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1. Tuberculosis contact-tracing among Syrian refugee populations: lessons from Jordan

Author

Edouard Hosten, Mandana Mehta, Emmanuel Andre, Khaled Abu Rumman, and Dimitri Van der Linden

Subjects
Syria, Refugees, Contact-tracing, Tuberculosis, Special situations and conditions, RC952-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background In response to the influx of displaced Syrians since 2011, the Jordanian National Tuberculosis Program (NTP) implemented a specific Tuberculosis (TB) reduction strategy, including contact-tracing (CT). Contacts of all refugees diagnosed with pulmonary TB (PTB) were registered by the International Organization for Migration and screened for active & latent TB infection (LTBI) in 6 NTP centres. The objectives of this study were to assess prevalence of active TB and LTBI, risk factors for LTBI as well as program performance. Methods We performed a retrospective study among contacts (N = 481) of all PTB cases diagnosed between March 2011 and May 2014 (N = 76). CT was performed using verbal screening of TB-related symptoms, tuberculin skin test (TST) and chest X-ray. Results LTBI was diagnosed in 24.1% of contacts tested with TST while active TB was diagnosed in 2.1% of contacts. Main risk factors for positive TST included smear-positive index case (IC) (OR: 6.33) and previous TB infection in the family (OR: 4.94). Among children, the risk of LTBI was higher when their IC was a care-giving female (OR: 2.83). Prevalence of active TB was two times higher in children under five (U5 s) (5.3%) compared to adults (2.5%). Conclusion We found a high prevalence of active TB and LTBI among contacts of PTB cases in the Syrian refugee population, emphasizing the urgent need for host countries to implement CT strategies for refugees. Our results underscore the vulnerability of U5s and contacts of smear-positive IC highlighting the need for specific actions focusing on those groups.

Published
2018
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2. Contributors

Author

Axel Adams, Clara Affun-Adegbulu, Rakan S. Al-Rasheed, Yasser A. Alaska, Abdulaziz D. Aldawas, Saleh Ali Alesa, George A. Alexander, Abdullah Ahmed Alhadhira, Fahad Saleha Alhajjaj, Hazem H. Alhazmi, Zainab Abdullah Alhussaini, Nawfal Aljerian, Majed Aljohani, Khaldoon H. AlKhaldi, Eyad Alkhattabi, Bryant Allen, Austin Almand, Moza M. Alnoaimi, Mohammad Alotaibi, Evan Avraham Alpert, Yasir A. Alrusayni, Mai Alshammari, Loui K. Alsulimani, Siraj Amanullah, Arian Anderson, David Arastehmanesh, Ali Ardalan, Killiam A. Argote-Araméndiz, Andrew W. Artenstein, Olivia E. Bailey, Russell Baker, Satchit Balsari, Gregory T. Banner, Fermin Barrueto M, Susan A. Bartels, Joshua J. Baugh, Frederic Berg, Vijai Bhola, William Binder, Michelangelo Bortolin, Vincent Bounes, Michael Bouton, Natasha Brown, Frederick M. Burkle, Jr, Lynn Barkley Burnett, Michele M. Burns, Nicholas V. Cagliuso, Sr, John Cahill, David W. Callaway, Duane C. Caneva, Srihari Cattamanchi, Alejandra Caycedo, Edward W. Cetaruk, Sneha Chacko, James C. Chang, Crystal Chiang, David T. Chiu, Gregory R. Ciottone, Jonathan Peter Ciottone, Melissa A. Ciottone, Robert A. Ciottone, Robert G. Ciottone, Vigen G. Ciottone, Alexander Clark, Jonathan Clark, Sean P. Conley, Joanne Cono, Arthur Cooper, Scott B. Cormier, Michael F. Court, Cord W. Cunningham, Fabrice Czarnecki, Supriya Davis, Timothy E. Davis, Gerard DeMers, Sharon Dilling, Ahmadreza Djalali, Timothy Donahoe, Joseph Donahue, Caleb Dresser, Jason Dylik, Benjamin Easter, Alexander Eastman, Laura Ebbeling, Chigozie Emetarom, Nir Eyal, Andrew J. Eyre, David J. Freeman, Franklin D. Friedman, Christie Fritz, Frederick Fung, Fiona E. Gallahue, Stephanie Chow Garbern, Mark E. Gebhart, William A. Gluckman, Craig Goolsby, Robert M. Gougelet, Fredrik Granholm, P. Gregg Greenough, Jennifer O. Grimes, Steve Grosse, Shamai A. Grossman, John T. Groves Jr, Tee L. Guidotti, George Guo, Sarah Haessler, Matthew M. Hall, John W. Hardin, Mason Harrell, Alexander Hart, MD, Melissa Harvey, Attila J. Hertelendy, PhD, Nishanth S. Hiremath, Jordan Hitchens, Christopher P. Holstege, Simon T. Horne, Steven Horng, Amer Hosin, Hans R. House, Pier Luigi Ingrassia, Fadi S. Issa, Irving 'Jake' Jacoby, Rajnish Jaiswal, Gregory Jay, J. Lee Jenkins, Josh W. Joseph, Shane Kappler, Mark E. Keim, Julie Kelman, Andrew R. Ketterer, Anas A. Khan, Ramu Kharel, Chetan U. Kharod, Thomas D. Kirsch, Anita Knopov, Max Kravitz, J. Austin Lee, Jay Lemery, Evan L. Leventhal, Jesse Loughlin, Stephanie Ludy, Brian J. Maguire, Selwyn E. Mahon, Paul M. Maniscalco, Philip Manners, Leonard Jay Marcus, Colton Margus, Taha M. Masri, Jeff Matthews, Sean D. McKay, Zeke J. McKinney, Robert K. McLellan, Eric J. McNulty, Faroukh Mehkri, Mandana Mehta, Rebecca A. Mendelsohn, Ofer Merin, Andrew Milsten, Dale M. Molé, Michael Sean Molloy, Ilaria Morelli, Jerry L. Mothershead, John Mulhern, Nicole F. Mullendore, Nicholas J. Musisca, Sonya Naganathan, Larry A. Nathanson, Erica L. Nelson, Lewis S. Nelson, Bradford A. Newbury, Kimberly Newbury, Ansley O’Neill, Robert Obernier, Jacopo M. Olagnero, Leonie Oostrom-Shah, Catherine Y. Ordun, Scott Parazynski, Andrew J. Park, Robert Partridge, Jeffrey S, James P. Phillips, Emily Pinter, David P. Polatty IV, Patrick Popieluszko, William Porcaro, Lawrence Proano, Peter B. Pruitt, Moiz Qureshi, Luca Ragazzoni, Murtaza Rashid, Paul Patrick Rega, Michael J. Reilly, Marc C. Restuccia, James J. Rifino, Paul M. Robben, Joy L. Rosenblatt, Kevin M. Ryan, Heather Rybasack-Smith, Richard James Salway, Daniel Samo, Leon D. Sanchez, Shawn M. Sanford, Ritu R. Sarin, Deesha Sarma, Jesse Schacht, Valarie Schwind, Geoffrey L. Shapiro, Joshua Sheehan, Brian Shreve, Grigor Simonyan, Devin M. Smith, E. Reed Smith, MD, Jack E. Smith, MA, Montray Smith, Peter B. Smulowitz, Angela M. Snyder, Joshua J. Solano, Bryan A. Stenson, Charles Stewart, M. Kathleen Stewart, Patrick Sullivan, Jared S. Supple, Derrick Tin, Jonathan Harris Valente, Kathryn M. Vear, P.R. Vidyalakshmi, Faith Vilas, Gary M. Vilke, Janna H. Villano, Amalia Voskanyan, C. James Watson, Nancy Weber, Scott G. Weiner, Brielle Weinstein, Eric S. Weinstein, Jordan R. Werner, Roy Karl Werner, MD, James D. Whitledge, Sage W. Wiener, Lauren Wiesner, Kenneth A. Williams, Robyn Wing, Richard E. Wolfe, Wendy Hin-Wing Wong, Robert Woolard, Prasit Wuthisuthimethawee, and Nadine A. Youssef

Published
2024
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4. Tuberculosis contact-tracing among Syrian refugee populations: lessons from Jordan

Author

Emmanuel André, Khaled Abu Rumman, Mandana Mehta, Dimitri Van der Linden, Edouard Hosten, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, and UCL - (SLuc) Service de pédiatrie générale

Subjects
medicine.medical_specialty, Health (social science), Tuberculosis, TRANSMISSION, IMPACT, PULMONARY TUBERCULOSIS, Population, lcsh:Special situations and conditions, Tuberculosis Contact, Tuberculin, CHILDREN, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Internal medicine, Contact-tracing, Epidemiology, INFECTION, medicine, BCG, 030212 general & internal medicine, education, Index case, METAANALYSIS, Public, Environmental & Occupational Health, education.field_of_study, Refugees, Science & Technology, Under-five, Syria, business.industry, lcsh:RC952-1245, Research, Public Health, Environmental and Occupational Health, lcsh:Medical emergencies. Critical care. Intensive care. First aid, lcsh:RC86-88.9, medicine.disease, bacterial infections and mycoses, PREVALENCE, DISEASES, RISK-FACTORS, business, Life Sciences & Biomedicine, Contact tracing
Abstract

BACKGROUND: In response to the influx of displaced Syrians since 2011, the Jordanian National Tuberculosis Program (NTP) implemented a specific Tuberculosis (TB) reduction strategy, including contact-tracing (CT). Contacts of all refugees diagnosed with pulmonary TB (PTB) were registered by the International Organization for Migration and screened for active & latent TB infection (LTBI) in 6 NTP centres.The objectives of this study were to assess prevalence of active TB and LTBI, risk factors for LTBI as well as program performance. METHODS: We performed a retrospective study among contacts (N = 481) of all PTB cases diagnosed between March 2011 and May 2014 (N = 76). CT was performed using verbal screening of TB-related symptoms, tuberculin skin test (TST) and chest X-ray. RESULTS: LTBI was diagnosed in 24.1% of contacts tested with TST while active TB was diagnosed in 2.1% of contacts. Main risk factors for positive TST included smear-positive index case (IC) (OR: 6.33) and previous TB infection in the family (OR: 4.94). Among children, the risk of LTBI was higher when their IC was a care-giving female (OR: 2.83). Prevalence of active TB was two times higher in children under five (U5 s) (5.3%) compared to adults (2.5%). CONCLUSION: We found a high prevalence of active TB and LTBI among contacts of PTB cases in the Syrian refugee population, emphasizing the urgent need for host countries to implement CT strategies for refugees. Our results underscore the vulnerability of U5s and contacts of smear-positive IC highlighting the need for specific actions focusing on those groups. ispartof: CONFLICT AND HEALTH vol:12 ispartof: location:England status: published

Published
2018

5. Antiretroviral treatment in low-resource settings: what has changed in the last 10 years and what needs to change in the coming years?

Author

Lutgarde Lynen, Fred C. Semitala, Mandana Mehta, and Robert Colebunders

Subjects
Volunteers, Counseling, Program evaluation, Economic growth, Pediatrics, HAART, Patient-to-patient, Resistance, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, WHO, Pre-exposure prophylaxis, Health care, Pharmacology. Therapy, Antiretrovirals, Availability, Task shifting, Accessibility, AIDS, Infectious Diseases, Retention, Anti-Retroviral Agents, Health Resources, Drug Therapy, Combination, Compliance, Microbiology (medical), medicine.medical_specialty, Monitoring, Developing country, Viral diseases, Guidelines, World Health Organization (WHO), Microbiology, Drug Costs, Medication Adherence, Acquired immunodeficiency syndrome (AIDS), Virology, Drug Resistance, Viral, medicine, Humans, Medical prescription, Developing Countries, Prophylaxis, business.industry, Community participation, HIV, medicine.disease, Collaboration, Antiretroviral therapy, Patient care management, Risk factors, Diagnosis delay, International initiatives, business
Abstract

In the past decade, access to antiretroviral therapy (ART) has witnessed a rapid scale-up. This has been made possible by significant donor funding, price reductions facilitated by flexible trade agreements and the standardization of antiretroviral prescription. Currently the global HIV community stands on the cusp of a new chapter in HIV care, that of initiating ART even earlier in the course of the infection, possibly as pre-exposure prophylaxis, or as part of a 'test-and-treat' approach. In this article, the authors provide an overview of the significant advances made in improving access to antiretrovirals in low-resource settings, as well as the challenges facing new approaches to ART in the next decade.

Published
2012
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7. Contributors

Author

Yasser A. Alaska, Abdulaziz D. Aldawas, Saleh Ali Alesa, George A. Alexander, Hazem H. Alhazmi, Nawfal Aljerian, Majed AlJohani, Khaldoon H. AlKhaldi, Bryant Allen, Bader S. Alotaibi, Mohammad Alotaibi, Evan Avraham Alpert, Rakan S. Al-Rasheed, Mai Alshammari, Asaad Alsufyani, Siraj Amanullah, Ali Ardalan, Andrew W. Artenstein, Miriam Aschkenasy, Matthew R. Babineau, Kavita Babu, Olivia E. Bailey, Gregory T. Banner, Fermin Barrueto, Susan A. Bartels, Bruce M. Becker, Paul D. Biddinger, Eike Blohm, Susan R. Blumenthal, Stephen W. Borron, Michelangelo Bortolin, Michael Bouton, Peter Brewster, Churton Budd, James M. Burke, Frederick M. Burkle, Lynne Barkley Burnett, Nicholas V. Cagliuso, John D. Cahill, David W. Callaway, Duane C. Caneva, David M. Canther, Srihari Cattamanchi, Edward W. Cetaruk, James C. Chang, Zeno L. Charles-Marcel, Anna I. Cheh, David T. Chiu, Teriggi J. Ciccone, Gregory R. Ciottone, Jonathan Peter Ciottone, Robert A. Ciottone, Diana Clapp, Raphael G. Cohen, Kathe M. Conlon, Joanne Cono, Hilarie Cranmer, Cord W. Cunningham, Steven O. Cunnion, Alison Sisitsky Curcio, Robert G. Darling, Neil B. Davids, Timothy E. Davis, Scott Deitchman, John B. Delaney, Francesco Della Corte, Gerard DeMers, William E. Dickerson, Sharon Dilling, Ahmadreza Djalali, Joseph Donahue, K. Sophia Dyer, Jason Dylik, Benjamin Easter, Laura Ebbeling, Nir Eyal, Andrew J. Eyre, Saleh Fares, Katherine Farmer, Denis J. FitzGerald, Elizabeth Foley, Kerry Fosher, David Freeman, Robert L. Freitas, Franklin D. Friedman, Frederick Fung, Fiona E. Gallahue, Lucille Gans, Stephanie Chow Garbern, Mark E. Gebhart, James Geiling, Brian C. Geyer, Mary Jo Giordano, William A. Gluckman, J. Scott Goudie, Robert M. Gougelet, Benjamin Graboyes, Michael I. Greenberg, P. Gregg Greenough, Ashley L. Greiner, Mark Greve, Stephen Grosse, Shamai A. Grossman, Tee L. Guidotti, Jason B. Hack, Matthew M. Hall, John W. Hardin, John L. Hick, Nishanth S. Hiremath, Steven Horng, Geoffrey D. Horning, Kurt R. Horst, Ali A. Hosin, Amer Hosin, Hans R. House, Pier Luigi Ingrassia, Patrick M. Jackson, Irving 'Jake' Jacoby, Rajnish Jaiswal, Adam J. Janicki, Gregory Jay, Miriam John, Shawn E. Johnson, James R. Johnston, Jerrilyn Jones, Michael D. Jones, Josh W. Joseph, Patrice Joseph, Alexis Kearney, Donald Keen, Mark E. Keim, Elizabeth Kenez, Katharyn E. Kennedy, Anas A. Khan, Chetan U. Kharod, Sylvia H. Kim, Kevin King, Mark A. Kirk, Leo Kobayashi, Lara K. Kulchycki, Rick G. Kulkarni, Joseph Lauro, Benjamin J. Lawner, David V. Le, Debra Lee, Terrance T. Lee, Jay Lemery, Jeanette A. Linder, Lawrence S. Linder, Michael A. Loesch, Heather Long, Kate Longley-Wood, Michael D. Mack, John M. Mackay, Laura Macnow, James M. Madsen, Brian J. Maguire, Patrick J. Maher, Selwyn E. Mahon, John D. Malone, Marco Mangini, Paul M. Maniscalco, David Marcozzi, Pietro D. Marghella, Jeff Matthews, Peter McCahill, Sean D. McKay, C. Crawford Mecham, Mandana Mehta, Patricia L. Meinhardt, Laura Diane Melville, Angela M. Mills, Andrew M. Milsten, Clifford S. Mitchell, Dale M. Molé, Michael Sean Molloy, John Moloney, Ilaria Morelli, Jerry L. Mothershead, John Mulhern, Nicole F. Mullendore, Larry A. Nathanson, Amelia Marie Nelson, Erica L. Nelson, Lewis S. Nelson, Carey Nichols, Mariann Nocera, Erin E. Noste, Catherine Y. Ordun, Peter D. Panagos, Robert Partridge, Jeffrey S. Paul, Catherine Pettit, James Pfaff, James P. Phillips, Jason Pickett, William Porcaro, Thérèse M. Postel, Charles N. Pozner, P.R. Vidyalakshmi, Lawrence Proano, Peter B. Pruitt, Jeffrey S. Rabrich, Jeffrey D. Race, Luca Ragazzoni, Najma Rahman-Kahn, Kristin Allyce Reed, Wende R. Reenstra, Paul P. Rega, Michael J. Reilly, Andrew T. Reisner, Marc C. Restuccia, James J. Rifino, James Michael Riley, Paul M. Robben, Kevin M. Ryan, Heather Rybasack-Smith, Leon D. Sanchez, Ritu R. Sarin, Debra D. Schnelle, Valarie Schwind, Malcolm Seheult, Kinjal N. Sethuraman, Geoffrey L. Shapiro, Marc J. Shapiro, Sam Shen, Suzanne M. Shepherd, William H. Shoff, Craig Sisson, Alexander P. Skog, Jonathan E. Slutzman, Devin M. Smith, E. Reed Smith, Jack E. Smith, Peter B. Smulowitz, Angela M. Snyder, Joshua J. Solano, John Sorenson, Kimberly A. Stanford, Charles Stewart, M. Kathleen Stewart, Carol Sulis, Robert J. Tashjian, Elizabeth S. Temin, Andrea G. Tenner, Craig D. Thorne, Jason A. Tracy, Milana Trounce, Jonathan Harris Valente, Alice Venier, Faith Vilas, Gary M. Vilke, Janna H. Villano, Barbara Vogt, Amalia Voskanyan, Scott G. Weiner, Brielle Weinstein, Eric S. Weinstein, Scott D. Weir, Roy Karl Werner, Sage W. Wiener, Kenneth A. Williams, Robyn Wing, Wendy Hin-Wing Wong, Richard E. Wolfe, Stephen P. Wood, Robert H. Woolard, Prasit Wuthisuthimethawee, Kevin Yeskey, Sami A. Yousif, Nadine A. Youssef, and Brian J. Yun

Published
2016
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