Fabio Scano

University of Cagliari

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Brian Williams

University of Mississippi Medical Center

Paul Nunn

Science Council

Dino Sgarabotto

Policlinico Abano Terme

Alexander S. Pym

University of KwaZulu-Natal

Lindiwe Mvusi

National Department of Health

Robert Colebunders

University of Antwerp

Kristina Wallengren

University of KwaZulu-Natal

Yogan Pillay

Stellenbosch University

Charles F. Gilks

University of Queensland

Bruce Margot

Centers for Disease Control and Prevention

Cooperative Institutions

Chinese Center For Disease Control and Prevention

World Health Organization

University of Padua

World Health Organization - Pakistan

Imperial College London

London School of Hygiene & Tropical Medicine

Azienda Ospedaliera di Padova

University of Cagliari

Peking University

China National Health Development Research Center

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Tuberculosis immune reconstitution inflammatory syndrome in countries with limited resources.

PubMed (2006)

Robert Colebunders John Liu Veerle Huyst Andrew Kambugu Fabio Scano

Mycobacterium tuberculosis infection accounts for probably one third of human immunodeficiency virus (HIV) related immune reconstitution inflammatory syndrome (IRIS) events, particularly in developing countries where HIV and tuberculosis (TB) co-infection is very common. Small cohort studies of HIV-positive patients with active TB treated with antiretroviral therapy (ART) suggest an incidence of TB IRIS varying between 11% and 45%. Risk factors for TB IRIS that have been suggested in certain studies but not in others include: starting ART within 6 weeks of starting TB treatment; extra-pulmonary or disseminated disease; a low CD4+ lymphocyte count and a high viral load at the start of ART; and a good immunological and virological response during highly active antiretroviral therapy (HAART). It is important to agree on a clinical case definition of TB IRIS that could be used in resource-limited settings. Such a case definition could be used to determine the exact incidence and consequences of TB IRIS and would be valuable worldwide in clinical trials that are needed to answer questions on how this phenomenon could be prevented and treated.

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Drug-Resistant Tuberculosis, KwaZulu-Natal, South Africa, 2001–2007

Emerging infectious diseases (2011)

Kristina Wallengren Fabio Scano Paul Nunn Bruce Margot Sandile Buthelezi

Abstract In Africa, incidence and prevalence of drug-resistant tuberculosis have been assumed to be low. However, investigation after a 2005 outbreak of extensively drug-resistant tuberculosis in KwaZulu-Natal Province, South Africa, found that the incidence rate for multidrug-resistant tuberculosis in KwaZulu-Natal was among the highest globally and would be higher if case-finding efforts were intensified.

Extensively drug-resistant tuberculosis

Drug resistant tuberculosis

10.3201/eid1710.100952_article.htm

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Global Tuberculosis Control: Toward the 2015 Targets and Beyond

Annals of Internal Medicine (2015)

Emilio Dirlikov Mario Raviǵlione Fabio Scano

Since 1990, progress has been made toward global tuberculosis (TB) control, as measured by targets set for 2015. However, TB remains a major threat to health around the world. In 2013, there were an estimated 11 million prevalent cases, and an estimated 9.0 million incident cases occurred globally. Approximately 1.5 million deaths were caused by TB, including 360,000 among people living with HIV. Substantial challenges threaten future control efforts. These include multidrug-resistant forms and co-infection with HIV, as well as other factors, such as the increased prominence of noncommunicable diseases and adverse socioeconomic conditions. Beyond 2015, TB control must be seen as both a public health imperative unto itself and a vital component of economic development plans. To that end, control strategies should exploit technical and operational innovations to improve TB control and care and should promote universal health coverage and social protection mechanisms to expand access to essential prevention, diagnostics, and treatment services while avoiding catastrophic costs incurred by patients.

Global Health

Tuberculosis control

10.7326/m14-2210

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Leuconostoc Species: A Case-cluster Hospital Infection

Scandinavian Journal of Infectious Diseases (1999)

Fabio Scano Larissa Rossi Anna Maria Cattelan Giovanni Carretta F. Meneghetti

Leuconostoc species are members of the Streptococcacae family. They are generally regarded as non-pathogenic culture contaminants and are thought to be an uncommon cause of infection. We present a study of a case-cluster nosocomial infection due to Leuconostoc spp. Three patients were hospitalized at the time of the infection with significant underlying diseases and all had a compromised skin and mucous barriers. Two had received previous antibiotic therapy. This report highlights the importance of Leuconostoc spp. as an emerging pathogen, even though the modes of transmission and reservoirs of Leuconostoc spp. are as yet unknown.

10.1080/00365549950163815

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T-cell assays for the diagnosis of latent tuberculosis infection: moving the research agenda forward

The Lancet Infectious Diseases (2007)

Madhukar Pai Keertan Dheda Jane Cunningham Fabio Scano Richard O’Brien

10.1016/s1473-3099(07)70086-5

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WHO clinical staging of HIV infection and disease, tuberculosis and eligibility for antiretroviral treatment: relationship to CD4 lymphocyte counts.

PubMed (2005)

Roger Teck O Ascurra P Gomani Marcel Manzi Olesu Pasulani

Thyolo district, Malawi.To determine in HIV-positive individuals aged over 13 years CD4 lymphocyte counts in patients classified as WHO Clinical Stage III and IV and patients with active and previous tuberculosis (TB).Cross-sectional study.CD4 lymphocyte counts were determined in all consecutive HIV-positive individuals presenting to the antiretroviral clinic in WHO Stage III and IV.A CD4 lymphocyte count of < or = 350 cells/microl was found in 413 (90%) of 457 individuals in WHO Stage III and IV, 96% of 77 individuals with active TB, 92% of 65 individuals with a history of pulmonary TB (PTB) in the last year, 91% of 89 individuals with a previous history of PTB beyond 1 year, 81% of 32 individuals with a previous history of extra-pulmonary TB, 93% of 107 individuals with active or past TB with another HIV-related disease and 89% of 158 individuals with active or past TB without another HIV-related disease.In our setting, nine of 10 HIV-positive individuals presenting in WHO Stage III and IV and with active or previous TB have CD4 counts of < or = 350 cells/microl. It would thus be reasonable, in this or similar settings where CD4 counts are unavailable for clinical management, for all such patients to be considered eligible for antiretroviral therapy.

History of tuberculosis

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Tuberculosis among Health Care Workers

Emerging infectious diseases (2011)

Iacopo Baussano Paul Nunn Brian Williams Emanuele Pivetta Massimiliano Bugiani

Abstract To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50–100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%–4.6%), 6.9% (95% CI 3.4%–10.3%), and 8.4% (95% CI 2.7%–14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2–3.6), 2.4 (95% CI 1.0–3.8), and 3.7 (95% CI 2.9–4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.

10.3201/eid1703.100947

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Citations (334)

Electronic recording and reporting system for tuberculosis in China: experience and opportunities

Journal of the American Medical Informatics Association (2013)

Fei Huang Siu Mee Cheng Xiangying Du W. Chen Fabio Scano

Tuberculosis (TB) surveillance in China is organized through a nationwide network of about 3200 hospitals and health facilities. In 2005, an electronic Tuberculosis Information Management System (TBIMS) started to be phased in to replace paper recording. The TBIMS collects key information on TB cases notified in TB care facilities, and exchanges real-time data with the Infectious Disease Reporting System, which covers the country's 37 notifiable diseases. The system is accessible to authorized users at every level of the TB network through a password-protected website. By 2009 the TBIMS achieved nationwide coverage. Completeness of data on patient bacteriological end points improved remarkably over time. Data on about a million active TB cases, including drug-resistant TB, are included each year. The sheer scale of the data handling and the intricate functions that the China TBIMS performs makes it stand apart from the electronic information systems for TB adopted in other countries.

Electronic data

10.1136/amiajnl-2013-002001

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Citations (69)

Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings

Carolina Digital Repository (University of North Carolina at Chapel Hill) (2008)

Graeme Meintjes Stephen D Lawn Fabio Scano Gary Maartens Martyn A. French

10.17615/p2xt-q966

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The Efficacy of Engineering and Personal Protective Interventions for Tuberculosis Infection Control: A Systematic Review.

DI Ling Madhukar Pai KA Hillier Fabio Scano

Personal Protective Equipment

10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a4779

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