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Lemaire JF, Cohn J, Kakayeva S, Tchounga B, Ekouévi PF, Ilunga VK, Ochieng Yara D, Lanje S, Bhamu Y, Haule L, Namubiru M, Nyamundaya T, Berset M, de Souza M, Machekano R, Casenghi M. Improving TB detection among children in routine clinical care through intensified case finding in facility-based child health entry points and decentralized management: A before-and-after study in Nine Sub-Saharan African Countries. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002865. [PMID: 38315700 PMCID: PMC10843113 DOI: 10.1371/journal.pgph.0002865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/03/2024] [Indexed: 02/07/2024]
Abstract
In 2022, an estimated 1.25 million children <15 years of age developed tuberculosis (TB) worldwide, but >50% remained undiagnosed or unreported. WHO recently recommended integrated and decentralized models of care as an approach to improve access to TB services for children, but evidence remains limited. The Catalyzing Paediatric TB Innovation project (CaP-TB) implemented a multi-pronged intervention to improve TB case finding in children in nine sub-Saharan African countries. The intervention introduced systematic TB screening in different facility-based child-health entry-points, decentralisation of TB diagnosis and management, improved sample collection with access to Xpert® MTB/RIF or MTB/RIF Ultra testing, and implementation of contact investigation. Pre-intervention records were compared with those during intervention to assess effect on paediatric TB cascade of care. The intervention screened 1 991 401 children <15 years of age for TB across 144 health care facilities. The monthly paediatric TB case detection rate increased significantly during intervention versus pre-intervention (+46.0%, 95% CI 36.2-55.8%; p<0.0001), with variability across countries. The increase was greater in the <5 years old compared to the 5-14 years old (+53.4%, 95% CI 35.2-71.9%; p<0.0001 versus +39.9%, 95% CI 27.6-52.2%; p<0.0001). Relative contribution of lower-tier facilities to total case detection rate increased from 37% (71.8/191.8) pre-intervention to 50% (139.9/280.2) during intervention. The majority (89.5%) of children with TB were identified through facility-based intensified case-finding and primarily accessed care through outpatient and inpatient departments. In this multi-country study implemented under real-life conditions, the implementation of integrated and decentralized interventions increased paediatric TB case detection. The increase was driven by lower-tier facilities that serve as the primary point of healthcare contact for most patients. The effect was greater in children < 5 years compared to 5-14 years old, representing an important achievement as the TB detection gap is higher in this subpopulation. (Study number NCT03948698).
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Affiliation(s)
| | - Jennifer Cohn
- Division of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Shirin Kakayeva
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, United States of America
| | - Boris Tchounga
- Elizabeth Glaser Pediatric AIDS Foundation, Yaounde, Cameroon
| | | | - Vicky Kambaji Ilunga
- Elizabeth Glaser Pediatric AIDS Foundation, Kinshasa, République Démocratique du Congo
| | | | - Samson Lanje
- Elizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho
| | - Yusuf Bhamu
- Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi
| | - Leo Haule
- Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania
| | - Mary Namubiru
- Elizabeth Glaser Pediatric AIDS Foundation, Kampala, Uganda
| | | | - Maude Berset
- Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland
| | | | - Rhoderick Machekano
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, United States of America
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Uwishema O, Rai A, Nicholas A, Abbass M, Uweis L, Arab S, El Saleh R, Adanur I, Stephen Masunga D, Nazir A. Childhood tuberculosis outbreak in Africa: is it a matter of concern? Int J Surg 2023; 109:1539-1542. [PMID: 36906762 PMCID: PMC10389634 DOI: 10.1097/js9.0000000000000140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 03/13/2023]
Affiliation(s)
- Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Clinton Global Initiative University, New York, New York, USA
- Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Anushree Rai
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Chhattisgarh Institute of Medical Sciences, Bilaspur, Chhattisgarh, India
| | - Aderinto Nicholas
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Mortada Abbass
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Lama Uweis
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Sara Arab
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Rayyan El Saleh
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Irem Adanur
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Daniel Stephen Masunga
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
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Vonasek BJ, Radtke KK, Vaz P, Buck WC, Chabala C, McCollum ED, Marcy O, Fitzgerald E, Kondwani A, Garcia-Prats AJ. Tuberculosis in children with severe acute malnutrition. Expert Rev Respir Med 2022; 16:273-284. [PMID: 35175880 PMCID: PMC9280657 DOI: 10.1080/17476348.2022.2043747] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/15/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION With growing attention globally to the childhood tuberculosis epidemic after decades of neglect, and with the burden of severe acute malnutrition (SAM) remaining unacceptably high worldwide, the collision of these two diseases is an important focus for improving child health. AREAS COVERED This review describes the clinical and public health implications of the interplay between tuberculosis and SAM, particularly for children under the age of five, and identifies priority areas for improved programmatic implementation and future research. We reviewed the literature on PubMed and other evidence known to the authors published until August 2021 relevant to this topic. EXPERT OPINION To achieve the World Health Organization's goal of eliminating deaths from childhood tuberculosis and to improve the abysmal outcomes for children with SAM, further research is needed to 1) better understand the epidemiologic connections between child tuberculosis and SAM, 2) improve case finding of tuberculosis in children with SAM, 3) assess unique treatment considerations for tuberculosis when children also have SAM, and 4) ensure tuberculosis and SAM are strongly addressed in decentralized, integrated models of providing primary healthcare to children.
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Affiliation(s)
- Bryan J Vonasek
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kendra K Radtke
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA
| | - Paula Vaz
- Fundação Ariel Glaser, Maputo, Mozambique
| | - W Chris Buck
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Chishala Chabala
- Children’s Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Eric D McCollum
- Global Program in Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Olivier Marcy
- University of Bordeaux, Inserm, French National Research Institute for Sustainable Development (IRD), Bordeaux, France
| | - Elizabeth Fitzgerald
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Alexander Kondwani
- Centre of Excellence for Nutrition, North West University, Potchefstroom, South Africa
| | - Anthony J Garcia-Prats
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Ehrlich J, Garcia-Basteiro AL, Brands A, Verkuijl S, Ndongosieme A, Detjen A, Lopez-Varela E. Integration of TB into child health policies in Africa's high-burden countries: a normative analysis. Public Health Action 2021; 11:167-170. [PMID: 34956842 DOI: 10.5588/pha.21.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
Integration of paediatric TB care into decentralised child health services has the potential to reduce the large proportion of childhood TB that remains undiagnosed. We performed a review of national guidelines and policies for TB and child health to evaluate the normative integration of paediatric TB into existing child health programmes in 15 high TB burden countries in Africa. While integration is addressed in 80% of the national strategic plans for TB, the child health strategies insufficiently address TB in their plans to reduce child mortality. Emphasis needs to be put on multi-sectoral collaboration among national health programmes.
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Affiliation(s)
- J Ehrlich
- IS Global, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - A L Garcia-Basteiro
- IS Global, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigacao em Saude de Manhica, Maputo, Mozambique
| | - A Brands
- Global TB Programme, World Health Organization (WHO), Geneva, Switzerland
| | - S Verkuijl
- Global TB Programme, World Health Organization (WHO), Geneva, Switzerland
| | - A Ndongosieme
- Regional Office for Africa, WHO, Brazzaville, Republic of Congo
| | | | - E Lopez-Varela
- IS Global, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
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Simen-Kapeu A, Reserva ME, Ekpini RE. Galvanizing Action on Primary Health Care: Analyzing Bottlenecks and Strategies to Strengthen Community Health Systems in West and Central Africa. GLOBAL HEALTH, SCIENCE AND PRACTICE 2021; 9:S47-S64. [PMID: 33727320 PMCID: PMC7971379 DOI: 10.9745/ghsp-d-20-00377] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/01/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The renewed commitment to primary health care (PHC) presents an opportunity to strengthen health systems in West and Central Africa (WCA). Though evidence-based cost-effective interventions that are predicted to prevent up to one-third of maternal, newborn, and child health complications and deaths with universal coverage have been identified, more than 50% of people living in rural areas or from poor families still do not have access to these interventions in resource-constrained settings. METHODS We conducted a multicountry systematic analysis of bottlenecks and proposed solutions to strengthen community health systems through a series of collaborative workshops in 22 countries in WCA. Countries were categorized by their under-5 mortality rate (U5MR) to assess specificities related to reported challenges. We also reviewed existing data on selected health system tracer interventions to analyze country profiles. RESULTS The bottlenecks identified as severe or very severe were related to health financing (19 countries, 86%), essential medical technology and products (16 countries, 73%), integrated health service delivery (14 countries, 64%), and community ownership and partnerships (self-reported by 14 countries, 64%). Only the integrated service delivery was self-reported as a severe challenge by countries with high U5MR. The issue of human resources for community health was one of the least reported challenges. CONCLUSION In WCA, strengthening community health systems as part of PHC revitalization efforts should focus on increasing health financing and innovative investments, strengthening the logistics management system, and fostering community ownership and partnerships. Countries with high U5MR should also reinforce integrated service delivery approaches through innovation. Government actions galvanized by global and regional ongoing initiatives should be sustained to ensure that no one is left behind.
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Affiliation(s)
- Aline Simen-Kapeu
- United Nations Children's Fund, West and Central Regional Office, Dakar, Senegal.
| | | | - Rene Ehounou Ekpini
- United Nations Children's Fund, West and Central Regional Office, Dakar, Senegal
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Marais BJ, Verkuijl S, Casenghi M, Triasih R, Hesseling AC, Mandalakas AM, Marcy O, Seddon JA, Graham SM, Amanullah F. Paediatric tuberculosis - new advances to close persistent gaps. Int J Infect Dis 2021; 113 Suppl 1:S63-S67. [PMID: 33716193 DOI: 10.1016/j.ijid.2021.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022] Open
Abstract
Young children are most vulnerable to develop severe forms of tuberculosis (TB) and are over-represented among TB deaths. Almost all children estimated to have died from TB were never diagnosed or offered TB treatment. Improved access to TB preventive treatment (TPT) requires major upscaling of household contact investigation with allocation of adequate resources. Symptom-based screening is often discouraged in adults for fear of generating drug resistance, if TB cases are missed. However, the situation in vulnerable young children is different, as they present minimal risk of drug resistance generation. Further, the perceived need for additional diagnostic evaluation presents a major barrier to TPT access and underlies general reluctance to consider pragmatic decentralised models of care. Widespread roll-out of Xpert MTB/RIF Ultra® represents an opportunity for improved case detection in young children, but attaining full impact will require the use of non-sputum specimens. The new Fujifilm SILVAMP TB LAM® urine assay demonstrated good diagnostic accuracy in HIV-positive and malnourished children, but further validation is required. Given the limited accuracy of all available tests and the excellent tolerance of TB drugs in children, the global community may have to accept some over-treatment if we want to close the persistent case detection gap in young children.
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Affiliation(s)
- Ben J Marais
- The Children's Hospital at Westmead and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
| | - Sabine Verkuijl
- Global TB Programme, World Health Organisation (WHO), Geneva, Switzerland
| | | | - Rina Triasih
- Department of Paediatrics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada and Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Anneke C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, South Africa
| | - Anna M Mandalakas
- Global Tuberculosis Program, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, United States
| | - Olivier Marcy
- University of Bordeaux, Inserm, French National Research Institute for Sustainable Development, UMR 1219, Bordeaux, France
| | - James A Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, South Africa; Department of Infectious Diseases, Imperial College London, London, United Kingdom
| | - Stephen M Graham
- Centre for International Child Health, University of Melbourne, Melbourne, Australia; International Union against Tuberculosis and Lung Disease, Paris, France
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Marais BJ, Nicol M, Zar HJ. Key advances and remaining challenges in childhood and adolescent tuberculosis. Paediatr Respir Rev 2020; 36:25-26. [PMID: 32830068 DOI: 10.1016/j.prrv.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 07/28/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Ben J Marais
- The Children's Hospital at Westmead, University of Sydney, Sydney, Australia.
| | - Mark Nicol
- The School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Heather J Zar
- Department of Paediatrics & Child Health and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
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Reuter A, Seddon JA, Marais BJ, Furin J. Preventing tuberculosis in children: A global health emergency. Paediatr Respir Rev 2020; 36:44-51. [PMID: 32253128 DOI: 10.1016/j.prrv.2020.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/26/2020] [Indexed: 12/13/2022]
Abstract
It is estimated that 20 million children are exposed to tuberculosis (TB) each year, making TB a global paediatric health emergency. TB preventative efforts have long been overlooked. With the view of achieving "TB elimination" in "our lifetime", this paper explores challenges and potential solutions in the TB prevention cascade, including identifying children who have been exposed to TB; detecting TB infection in these children; identifying those at highest risk of progressing to disease; implementing treatment of TB infection; and mobilizing multiple stakeholders support to successfully prevent TB.
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Affiliation(s)
- Anja Reuter
- Medecins Sans Frontieres, Khayelitsha, South Africa.
| | - James A Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa; Department of Infectious Diseases, Imperial College London, United Kingdom
| | - Ben J Marais
- The University of Sydney and the Children's Hospital at Westmead, Sydney, Australia
| | - Jennifer Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Jeffree MS, Ahmedy F, Ibrahim MY, Awang Lukman K, Ahmed K, Giloi N, Naing DKS, Yusuff AS. A training module to empower marginalised Northern Borneo islanders for tuberculosis control. J Public Health Res 2020; 9:1757. [PMID: 33117755 PMCID: PMC7582020 DOI: 10.4081/jphr.2020.1757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022] Open
Abstract
Empowering marginalised urban islanders with limited health accessibility through knowledge transfer program for controlling pulmonary tuberculosis (PTB) requires a specific training module. The study was aimed to develop this training module by adapting and modifying the IMCI (Integrated Management of Childhood Illness) framework. Structuring the content for the knowledge and skills for PTB control in the module was based on the National Strategic Plan for Tuberculosis Control 2016-2020. A total of five knowledge and skills were structured: i) PTB disease and diagnosis, ii) PTB treatment, iii) preventive PTB measures, iv) prevention of malnutrition, and v) psychosocial discrimination. The IMCI framework was modified through 3 ways: i) identifying signs and symptoms of PTB, ii) emphasising the IMCI’s 5 steps of integrated management: assess, diagnose, treat, counsel and detect, and iii) counseling on BCG immunisation, malnutrition, environmental modifications and stigma on PTB. Significance for public health Controlling tuberculosis in high pulmonary tuberculosis (PTB) regions among marginalised islanders with limited health accessibility requires a concerted effort from the community and the healthcare system. An efficient implementation is through community empowerment by transferring adequate knowledge and skills on PTB detection and treatment within the community for reducing the spread of the disease. Developing a training module for the knowledge transfer purpose has to be contextually relevant and adapted to the lack of healthcare resources of the targeted region. Adapting Integrated Management of Childhood Illness (IMCI) framework for developing such training module is feasible for PTB and should be extended to other diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Aza Sherin Yusuff
- Department of Biomedical Sciences and Therapeutics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah
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Reuter A, Hughes J, Furin J. Challenges and controversies in childhood tuberculosis. Lancet 2019; 394:967-978. [PMID: 31526740 DOI: 10.1016/s0140-6736(19)32045-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/29/2019] [Accepted: 08/06/2019] [Indexed: 01/03/2023]
Abstract
Children bear a substantial burden of suffering when it comes to tuberculosis. Ironically, they are often left out of the scientific and public health advances that have led to important improvements in tuberculosis diagnosis, treatment, and prevention over the past decade. This Series paper describes some of the challenges and controversies in paediatric tuberculosis, including the epidemiology and treatment of tuberculosis in children. Two areas in which substantial challenges and controversies exist (ie, diagnosis and prevention) are explored in more detail. This Series paper also offers possible solutions for including children in all efforts to end tuberculosis, with a focus on ensuring that the proper financial and human resources are in place to best serve children exposed to, infected with, and sick from all forms of tuberculosis.
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Affiliation(s)
- Anja Reuter
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - Jennifer Hughes
- Desmond Tutu Tuberculosis Center, Stellenbosch University, Stellenbosch, South Africa
| | - Jennifer Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
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Petersen E, Rao M, Ippolito G, Gualano G, Chakaya J, Ntoumi F, Moore D, Allen R, Gaskell K, Öhd JN, Hergens MP, Krishnamoorthy S, Ugarte-Gil C, Kirwan DE, Honeyborne I, McHugh TD, Köser CU, Kranzer K, Tiberi S, Migliori GB, Mao Q, Yang Y, Oliveira SP, Cardoso RF, Detjen A, Marais B, de Gijsel D, von Reyn CF, Goscé L, Abubakar I, Maeurer M, Zumla A. World Tuberculosis Day March 24th 2019 Theme: "It's TIME" - International Journal of Infectious Diseases Tuberculosis Theme Series. Int J Infect Dis 2019; 80S:S1-S5. [PMID: 30802624 DOI: 10.1016/j.ijid.2019.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Eskild Petersen
- Institute of Clinical Medicine, University of Aarhus, Denmark; The Royal Hospital, Muscat, Oman; ESCMID Emerging Infections Task Force, Basel, Switzerland.
| | - Martin Rao
- Champalimaud Centre for the Unknown, Lisbon, Portugal.
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.
| | - Gina Gualano
- National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.
| | - Jeremiah Chakaya
- International Union Against TB and Lung Diseases, Paris, France; Department of Medicine, Kenyatta University, Nairobi, Kenya.
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo.
| | - David Moore
- TB Centre, London School of Hygiene and Tropical Medicine, London, UK.
| | - Rhiannon Allen
- Public Health England National Mycobacteriology Laboratory North and Central, Heartlands Hospital, Birmingham, United Kingdom
| | - Katherine Gaskell
- TB Centre, London School of Hygiene and Tropical Medicine, London, UK.
| | - Joanna Nederby Öhd
- Department of Public Health Science, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Communicable Disease Control and Prevention, Stockholm County Council, Stockholm, Sweden.
| | - Maria-Pia Hergens
- Department of Public Health Science, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Communicable Disease Control and Prevention, Stockholm County Council, Stockholm, Sweden.
| | - Sriram Krishnamoorthy
- Department of Urology & Renal transplantation, Sri Ramachandra Medical College & Research Institute, Chennai, Tamil Nadu, India.
| | - Cesar Ugarte-Gil
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102 Lima, Peru; TB Centre and Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Daniela E Kirwan
- Infection & Immunity Research Institute, St. George's, University of London, UK.
| | - Isobella Honeyborne
- Division of Infection and Immunity, Center for Clinical Microbiology, University College London, London, UK.
| | - Timothy D McHugh
- Division of Infection and Immunity, Center for Clinical Microbiology, University College London, London, UK.
| | - Claudio U Köser
- Department of Genetics, University of Cambridge, Cambridge, UK
| | - Katharina Kranzer
- Clinical Research Department, London School of Hygiene and Tropical Medicine & Biomedical Research and Training Institute, Harare, Zimbabwe.
| | - Simon Tiberi
- Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK; Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | | | - Qiang Mao
- Department of Infection Management, Gansu Provincial People's Hospital, China.
| | - Yahong Yang
- Department of Medical Records Statistics, The First People's Hospital of Jingmen, China.
| | - Simoni P Oliveira
- Health Secretariat of Paraná State, Postgraduate Program in Health Sciences, Maringá State University, Paraná, Brazil.
| | | | - Anne Detjen
- United Nations Children's Fund (UNICEF), New York, USA.
| | - Ben Marais
- Centre for Research Excellence in Tuberculosis and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
| | - David de Gijsel
- Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - C Fordham von Reyn
- Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - Lara Goscé
- Institute for Global Health, University College London, London, UK.
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK.
| | - Markus Maeurer
- Champalimaud Centre for the Unknown, Lisbon, Portugal; Department of Haematology and Oncology, Krankenhaus Nordwest, Frankfurt, Germany.
| | - Alimuddin Zumla
- Division of Infection and Immunity, Center for Clinical Microbiology, University College London, UK; The National Institute of Health Research Biomedical Research Centre at UCL Hospitals, London, UK.
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