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Development of a cost-effective drug sensitivity test for multi-drug resistant and extensively drug-resistant tuberculosisPatel, Fadheela January 2010 (has links)
Thesis (MTech (Biomedical Technology))--Cape Peninsula University of Technology, 2010 / The World Health Organisation estimates that nine million people are infected with
tuberculosis (TB) every year of which ninety-five percent live in developing countries.
Africa has one of the highest incidences of TB in the world. but few of its countries are
equipped to diagnose drug-resistant TB. This study aimed to develop a robust. yet
simple and cost-effective assay. which would require minimal sophisticated
instrumentation and specialised personnel that would make drug sensitivity screening for
multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis
(XDR-TB) accessible to resource-poor high-burden settings.
A four-quadrant colorimetric agar plate method was developed which showed good
specificity (97.3%-100%) and sensitivity (77.8%-100%) compared to the polymerase
chain reaction (PCR) method used as gold standard. Agreement between the methods.
using Simple Kappa Coefficients. ranged between very good and excellent. all with high
statistical significance (P < 0.0001). The currently used BACTEC MGIT SIREN
sensitivity assay coupled with the E-test® strip method. as routinely used in the TB
reference laboratory. was compared and showed excellent comparison with the newlydeveloped
plate method. for each antibiotic tested. as well as the resultant monoresistant,
MDR- or XDR-TB diagnoses. Moreover. the new method was found to be
extremely cost-effective. priced at half the cost of a peR assay.
These four quadrant plates. with a colorimetric indicator and selected antibiotics. can be
considered as an economic altemative or a complimentary method for laboratories
wishing to reduce the cost and complexity for TB drug sensitivity testing. Routine
diagnostic testing would thus be made more accessible and affordable to laboratories
that are not presently diagnosing drug resistant TB. therefore enhancing case detection
and treatment in the resource-poor settings hardest hit by this curable disease.
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An analysis of the contact patterns perpetuating the transmission of tuberculosis in two high incidence communities in the Cape Town Metropolitan areaClassen, Collette Natasha January 1997 (has links)
Magister Artium - MA (Anthropology/Sociology) / Biomedicine positively maintains that tuberculosis transmission occurs due to close
contact with a diseased individual (Coovadia and Benatar, 1991). Consequently, this
refers to a direct mode of transmission where individuals are at direct risk of
becoming infected.
It is often taken for granted that when one speaks of contact within the context of
tuberculosis, one is necessarily referring to contact or interactions among tuberculosis
patients and people in the community with whom they have contact of any nature. It
is then assumed that tuberculosis is transmitted in this manner. However, there are
also indirect modes of transmission which are often neglected to be explored, but
have an equally serious effect on transmission in high incidence areas. This paper
also addresses other contact patterns that are also role-players in the tuberculosis
epidemic.
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Screening for childhood pulmonary tuberculosis infection: a diagnostic strategy in a developing countryGeetha, Bharathi. January 2002 (has links)
published_or_final_version / Medical Sciences / Master / Master of Medical Sciences
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A conceptual model of tuberculosis transmission risk in free-ranging bison herds of northern CanadaDewar, David 04 April 2012 (has links)
Tuberculosis transmission in free-ranging bison of northern Canada is of significant
concern to wildlife managers because of its effects on condition and mortality in bison herds and
the potential for transmission to local hunters and neighbouring cattle populations. The chronic
nature of tuberculosis combined with the gregarious behaviours of bison permit its persistence in
free-ranging herds even at low densities, which makes disease eradication difficult without
whole herd depopulation. The protection of remaining non-infected free-ranging bison
populations is thus of paramount importance to the conservation of specific disease-free wild
bison in northern Canada and to the economic stability of cattle farms. Detection of movements
and removal of dispersing animals between spatially separated free-ranging populations reduces
the potential for contact between bison populations and minimizes the probability of tuberculosis
transmission. In this thesis, a conceptual model was developed to assess the potential for
tuberculosis transmission between two infected bison herds (Nyarling River and Garden River)
in Wood Buffalo National Park and the spatially separated, Mackenzie Bison herd in the
Northwest Territories. This conceptual model identifies gaps in knowledge and highlights areas
where research is required to ensure accurate evaluation of tuberculosis transmission risk in freeranging
bison. The main finding was that the bison cohort representing the highest risk for
tuberculosis transmission between spatially separated free-ranging herds is mature males. The
propensity of mature males to make long-distance movements is also not fully understood and
research to predict these movements would make a significant contribution to risk assessment
and management planning to reduce the probability of contact between infected and non-infected
bison populations.
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The determinants of tuberculosis transmission in Indigenous people in Canada and New ZealandGrant, Jessica M. 04 July 2011
The disparity in tuberculosis rates between Indigenous and non-Indigenous people persists in Canada and New Zealand. The most common form of tuberculosis in humans is pulmonary tuberculosis so eliminating tuberculosis transmission is an important obstacle to decreasing the overall rates of the disease. In both Canada and New Zealand, social determinants of health such as housing conditions, access to health care and historical influences (including similar experiences with colonization) have been implicated in the high rates of tuberculosis. This thesis examines and compares the social determinants of tuberculosis transmission among Aboriginal people in the Canadian province of Alberta and Maori and Pacific people in New Zealand.
In Alberta, ten Aboriginal individuals with smear-positive pulmonary tuberculosis participating in a larger prairie wide study were divided into two groups (transmitter and non-transmitter) based on transmission events identified through contact tracing and DNA fingerprinting. Interviews with the ten participants were analyzed and compared using an interpretive phenomenological perspective and informed by an Aboriginal framework of health. Survey data from the same individuals provided complementary descriptive statistics. In New Zealand, interviews with Maori and Pacific pulmonary TB participants that had been conducted as part of other studies were accessed and analyzed using an interpretive phenomenological perspective. Like in Canada, Indigenous frameworks of health specific to Maori and Pacific people informed the analysis.
The Canadian analysis identified three factors of greater relevance within the transmission group: substance use, patient-delay-in-seeking-treatment, and number of contacts. These factors were also relevant for the Maori and Pacific experience of tuberculosis. The results of this cross-cultural comparative study highlight the complexity of the experience of tuberculosis for Indigenous people in both Canada and New Zealand. Future research and education and intervention programs must not only consider the proximal social determinants of health, such as poverty, unemployment, etc, but also the more distal social determinants of health and the causes of causes such as colonization and its multi-generational effects.
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The determinants of tuberculosis transmission in Indigenous people in Canada and New ZealandGrant, Jessica M. 04 July 2011 (has links)
The disparity in tuberculosis rates between Indigenous and non-Indigenous people persists in Canada and New Zealand. The most common form of tuberculosis in humans is pulmonary tuberculosis so eliminating tuberculosis transmission is an important obstacle to decreasing the overall rates of the disease. In both Canada and New Zealand, social determinants of health such as housing conditions, access to health care and historical influences (including similar experiences with colonization) have been implicated in the high rates of tuberculosis. This thesis examines and compares the social determinants of tuberculosis transmission among Aboriginal people in the Canadian province of Alberta and Maori and Pacific people in New Zealand.
In Alberta, ten Aboriginal individuals with smear-positive pulmonary tuberculosis participating in a larger prairie wide study were divided into two groups (transmitter and non-transmitter) based on transmission events identified through contact tracing and DNA fingerprinting. Interviews with the ten participants were analyzed and compared using an interpretive phenomenological perspective and informed by an Aboriginal framework of health. Survey data from the same individuals provided complementary descriptive statistics. In New Zealand, interviews with Maori and Pacific pulmonary TB participants that had been conducted as part of other studies were accessed and analyzed using an interpretive phenomenological perspective. Like in Canada, Indigenous frameworks of health specific to Maori and Pacific people informed the analysis.
The Canadian analysis identified three factors of greater relevance within the transmission group: substance use, patient-delay-in-seeking-treatment, and number of contacts. These factors were also relevant for the Maori and Pacific experience of tuberculosis. The results of this cross-cultural comparative study highlight the complexity of the experience of tuberculosis for Indigenous people in both Canada and New Zealand. Future research and education and intervention programs must not only consider the proximal social determinants of health, such as poverty, unemployment, etc, but also the more distal social determinants of health and the causes of causes such as colonization and its multi-generational effects.
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The geography of tuberculosis and its transmission on the Island of Montreal /Haase, Ian. January 2005 (has links)
While the overall annual incidence of tuberculosis (TB) on the Island of Montreal has been stable at 10 per 100,000 in recent years, incidence varies tremendously by country of birth and by neighbourhood. It is not clear how much of this variation reflects population distribution, and how much reflects localized risk factors and/or local transmission. Precise mapping and spatial statistical analysis allowed for the identification of two types of TB concentrations: hotspots---raw concentrations of cases, and high-incidence zones---where TB incidence significantly exceeds the rate expected. The high-incidence zones were not fully explained by known risk factors for TB, such as high population densities or low incomes, when aggregated at the census tract level. The results were linked with Mycobacterium tuberculosis genotyping data to search for evidence of recent transmission. We found that there is substantial aggregation of TB in Montreal, beyond the concentration of the foreign-born as a group, and evidence of recent transmission contributing to high incidence was uncovered in one area of the city.
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The geography of tuberculosis and its transmission on the Island of Montreal /Haase, Ian. January 2005 (has links)
No description available.
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Distinct immune profiles of recently exposed household contacts in a tuberculosis endemic setting in the Western CapeNgombane, Nokwanda Crystal 03 1900 (has links)
Thesis (MScMedSc)--University of Stellenbosch, 2011. / Please refer to full text to view abstract.
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The development of a novel fluorescentmarker phage technology system for the early diagnosis of tuberculosis diseaseVan der Merwe, Ruben Gerhard 12 1900 (has links)
Thesis (PhD)--Stellenbosch University, 2012. / Includes bibliography / ENGLISH ABSTRACT: Mycobacterium tuberculosis, the causative organism of tuberculosis (TB), is a major cause for mortality and
morbidity world-wide with a death toll only second to HIV among infectious diseases. Drug resistance is widespread
and cases of multiple drug resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB) have
emerged in several countries. Drug treatment is problematic and new drugs are not developed rapidly
enough to offset the rapid drug resistance mutation rate of M. tuberculosis. Simple and effective diagnostics
are required to contain the spread of the disease as current routine diagnostics are not fulfilling this role.
Additionally, current rapid TB diagnostics are out of reach to resource poor settings due to infrastructure, cost
and skill requirements. Novel TB diagnostics are thus required that meet these requirements.
Mycobacteriophages are phages that infect mycobacteria and could offer a viable and cost effective
alternative rapid TB diagnostics. In this study, an affinity-tagged fluorescent reporter mycobacteriophage is
described, which was engineered to act as a TB diagnostic. Its performance proved favourable and superior
to current existing mycobacteriophage-based TB diagnostics. / AFRIKAANSE OPSOMMING: Mycobacterium tuberculosis, die organisme verantwoordelik vir tuberkulose (TB), is `n groot bron van
mortaliteit en morbiditeit wêreldwyd en slegs HIV is verantwoordelik vir groter getalle sterftes as gevolg van n
aansteeklike siekte. Middelweerstandigheid is algemeen en gevalle van meervoudigemiddelweerstandige
tuberkulose (MDR-TB) en uiters weerstandige tuberkulose (XDR-TB) kom in verskeie lande voor. Antibiotika
behandeling is problematies en nuwe anti-TB middels word nie vinnig genoeg ontwikkel om die antibiotika
weerstandigheid mutasie spoed van M. tuberculosis te bekamp nie. Doeltreffende diagnostiese toetse word
benodig om die verspreiding van die siekte te beheer en bestaande roetine diagnostiese toetse voldoen tans
nie aan hierdie vereiste nie. Behalwe hiervoor, is huidige vinnige TB diagnostiese toetse buite bereik van arm
instansies weens vereistes aan infrastruktuur, meegaande kostes en werknemervaardigheid. Nuwe TB
diagnostiese toetse is dus nodig om aan hierdie vereistes te voldoen. Mikobacteriofaage is fage wat
mikobacteria infekteer en kan moontlik 'n lewensvatbare en koste-effektiewe alternatief bied vir
vinnige TB diagnostiese toetse. In hierdie studie word 'n affiniteitgekoppelde fluoreserende
rapporteringsmikobakteriofaag beskryf wat ontwerp is om op te tree as `n nuwe vinnige TB diagnostiese
toets. Die werking hiervan vertoon gunstige en beter resultate as die huidige, mikobacteriofaaggebaseerde
TB-diagnostiese toetse.
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