La presente norma es un poderoso instrumento de gestión, que permite unificar los criterios de manejo clínico operacional en la lucha contra la tuberculosis, es de alcance nacional y de aplicación en todos los establecimientos de salud públicos y privados, incluye las lecciones aprendidas durante la ejecución de las diferentes actividades e incorpora las modificaciones necesarias para consolidar y expandir la estrategia DOTS y DOTS Plus (estrategias recomendadas internacionalmente para asegurar la curación de la tuberculosis). Agencia de Estados Unidos para el Desarrollo Internacional - USAID
"These delays in diagnosis of MDR-TB may contribute to prolonged infectiousness and thus a relatively high effective reproductive number of MDR-TB in this setting (Cohen et al., 2009). We note expanded efforts to provide early access to DST, originally included within the Peruvian technical guidelines in 2006 (Ministerio de Salud, 2006) and most recently codified as policy for universal access to rapid pre-treatment tests for resistance for all TB patients in 2013 (Ministerio de Salud, 2013), was associated in time with declining per capita rate of MDR-TB among new TB cases. In previous analyses, the Republic of Korea has had a statistically significant rising trend in MDR-TB (Zignol et al., 2012; Dye, 2009). "
[Show abstract][Hide abstract] ABSTRACT: Background
Multidrug resistant tuberculosis (MDR-TB) poses serious challenges for tuberculosis control in many settings, but trends of MDR-TB have been difficult to measure.
We analyzed surveillance and population-representative survey data collected worldwide by the World Health Organization between 1993 and 2012. We examined setting-specific patterns associated with linear trends in the estimated per capita rate of MDR-TB among new notified TB cases to generate hypotheses about factors associated with trends in the transmission of highly drug resistant tuberculosis.
59 countries and 39 sub-national settings had at least three years of data, but less than 10% of the population in the WHO-designated 27-high MDR-TB burden settings were in areas with sufficient data to track trends. Among settings in which the majority of MDR-TB was autochthonous, we found 10 settings with statistically significant linear trends in per capita rates of MDR-TB among new notified TB cases. Five of these settings had declining trends (Estonia, Latvia, Macao, Hong Kong, and Portugal) ranging from decreases of 3-14% annually, while five had increasing trends (four individual oblasts of the Russian Federation and Botswana) ranging from 14-20% annually. In unadjusted analysis, better surveillance indicators and higher GDP per capita were associated with declining MDR-TB, while a higher existing absolute burden of MDR-TB was associated with an increasing trend.
Only a small fraction of countries in which the burden of MDR-TB is concentrated currently have sufficient surveillance data to estimate trends in drug-resistant TB. Where trend analysis was possible, smaller absolute burdens of MDR-TB and more robust surveillance systems were associated with declining per capita rates of MDR-TB among new notified cases.
Drug Resistance Updates 10/2014; 17(4-6). DOI:10.1016/j.drup.2014.10.001 · 9.12 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The recurrent hemoptysis in patients with bleeding bronchiectasis are a risk factor of death; but also there is high ignorance for the medical community about the existence of other opportunistic agents, and not only tuberculosis, that can produce them. Objectives. To describe the histopathological and microbiological characteristics of a series of bleeding patients with bronchiectasis that were negative for tuberculosis, HIV and cancer in preliminary studies. Material and methods. We developed a pathological and microbiological evaluation in search of fungi, tuberculosis, lung neoplasia and common germs; in 24 surgical patients with hemoptysis of bleeding bronchiectasis with a history of pulmonary tuberculosis or contact with people that suffering this disease. Results. The fungus Aspergillus was found in 20 of the 24 patients studied. No positive results were reported on tests carried out for common aerobic bacteria and tuberculosis. The pathologic examination confirmed the presence of Aspergillus and mycetoma. The cicatricial tissue, that was invaded, is highly vascularized with a predisposition to bleeding and prolonged surgery time. Conclusions. Aspergillus fungus is the single biggest infectious agent present in patients with bleeding bronchiectasis in this series.
Revista peruana de medicina experimental y salud publica 01/2009; 26(1).
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