus co-infection., Objective: To determine the impact of HCV/HBV co-infection on the course of treatment in patients with TB treatment interrupted due to transaminitis., Design: TB patients with treatment interruption during 2013-2014 were identified through the Singapore national TB registry. Case notes of those with transaminitis were perused., Results: Of 3860 TB patients notified, 140 had suspected TB-DILI. Of these, respectively 20/140 (14.3%) and 16/140 (11.4%) were HCV- or HBV-positive. The median time to treatment interruption/transaminitis was 5 weeks vs. 9.9 weeks and 9.6 weeks for transaminitis patients without chronic liver disease and with HCV/HBV co-infection ( P < 0.01). Multivariate logistic regression analysis revealed that having HCV/HBV co-infection was associated with treatment interruption occurring beyond 8 weeks (adjusted OR [aOR] 4.06, 95%CI 1.28-12.85); HCV transaminitis patients were more likely to take 10 months to complete anti-tuberculosis treatment (aOR 5.11, 95%CI 1.21-21.67) than those without chronic liver disease., Conclusion: TB treatment interruption due to transaminitis in HCV/HBV co-infected patients occurred later than in those without liver disease. Most had completed 2 months of pyrazinamide-containing intensive phase treatment before the onset of transaminitis.
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- 2018
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8. Spatial dynamics of TB within a highly urbanised Asian metropolis using point patterns.
- Author
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Das S, Cook AR, Wah W, Win KM, Chee CB, Wang YT, and Yang Hsu L
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- Age Factors, Demography, Humans, Incidence, Singapore epidemiology, Urban Population, Tuberculosis, Pulmonary epidemiology
- Abstract
Singapore is a high-income country in a region with a high prevalence of tuberculosis. The Singapore Tuberculosis (TB) Elimination Program (STEP) was set up in 1997, and the better surveillance and clinical management practices initiated under STEP led to a decade-long decline in the incidence levels. However, incidence rates started to rise again since 2008. The reasons for this rise are unclear. This study involved a spatial analysis of the epidemiology of TB among Singapore residents. More than 30 000 cases reported during 1995-2011 and their residential addresses were analysed for spatial risk and spatial clustering, using spatial point pattern methodology. The principal factor responsible for the increasing resident TB incidence in Singapore is the changing age profile of the population. In particular the burgeoning population aged above 65 years accounts for the increase in reported cases. Singapore's population has one of the world's lowest fertility and mortality rates, and the elderly population is projected to grow substantially over the next few decades. Tuberculosis rates may therefore continue to rise even with static or improving case management and surveillance.
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- 2017
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9. Dietary Cholesterol Increases the Risk whereas PUFAs Reduce the Risk of Active Tuberculosis in Singapore Chinese.
- Author
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Soh AZ, Chee CB, Wang YT, Yuan JM, and Koh WP
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- Aged, Asian People, China ethnology, Diet Surveys, Dose-Response Relationship, Drug, Energy Intake, Female, Humans, Incidence, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk Factors, Singapore, Tuberculosis epidemiology, Tuberculosis microbiology, Tuberculosis prevention & control, Cholesterol, Dietary adverse effects, Diet, Fatty Acids, Omega-3 pharmacology, Fatty Acids, Omega-6 pharmacology, Feeding Behavior, Mycobacterium tuberculosis growth & development, Tuberculosis etiology
- Abstract
Background: Experimental studies suggest that cholesterol enhances the intracellular survival of Mycobacterium tuberculosis, whereas marine ω-3 (n-3) and ω-6 (n-6) fatty acids (FAs) may modulate responses to M. tuberculosis in macrophage and animal models. However, there are no epidemiologic data from prospective studies of the relation between dietary cholesterol and FAs and the risk of developing active tuberculosis., Objective: We aimed to investigate the relation between dietary intake of cholesterol and FAs and the risk of active tuberculosis in a prospective cohort in Singapore., Methods: We analyzed data from the Singapore Chinese Health Study, a cohort of 63,257 Chinese men and women aged 45-74 y recruited between 1993 and 1998. Dietary intake of cholesterol and FAs was determined with the use of a validated food-frequency questionnaire. Incident cases of active tuberculosis were identified via linkage with the nationwide tuberculosis registry. Analysis was performed with the use of Cox proportional hazards models., Results: As of 31 December 2013, 1136 incident cases of active tuberculosis were identified. Dietary cholesterol was positively associated with an increased risk of active tuberculosis in a dose-dependent manner. Compared with the lowest intake quartile, the HR was 1.22 (95% CI: 1.00, 1.47) for the highest quartile (P-trend = 0.04). Conversely, dietary marine n-3 and n-6 FAs were associated with a reduced risk of active tuberculosis in a dose-dependent manner. Compared with the lowest quartile, the HR for the highest intake quartile was 0.77 (95% CI: 0.62, 0.95) for marine n-3 FAs (P-trend = 0.01) and 0.82 (95% CI: 0.68, 0.98) for n-6 FAs (P-trend = 0.03). There was no association with saturated, monounsaturated, or plant-based n-3 FA intake., Conclusion: Dietary intake of cholesterol may increase the risk of active tuberculosis, whereas marine n-3 and n-6 FAs may reduce the risk of active tuberculosis in the Chinese population., (© 2016 American Society for Nutrition.)
- Published
- 2016
- Full Text
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10. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries.
- Author
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Getahun H, Matteelli A, Abubakar I, Aziz MA, Baddeley A, Barreira D, Den Boon S, Borroto Gutierrez SM, Bruchfeld J, Burhan E, Cavalcante S, Cedillos R, Chaisson R, Chee CB, Chesire L, Corbett E, Dara M, Denholm J, de Vries G, Falzon D, Ford N, Gale-Rowe M, Gilpin C, Girardi E, Go UY, Govindasamy D, D Grant A, Grzemska M, Harris R, Horsburgh CR Jr, Ismayilov A, Jaramillo E, Kik S, Kranzer K, Lienhardt C, LoBue P, Lönnroth K, Marks G, Menzies D, Migliori GB, Mosca D, Mukadi YD, Mwinga A, Nelson L, Nishikiori N, Oordt-Speets A, Rangaka MX, Reis A, Rotz L, Sandgren A, Sañé Schepisi M, Schünemann HJ, Sharma SK, Sotgiu G, Stagg HR, Sterling TR, Tayeb T, Uplekar M, van der Werf MJ, Vandevelde W, van Kessel F, van't Hoog A, Varma JK, Vezhnina N, Voniatis C, Vonk Noordegraaf-Schouten M, Weil D, Weyer K, Wilkinson RJ, Yoshiyama T, Zellweger JP, and Raviglione M
- Subjects
- Antirheumatic Agents therapeutic use, Coinfection epidemiology, Comorbidity, Disease Management, Drug Users, Emigrants and Immigrants, Evidence-Based Medicine, HIV Infections epidemiology, Health Personnel, Ill-Housed Persons, Humans, Interferon-gamma Release Tests, Kidney Failure, Chronic epidemiology, Kidney Failure, Chronic therapy, Latent Tuberculosis diagnosis, Latent Tuberculosis epidemiology, Mass Screening, Practice Guidelines as Topic, Prisoners, Public Health, Radiography, Thoracic, Renal Dialysis, Risk Assessment, Silicosis epidemiology, Substance-Related Disorders epidemiology, Transplant Recipients, Tuberculin Test, Tumor Necrosis Factor-alpha antagonists & inhibitors, World Health Organization, Antitubercular Agents therapeutic use, Isoniazid therapeutic use, Latent Tuberculosis drug therapy, Rifampin analogs & derivatives, Rifampin therapeutic use
- Abstract
Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone., (Copyright ©ERS 2015.)
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- 2015
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11. First use of bedaquiline in a patient with XDR-TB in Singapore.
- Author
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Chua AP, Hoo GS, Chee CB, and Wang YT
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- Adult, Female, Humans, Mycobacterium tuberculosis genetics, Radiography, Thoracic, Singapore, Tomography, X-Ray Computed, Antitubercular Agents therapeutic use, Diarylquinolines therapeutic use, Extensively Drug-Resistant Tuberculosis drug therapy
- Abstract
Drug-resistant tuberculosis (TB) continues to pose a threat to global control of TB: 3.5% of new and 20.5% of previously treated TB cases were estimated to have multidrug-resistant (MDR)-TB in 2013. Approximately 9% of patients with MDR-TB had extensively drug-resistant (XDR)-TB. A 30-year-old Vietnamese woman previously treated for TB in her home country presented with 5 months of cough and shortness of breath 1 year after migrating to Singapore. Xpert MTB/Rif testing showed rpoB gene mutation. Phenotypic drug susceptibility testing revealed XDR-TB. Second and third-line TB drugs were commenced. To strengthen the efficacy of her treatment regimen, the novel anti-TB drug bedaquiline was obtained for the patient on compassionate grounds. We report the first use in Singapore of bedaquiline for the treatment of XDR-TB., (2015 BMJ Publishing Group Ltd.)
- Published
- 2015
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12. Measurement of phenotype and absolute number of circulating heparin-binding hemagglutinin, ESAT-6 and CFP-10, and purified protein derivative antigen-specific CD4 T cells can discriminate active from latent tuberculosis infection.
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Hutchinson P, Barkham TM, Tang W, Kemeny DM, Chee CB, and Wang YT
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- Adult, Aged, Antigens, CD analysis, Cytokines metabolism, Diagnosis, Differential, Female, Flow Cytometry methods, Humans, Male, Middle Aged, ROC Curve, Singapore, Tuberculosis immunology, Young Adult, Antigens, Bacterial immunology, Bacterial Proteins immunology, CD4-Positive T-Lymphocytes immunology, Lectins immunology, Mycobacterium tuberculosis immunology, Tuberculin immunology, Tuberculosis diagnosis
- Abstract
The tuberculin skin test (TST) and interferon gamma (IFN-γ) release assays (IGRAs) are used as adjunctive tests for the evaluation of suspected cases of active tuberculosis (TB). However, a positive test does not differentiate latent from active TB. We investigated whether flow cytometric measurement of novel combinations of intracellular cytokines and surface makers on CD4 T cells could differentiate between active and latent TB after stimulation with Mycobacterium tuberculosis-specific proteins. Blood samples from 60 patients referred to the Singapore Tuberculosis Control Unit for evaluation for active TB or as TB contacts were stimulated with purified protein derivative (PPD), ESAT-6 and CFP-10, or heparin-binding hemagglutinin (HBHA). The CD4 T cell cytokine response (IFN-γ, interleukin-2 [IL-2], interleukin-17A [IL-17A], interleukin-22 [IL-22], granulocyte-macrophage colony-stimulating factor [GM-CSF], and tumor necrosis factor alpha [TNF-α]) and surface marker expression (CD27, CXCR3, and CD154) were then measured. We found that the proportion of PPD-specific CD4 T cells, defined as CD154(+) TNF-α(+) cells that were negative for CD27 and positive for GM-CSF, gave the strongest discrimination between subjects with latent and those with active TB (area under the receiver operator characteristic [ROC] curve of 0.9277; P < 0.0001). Also, the proportions and absolute numbers of HBHA-specific CD4 T cells were significantly higher in those with latent TB infection, particularly CD154(+) TNF-α(+) IFN-γ(+) IL-2(+) and CD154(+) TNF-α(+) CXCR3(+). Finally, we found that the ratio of ESAT-6- and CFP-10-responding to HBHA-responding CD4 T cells was significantly different between the two study populations. In conclusion, we found novel markers of M. tuberculosis-specific CD4 cells which differentiate between active and latent TB., (Copyright © 2015, American Society for Microbiology. All Rights Reserved.)
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- 2015
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13. Multidrug-resistant tuberculosis outbreak in gaming centers, Singapore, 2012.
- Author
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Chee CB, Gan SH, Ong RT, Sng LH, Wong CW, Cutter J, Gong M, Seah HM, Hsu LY, Solhan S, Ooi PL, Xia E, Lim JT, Koh CK, Lim SK, Lim HK, and Wang YT
- Subjects
- Adult, Contact Tracing, Humans, Male, Singapore epidemiology, Video Games, Young Adult, Disease Outbreaks, Tuberculosis, Multidrug-Resistant epidemiology
- Published
- 2015
- Full Text
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14. False-negative interferon-γ release assay results in active tuberculosis: a TBNET study.
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de Visser V, Sotgiu G, Lange C, Aabye MG, Bakker M, Bartalesi F, Brat K, Chee CB, Dheda K, Dominguez J, Eyuboglu F, Ghanem M, Goletti D, Dilektasli AG, Guglielmetti L, Koh WJ, Latorre I, Losi M, Polanova M, Ravn P, Ringshausen FC, Rumetshofer R, de Souza-Galvão ML, Thijsen S, Bothamley G, and Bossink A
- Subjects
- Adult, Cross-Sectional Studies, Female, Genetic Variation, Humans, International Cooperation, Logistic Models, Male, Middle Aged, Multivariate Analysis, Regression Analysis, Retrospective Studies, Risk Factors, Surveys and Questionnaires, False Negative Reactions, Interferon-gamma metabolism, Interferon-gamma Release Tests methods, Tuberculosis diagnosis
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- 2015
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15. Time series analysis of demographic and temporal trends of tuberculosis in Singapore.
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Wah W, Das S, Earnest A, Lim LK, Chee CB, Cook AR, Wang YT, Win KM, Ong ME, and Hsu LY
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- Adolescent, Adult, Aged, Aged, 80 and over, Forecasting, Humans, Incidence, Middle Aged, Models, Theoretical, Retrospective Studies, Singapore epidemiology, Socioeconomic Factors, Time Factors, Young Adult, Demography trends, Emigrants and Immigrants statistics & numerical data, Population Groups statistics & numerical data, Tuberculosis epidemiology
- Abstract
Background: Singapore is an intermediate tuberculosis (TB) incidence country, with a recent rise in TB incidence from 2008, after a fall in incidence since 1998. This study identified population characteristics that were associated with the recent increase in TB cases, and built a predictive model of TB risk in Singapore., Methods: Retrospective time series analysis was used to study TB notification data collected from 1995 to 2011 from the Singapore Tuberculosis Elimination Program (STEP) registry. A predictive model was developed based on the data collected from 1995 to 2010 and validated using the data collected in 2011., Results: There was a significant difference in demographic characteristics between resident and non-resident TB cases. TB risk was higher in non-residents than in residents throughout the period. We found no significant association between demographic and macro-economic factors and annual incidence of TB with or without adjusting for the population-at-risk. Despite growing non-resident population, there was a significant decrease in the non-resident TB risk (p < 0.0001). However, there was no evidence of trend in the resident TB risk over this time period, though differences between different demographic groups were apparent with ethnic minorities experiencing higher incidence rates., Conclusion: The study found that despite an increasing size of non-resident population, TB risk among non-residents was decreasing at a rate of about 3% per year. There was an apparent seasonality in the TB reporting.
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- 2014
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16. Latent tuberculosis in patients with diabetes mellitus: prevalence, progression and public health implications.
- Author
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Leow MK, Dalan R, Chee CB, Earnest A, Chew DE, Tan AW, Kon WY, Jong M, Barkham T, and Wang YT
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- Adult, Aged, Comorbidity, Cross-Sectional Studies, Diabetes Mellitus therapy, Female, Follow-Up Studies, Humans, Latent Tuberculosis prevention & control, Male, Middle Aged, Prevalence, Diabetes Mellitus epidemiology, Latent Tuberculosis epidemiology, Registries
- Abstract
Background: Diabetes mellitus (DM) confers a higher risk for tuberculosis (TB). Yet, TB screening and chemoprophylaxis for latent TB infection (LTBI) in DM remains controversial. We conducted a cross-sectional study to elucidate LTBI prevalence and longitudinal follow-up to ascertain LTBI to active TB progression rate in DM., Methods: 220 DM patients without previous TB from the outpatient diabetes clinic of the hospital were enrolled. T-Spot TB, tuberculin-skin-test (TST) and chest radiography (CXR) were performed. LTBI was defined by negative CXR with reactive T-Spot TB. Progression to active TB was confirmed by cross-checking against the TB registry., Results: The prevalence of LTBI was 28.2% (62/220) by reactive T-Spot. None progressed to active TB from 2007-2013. Multivariate analysis revealed that any co-morbidity (p=0.016) was positively associated while metformin (p=0.008) was negatively associated with LTBI., Conclusions: Over a quarter of DM patients harbor LTBI. While the lack of demonstrable progression to active TB within the follow-up time frame up to this point does not unequivocally support a routine TB screening policy or anti-TB chemoprophylaxis for LTBI in a diabetic population for now, this preliminary evidence needs re-evaluation with longer follow-up of this enrolled cohort over the next decade., (© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2014
- Full Text
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