T. Arnadottir

International Union Against Tuberculosis and Lung Disease

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Arnaud Trébucq

International Union Against Tuberculosis and Lung Disease

Donald A. Enarson

International Union Against Tuberculosis and Lung Disease

Einar Heldal

Norwegian Institute of Public Health

H. L. Rieder

Royal United Hospital Bath NHS Trust

Tardencilla Gutierrez Aa

Cruz

Centro Escolar University

A Tardencilla

Kasalika Ac

Enarson Da

International Union Against Tuberculosis and Lung Disease

M. Gninafon

Progamme National Contre le Tuberculose

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International Union Against Tuberculosis and Lung Disease

London School of Hygiene & Tropical Medicine

Stellenbosch University

University of Alberta

University of British Columbia

Progamme National Contre le Tuberculose

Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA

Université d'Abomey-Calavi

Norwegian Institute of Public Health

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Prevalence and annual risk of tuberculosis infection in Laos.

PubMed (2001)

T. Arnadottir H Soukaseum P Vangvichit Soth Bounmala V Prasanna E

Laos, where the implementation of a national tuberculosis program started in 1995.To estimate the prevalence (P) and annual risk of tuberculosis infection (ARTI) and relate this to case rates in the tuberculosis program.Tuberculin survey in schools in Vientiane municipality and three provinces. Sampling was not representative, but included schools in accessible districts in provinces with different characteristics. A group of 150 tuberculosis patients were tested for comparison.An intra-dermal tuberculin test (PPD RT23/ Tween80) was applied to 11237 children; 9968 reactions were read, 4035 among first and second grade children with no BCG scar: 818 in Vientiane (mean age 8.4), 803 in Savannakhet (8.9), 1563 in Xiengkhuang (8.4), and 851 in Luangprabang (7.9). If reactions of > or =10 mm are counted, ARTI is estimated as 1.1% for the areas included in the survey with a strong variation by province (Vientiane 1.3%; Savannakhet 1.4%; Luangprabang 0.6%; Xiengkhuang 0.1%). The difference in ARTI is in accordance with differences in reported case rates in the provinces. The ARTI varied from 0.5% to 1.2%, depending on the method used for calculating P (Vientiane 0.6%-1.4%; Savannakhet 0.5-1.5%; Xiengkhuang 0.1%-0.2%; Luangprabang 0.4%-0.9%).The ARTI is unequally distributed geographically and/or by ethnic group. It is generally higher in south and lower in central and north Laos. Improved methods are needed for estimating the prevalence of infection.

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Citations (16)

Tuberculosis case-finding in Nicaragua: evaluation of routine activities in the control programme

Tubercle and Lung Disease (1994)

José Ramón Alvero Cruz Einar Heldal T. Arnadottir Ireri Ocampo Juárez Donald A. Enarson

Tuberculosis control

10.1016/0962-8479(94)90114-7

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Guidelines for conducting tuberculin skin test surveys in high prevalence countries

Tubercle and Lung Disease (1996)

T. Arnadottir H. L. Rieder Arnaud Trébucq Hans Th. Waaler

Tuberculin test

Skin test

10.1016/s0962-8479(96)90127-6

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Citations (144)

Management of tuberculosis : a guide for low income countries

D. A. Enarson H. L. Rieder T. Arnadottir Arnaud Trébucq

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Successful management of a national tuberculosis programme under conditions of war.

PubMed (1997)

Einar Heldal Cruz T. Arnadottir A Tardencilla Enarson Da

To compare treatment results before and after introduction of short course tuberculosis chemotherapy and to identify factors affecting the results.An eight-month chemotherapy regimen for smear-positive pulmonary tuberculosis was introduced in Nicaragua in 1984 with external financial assistance. We performed a retrospective record review to compare treatment results before and after introduction of short-course chemotherapy. Information on support services and programme administration, availability of hospital beds for tuberculosis patients, access to health services and the economic and war situation in the two periods was assessed.The overall success ratio improved by 39% between the two periods reviewed, in spite of evidence of a deteriorating economy and escalation in civil war. A success ratio of 71% was achieved and we estimate that between 80 and 90% of registered cases stopped transmitting tuberculosis. The best results were obtained in the treatment of previously untreated patients with eight-month chemotherapy and in retreatment of relapses. The worst results were obtained in retreatment of defaulters. Analysis of the findings by region suggests that short-course chemotherapy was important, but not enough by itself to guarantee success. Factors likely to have influenced treatment results are: commitment by health authorities in guaranteeing personnel and hospital beds, training of personnel, and supervision of service delivery. Possibilities for further improvement are discussed.Good results were achieved in tuberculosis control with the introduction of short-course chemotherapy in spite of poverty and war. Government commitment and simultaneous improvement in supportive services and programme management is important when introducing short-course chemotherapy in low income countries.

Short course

Regimen

Chemotherapy regimen

Tuberculosis control

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Citations (19)

Tuberculosis treatment: dangerous regimens?

PubMed (2001)

Hans L. Rieder T. Arnadottir Arnaud Trébucq Donald A. Enarson

The results of the USPHS Study are a warning of the potentially frightening consequences of functional monotherapy. While it remains a single study the question arises as to whether it is justified to await confirmatory studies before reconsidering recommendations for anti-tuberculosis treatment in national tuberculosis programs in low-income countries. We conclude that the utilization of isoniazid and rifampicin in the continuation phase should be discouraged in settings where second-line drugs are not routinely available for re-treatment of failures particularly if HIV infection is prevalent in the patient population and there is important resistance to isoniazid. (excerpt)

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Citations (41)

Assessment of tuberculosis: Is ‘rapid assessment’ needed?

Tubercle and Lung Disease (1995)

T. Arnadottir

Survey Methodology

10.1016/0962-8479(95)90000-4

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Citations (1)

Evaluation of a standardized recording tool for sputum smear microscopy for acid-fast bacilli under routine conditions in low income countries.

PubMed (1997)

Rieder Hl T. Arnadottir Tardencilla Gutierrez Aa Kasalika Ac Salaniponi Fl

Laboratories performing sputum smear microscopy for tuberculosis in Benin, Malawi, Nicaragua and Senegal.Analysis of computerized laboratory registers to ascertain workload, yield from serial smear examination, and demographic characteristics of examinees.Data from more than 60,000 examinees in 42 laboratories showed that the average number of smears examined per day ranged from 4 to 19 (mean 6) per country. To find one case of tuberculosis, on average 21 smears of suspects were examined (range 8 to 50). Of all cases with ultimately at least one positive result, 87% were already positive on the first examination. Demographic characteristics of cases differed considerably by country and gender. In 35 of 42 laboratories, males were more frequently found to be cases than females, and with increasing age an increasingly larger number of female than male suspects had to be examined to identify one case.This study demonstrates the usefulness of a standardized recording system for results of acid-fast microscopy in obtaining essential information for program management and on demographic characteristics of persons presenting for examination.

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Citations (23)