Tuberculosis: Laboratory Diagnosis and Treatment Strategies
Tuberculosis is a disease of poverty aff ecting adults in their most productive years. In 2010, there were 8.8 million incident cases with 1.1 million tuberculosis deaths in patients not infected with HIV. A further 0.35 million deaths were associated with HIV-positive patients (WHO, 2011). Th...
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| Tác giả chính: | |
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| Định dạng: | Sách |
| Ngôn ngữ: | English |
| Được phát hành: |
2014
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| Những chủ đề: | |
| Truy cập trực tuyến: | https://scholar.dlu.edu.vn/thuvienso/handle/DLU123456789/37180 |
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| Thư viện lưu trữ: | Thư viện Trường Đại học Đà Lạt |
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| Tóm tắt: | Tuberculosis is a disease of poverty aff ecting adults in their most productive years. In 2010,
there were 8.8 million incident cases with 1.1 million tuberculosis deaths in patients not
infected with HIV. A further 0.35 million deaths were associated with HIV-positive patients
(WHO, 2011). These ot -quoted fi gures demonstrate the challenge that tuberculosis control
presents and this book highlights the state of the art in the mainstays of tuberculosis control:
laboratory diagnosis and treatment.
Tuberculosis control is a multifaceted problem, but positive identifi cation of the tubercle
bacillus and assessment of its drug susceptibility are essential components in the strategy. It is
telling that in 2010, 8 out of 22 high-burden countries did not meet the benchmark of 1
microscopy unit per 100,000 population. Furthermore, in a combined list of 36 countries that
were high-burden countries and/or high MDR-TB burden countries, 20 had less than the
benchmark of one laboratory capable of culture and drug sensitivity testing per 5 million
population (WHO, 2011). It is hoped that the rational approach to conventional testing and
roll-out of novel technologies described here will serve to provide cost-eff ective and robust
technologies that will improve delivery of diagnostic services in resource-poor set ings.
For many years, there was stasis in the development of drugs for the treatment of
tuberculosis. The HIV pandemic and, more recently, the development of MDR- and XDR-TB
(and indeed now TDR-TB) have changed our perspective. New drugs are being developed and
our approaches to evaluating them require review. The spectrum of this activity is outlined in
chapters covering the fundamental biology of drug action (Chapters 12 and 13), as well those
focused on clinical trial methodology (Chapters 10, 11 and 15).
I have included three examples of approaches to new drug development; the ATC
compounds (Chapter 16) represent a design-based approach in which the ATC scaff old is
designed to inhibit the fat y acid synthase pathway. By comparison, Chapters 17 and 18 discuss
repurposing established drugs: in Chapter 17 the rifamycins are revisited and Chapter 18
discusses how the imperative of MDR-TB has driven the reconsideration of thioridazine. Of
course, matching these developments are exciting developments in vaccine design and these
are captured in Chapter 19. |
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