Extensively drug-resistant tuberculosis: Epidemiology and management challenges
ABSTRACT Widespread global use of rifampin for 2 decades preceded the emergence of clinically significant multidrug-resistant tuberculosis (MDR-TB) in the early 1990s. The prevalence of MDR-TB has gradually increased such that it accounts for approximately 5% of the global case burden of disease (approximately half a million cases in 2007). Eclipsing this worrying trend is the widespread emergence of extensively drug-resistant TB (XDR-TB). This article reviews the insights provided by clinical and molecular epidemiology regarding global trends and transmission dynamics of XDR-TB, and the challenges clinicians have to face in diagnosing and managing cases of XDR-TB. The ethical and management dilemmas posed by recurrent defaulters, XDR-TB treatment failures, and isolation of incurable patients are also discussed. Given the past global trends in MDR-TB, if aggressive preventive and management strategies are not implemented, XDR-TB has the potential to severely cripple global control efforts of TB.
- SourceAvailable from: Shashikiran Umakanth
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- "Multidrug-resistant tuberculosis has now reached an approximate prevalence rate of 5% of the total global tuberculosis burden,3 amounting to half a million cases, of which most cases are from Indian, China, and Russia.4,5 Although the measures adopted by various countries have resulted in a 51% case detection rate for tuberculosis and a 70% successful treatment rate worldwide, there is still a long way to go to achieve a 70% case detection rate and 85% successful treatment rate for nonresistant tuberculosis, as suggested by the WHO.6 Also, the WHO has suggested 70% case detection and treatment rates for multidrug-resistant tuberculosis to curb the development of extensively drug-resistant tuberculosis.4 "
ABSTRACT: Despite intensive efforts to eradicate the disease, tuberculosis continues to be a major threat to Indian society, with an estimated prevalence of 3.45 million cases in 2006. Emergence of multidrug-resistant tuberculosis has complicated eradication attempts in recent years. Incomplete and/inadequate treatment are the main causes for development of drug resistance. Directly observed therapy, short-course (DOTS) is the World Health Organization (WHO) strategy for worldwide eradication of tuberculosis, and our country achieved 100% coverage for DOTS through the Revised National Tuberculosis Control Program in 2006. For patients with multidrug-resistant tuberculosis, the WHO recommends a DOTS-Plus treatment strategy. Early detection and prompt treatment of multidrug-resistant tuberculosis is crucial to avoid spread of the disease and also because of the chances of development of potentially incurable extensively drug-resistant tuberculosis in these cases. This review discusses the epidemiologic, diagnostic, and therapeutic aspects of multidrug-resistant tuberculosis, and also outlines the role of primary care doctors in the management of this dangerous disease.Infection and Drug Resistance 10/2010; 3:115-22. DOI:10.2147/IDR.S10743
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ABSTRACT: InGaAs/InP epitaxial layers were grown on four-inch S-doped InP substrates using production-scale organometallic vapor-phase epitaxy (OMVPE) system. High uniformity has been obtained by optimizing the growth conditions. For example, thickness uniformity of 1.09% in InGaAs layer, 1.39% in InP layer has been obtained. Also low dark current (<0.3 nA/200 μm φ at V<sub>R</sub>=5 V) has been achieved in planar type PIN-PD device. These results will highlight the large-diameter InGaAs/InP epitaxial growth for device cost performanceIndium Phosphide and Related Materials Conference, 2002. IPRM. 14th; 02/2002
Article: The MIFARE Classic story[Show abstract] [Hide abstract]
ABSTRACT: The MIFARE Classic product from NXP Semiconductors has been much maligned over recent years and whilst some of the criticism is well justified by virtue of the inherent security problems, it is by no means the weakest card/RFID in use today. In this article we give a brief overview of the MIFARE Classic card, its use, design and security. We start by looking at the range of card and RFID products and placing the MIFARE Classic in its intended position. The process of risk assessment is then discussed as a means of choosing “appropriate” products and solutions. We then discuss the history of the MIFARE Classic, its design, security features and associated attacks. The long-lasting effects of the attacks and publicity are considered with respect to not only the MIFARE Classic, but for similar product risk reviews.Information Security Technical Report 02/2010; DOI:10.1016/j.istr.2010.10.009