Search

The steadily growing epidemic of diabetes mellitus poses a threat for global tuberculosis (TB) control. Previous studies have identified an important association between diabetes mellitus and TB. However, these studies have limitations: very few were carried out in low-income countries, with none in Africa, raising uncertainty about the strength of the diabetes mellitus-TB association in these settings, and many critical questions remain unanswered. An expert meeting was held in November 2009 to discuss where there was sufficient evidence to make firm recommendations about joint management of both diseases, to address research gaps and to develop a research agenda. Ten key research questions were identified, of which 4 were selected as high priority: (i) whether, when and how to screen for TB in patients with diabetes mellitus and vice versa; (ii) the impact of diabetes mellitus and non-diabetes mellitus hyperglycaemia on TB treatment outcomes and deaths, and the development of strategies to improve outcomes; (iii) implementation and evaluation of the tuberculosis 'DOTS' model for diabetes mellitus management; and (iv) the development and evaluation of better point-of-care diagnostic and monitoring tests, including measurements of blood glucose and glycated haemoglobin A(1c) (HbA(1c)) for patients with diabetes mellitus. Implementation of this research agenda will benefit the control of both diseases.

In 2001, the World Health Organization developed a dose pole, which employs height measurements for the estimation of the dose of praziquantel. In the present study, conducted during a mass treatment campaign for the control of opisthorchiasis on 232 individuals in Nala Village, Keo Udom District, the performances of the dose pole in estimating dosages of praziquantel, was compared with a bathroom scale, whereas a digital scale was used as golden standard. Results showed that the bathroom scale performed significantly better than the dose pole in delivering dosages of 40-50 mg/kg for opisthorchiasis treatment (70.7% vs. 44.8%). Furthermore, the dose pole performed significantly better for children than adults. The reason of the poor performance of the dose pole among adults is likely to be due to the high percentage (19.4%) of overweight individuals in the adult population of the village. It was concluded that the WHO dose pole is not recommended for the distribution of praziquantel for opisthorchiasis treatment to populations where overweight is common.

Opisthorchis viverrini is an important food-borne trematode in Southeast Asia. The infection causes significant morbidity in terms of hepatobiliary diseases and cholangiocarcinoma. The aim of this study was to improve the sensitivity of the PCR-based diagnosis of O. viverrini infection. A new fecal DNA extraction protocol for the detection of O. viverrini DNA using cetyltrimethyl-ammoniumbromide to remove PCR inhibitor was used and compared with the commercial stool kit method. The sensitivity of the new test was 79.3%, compared with the 44.8% of the previous method ( P < 0.01). PCR-positive tests identified several cases judged parasite negative by the parasitological method (28.6%), indicating the new test's advantage in the diagnosis of individuals with light infections.