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maandag 30 april 2018

The Lancet: [Articles] Internal migration and transmission dynamics of tuberculosis in Shanghai, China: an epidemiolo...

[Articles] Internal migration and transmission dynamics of tuberculosis in Shanghai, China: an epidemiological, spatial, genomic analysis
The primary mechanism driving local incidence of tuberculosis in urban centres is local transmission between both migrants and residents. Combined analysis of epidemiological, genomic, and spatial data contributes to a richer understanding of local transmission dynamics and should inform the design of more effective interventions.
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[Comment] Urban transmission of tuberculosis in China
Tuberculosis control in urban settings is a huge challenge. Risk factors and conditions favouring transmission of tuberculosis include increasing spatial proximity and large population influxes.1 Worldwide, migration starts in poorer, rural places and ends in large urban centres.2 Cities become important hubs for the transmission of infectious diseases and have higher rates of tuberculosis infection than do rural areas.3
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[Articles] Prevalence of drug-resistant tuberculosis and imputed burden in South Africa: a national and sub-national cross-sectional survey
The overall prevalence of MDR tuberculosis in South Africa in 2012–14 was similar to that in 2001–02; however, prevalence of rifampicin-resistant tuberculosis almost doubled among new cases. Furthermore, the high prevalence of isoniazid mono-resistant tuberculosis, not routinely screened for, and resistance to second-line drugs has implications for empirical management.
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[Comment] Drug-resistant tuberculosis: the rise of the monos
The diagnostic and therapeutic landscape of tuberculosis has never been more dynamic: efficacious 1-month-preventive treatment regimens;1 rapid and improving tuberculosis assays; WHO guidelines that include shorter-course regimens for multidrug-resistant (MDR) and isoniazid monoresistant strains; policy on use of novel-class drugs such as diarylquinalone (bedaquiline) and the nitroimidazoles (delaminid and pretominid); and repurposing existing drugs such as linezolid, clofazamine, and imipenem.2–5 The timely report by Nazir Ahmed Ismail and colleagues6 in the Lancet Infectious Diseases contributes to this landscape by describing the prevalence of combinations of drug resistance in Mycobacterium tuberculosis detected in adults attending South African health facilities with at least one symptom suggestive of tuberculosis, in a survey done between 2012–14.
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[Corrections] Corrections
Tiberi D, du Plessis N, Walzl G, et al. Tuberculosis: progress and advances in development of new drugs, treatment regimens, and host-directed therapies. Lancet Infect Dis 2018; published online March 23. http://dx.doi.org/10.1016/S1473-3099(18)30110-5—In the author affiliations of this Series paper and for the accompanying Online Appendix, "Centers for Disease Control and Prevention Tuberculosis Trials Consortium Core Science Group, Veterans Affairs Medical Center, Washington, DC, USA (M J Vjecha MD)" should read as, "Veterans Affairs Medical Center, Washington, DC, USA (M J Vjecha MD)".
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