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dinsdag 12 december 2017

The Lancet: [Comment] Tuberculosis eradication: renewed commitment and global investment required

[Comment] Tuberculosis eradication: renewed commitment and global investment required
Despite centuries of scientific endeavour and social struggle, tuberculosis continues to claim more than 1·6 million lives each year.1 Tuberculosis has killed and continues to kill more people than any other infectious disease. In The Lancet Infectious Diseases, the GBD Tuberculosis Collaborators2 estimate that 10·2 million (95% uncertainty interval [95% UI] 9·2 million to 11·5 million) individuals developed tuberculosis in 2015. While this estimate represents a modest decline since peaking in the early years of this century, the continued high burden, along with a woefully inadequate response to drug-resistant tuberculosis,1 show a profound failure of public health globally.
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[Articles] The global burden of tuberculosis: results from the Global Burden of Disease Study 2015
Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action.
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[Articles] Post-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: an open-label randomised substudy of the ANRS IPERGAY trial
Doxycycline PEP reduced the occurrence of a first episode of bacterial STI in high-risk men who have sex with men.
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[Comment] Doxycycline post-exposure prophylaxis: let the debate begin
Should physicians prescribe doxycycline to prevent syphilis? In their study published in The Lancet Infectious Diseases, Jean-Michel Molina and colleagues1 report on the findings of the first large, open-label randomised control trial to help answer this question.2 Their findings show that, among men who have sex with men (MSM) who were using pre-exposure prophylaxis (PrEP) for HIV and who had a median of ten partners every 2 months, taking doxycycline within 24 h after sex reduced the incidence of chlamydia by 70% when compared with no prophylaxis (hazard ratio [HR] 0·30, 95% CI 0·13–0·70; p=0·006); similar results were observed for syphilis (0·27, 0·07–0·98; p=0·047), but not for gonorrhoea (0·83, 0·47–1·47; p=0·52).
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[Articles] Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study
The association between microcephaly and congenital Zika virus infection was confirmed. We provide evidence of the absence of an effect of other potential factors, such as exposure to pyriproxyfen or vaccines (tetanus, diphtheria, and acellular pertussis, measles and rubella, or measles, mumps, and rubella) during pregnancy, confirming the findings of an ecological study of pyriproxyfen in Pernambuco and previous studies on the safety of Tdap vaccine administration during pregnancy.
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