WHO's new Stop TB Strategy

Raviglione, Mario; Uplekar, Mukund

doi:10.1016/s0140-6736(06)68392-x

Cited by 322 publications

(234 citation statements)

References 2 publications

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“…Mycobacterium tuberculosis infection (LTBI) is an important step towards the goal of tuberculosis elimination, as laid out by the WHO Stop TB strategy [1] and The European Centre for Disease Prevention and Control (ECDC) Framework Action Plan to Fight TB in the European Union [2]. As part of reaching this goal, individuals infected with M. tuberculosis need to be identified and offered preventive therapy to stop the progression to active tuberculosis and prevent further M. tuberculosis transmission [3].…”

Section: Mprovement Of Diagnostic Methods For Latentmentioning

confidence: 99%

Interferon-γ release assays for the diagnosis of latentMycobacterium tuberculosisinfection: a systematic review and meta-analysis

Diel¹,

Goletti²,

Ferrara³

et al. 2010

Eur Respir J

493

315

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We conducted a systematic review and meta-analysis to compare the accuracy of the QuantiFERON-TB1 Gold In-Tube (QFT-G-IT) and the T-SPOT1.TB assays with the tuberculin skin test (TST) for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI).The Medline, Embase and Cochrane databases were explored for relevant articles in November 2009. Specificities, and negative (NPV) and positive (PPV) predictive values of interferon-c release assays (IGRAs) and the TST, and the exposure gradient influences on test results among bacille Calmette-Guérin (BCG) vaccinees were evaluated.Specificity of IGRAs varied 98-100%. In immunocompetent adults, NPV for progression to tuberculosis within 2 yrs were 97.8% for T-SPOT1.TB and 99.8% for QFT-G-IT. When test performance of an immunodiagnostic test was not restricted to prior positivity of another test, progression rates to tuberculosis among IGRA-positive individuals followed for 19-24 months varied 8-15%, exceeding those reported for the TST (2-3%). In multivariate analyses, the odd ratios for TST positivity following BCG vaccination varied 3-25, whereas IGRA results remained uninfluenced and IGRA positivity was clearly associated with exposure to contagious tuberculosis cases.IGRAs may have a relative advantage over the TST in detecting LTBI and allow the exclusion of M. tuberculosis infection with higher reliability.

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Section: Mprovement Of Diagnostic Methods For Latentmentioning

confidence: 99%

Interferon-γ release assays for the diagnosis of latentMycobacterium tuberculosisinfection: a systematic review and meta-analysis

Diel¹,

Goletti²,

Ferrara³

et al. 2010

Eur Respir J

493

315

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“…The targets of the Stop TB Partnership, an international coalition designed to coordinate the efforts against TB, are to halve deaths and prevalence of TB by 2015, relative to 1990 levels and to reduce the global incidence of less than one per million population by 2050 [1]. …”

Section: Introductionmentioning

confidence: 99%

Vaccine against tuberculosis: what’s new?

et al. 2014

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Backgroundone of the World Health Organization Millennium Development Goal is to reduce tuberculosis incidence by 2015. However, more of 8.5 million tuberculosis cases have been reported in 2011, with an increase of multidrug-resistant strains. Therefore, the World Health Organization target cannot be reach without the help of a vaccine able to limit the spread of tuberculosis. Nowadays, bacille Calmette-Guérin is the only vaccine available against tuberculosis. It prevents against meningeal and disseminated tuberculosis in children, but its effectiveness against pulmonary form in adolescents and adults is argued.Methoda systematic review was performed by searches of Pubmed, references of the relevant articles and Aeras and ClinicalTrial.gov websites.Results100 articles were included in this review. Three viral vectored booster vaccines, five protein adjuvant booster vaccines, two priming vaccines and two therapeutic vaccines have been analyzed.ConclusionsSeveral vaccines are in the pipeline, but further studies on basic research, clinical trial and mass vaccination campaigns are needed to achieve the TB eradication target by 2050.

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“…Funded by BMFG and other sources, the Aeras Global TB Vaccine Foundation oversees vaccine development (1), the TB Alliance seeks novel drug regimens (2), and the Foundation for Innovative New Diagnostics (FIND) looks for new diagnostic tools (3). The current cornerstone of TB intervention is directly observed short-course therapy (DOTS), lasting generally 6 months and prone to dropout (4). DOTS is currently implemented in the 184 countries where 99% of all estimated TB cases occurred and 93% of the world population lived in 2006 (5).…”

mentioning

confidence: 99%

Epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnostics

Abu‐Raddad

Sabatelli

Achterberg

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

325

303

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The Bill and Melinda Gates Foundation supports an ambitious portfolio of novel vaccines, drug regimens, and diagnostic tools for tuberculosis (TB). We elicited the expected efficacies and improvements of the novel interventions in discussions with the foundations managing their development. Using an age-structured mathematical model of TB, we explored the potential benefits of novel interventions under development and those not yet in the portfolio, focusing on the WHO Southeast Asia region. Neonatal vaccination with the portfolio vaccine decreases TB incidence by 39% to 52% by 2050. Drug regimens that shorten treatment duration and are efficacious against drug-resistant strains reduce incidence by 10 -27%. New diagnostics reduce incidence by 13-42%. A triple combination of a portfolio vaccine, drug regimen, and diagnostics reduces incidence by 71%. A short mass vaccination catch-up campaign, not yet in the portfolio, to augment the triple combination, accelerates the decrease, preventing >30% more cases by 2050 than just the triple combination. New vaccines and drug regimens targeted at the vast reservoir of latently infected people, not in the portfolio, would reduce incidence by 37% and 82%, respectively. The combination of preventive latent therapy and a 2-month drug treatment regimen reduces incidence by 94%. Novel technologies in the pipeline would achieve substantial reductions in TB incidence, but not the Stop TB Partnership target for elimination. Elimination will require new delivery strategies, such as mass vaccination campaigns, and new products targeted at latently infected people. latent infection ͉ novel interventions ͉ transmission model ͉ latent therapy T he Bill and Melinda Gates Foundation (BMGF) supports an ambitious portfolio of novel vaccines, treatment regimens, and diagnostic tools for tuberculosis (TB). Funded by BMFG and other sources, the Aeras Global TB Vaccine Foundation oversees vaccine development (1), the TB Alliance seeks novel drug regimens (2), and the Foundation for Innovative New Diagnostics (FIND) looks for new diagnostic tools (3). The current cornerstone of TB intervention is directly observed short-course therapy (DOTS), lasting generally 6 months and prone to dropout (4). DOTS is currently implemented in the 184 countries where 99% of all estimated TB cases occurred and 93% of the world population lived in 2006 (5). Cases are passively ascertained. Sputum smear light microscopy has been the mainstay of TB diagnosis for more than a century, but has important limitations (3). Delays between the patient visit to the clinic and diagnosis often lead to delays in treatment. Neonatal vaccination with bacillus Calmette-Guérin (BCG) vaccine is part of the expanded program of immunization in many countries, but its efficacy against pulmonary TB is poor (1). Despite these efforts, in large parts of Asia, Africa, Eastern Europe, and Latin America, incidence remains 2 orders of magnitude (5) above the Stop TB Partnership goal to eliminate TB as a public health problem, defined as Ͻ1 ...

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WHO's new Stop TB Strategy

Cited by 322 publications

References 2 publications

Interferon-γ release assays for the diagnosis of latentMycobacterium tuberculosisinfection: a systematic review and meta-analysis

Interferon-γ release assays for the diagnosis of latentMycobacterium tuberculosisinfection: a systematic review and meta-analysis

Vaccine against tuberculosis: what’s new?

Epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnostics

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