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A Trébucq

Publications and source records attributed to A Trébucq.

12 recordsLinked to original sources
PubMed2005

Prevalence and trends of infection with Mycobacterium tuberculosis in Djibouti, testing an alternative method.

SETTING: Djibouti, 1994 and 2001. OBJECTIVE: To estimate the prevalence of tuberculosis (TB) and average annual risk of TB infection (ARTI) and trends, and to test a new method for calculations. METHODS: Tuberculin surveys among schoolchildren and sputum smear-positive TB patients. Prevalence of infection was calculated using cut-off points, the mirror image technique, mixture analysis, and a new method based on the operating characteristics of the tuberculin test. Test sensitivity was derived from tuberculin reactions among TB patients and test specificity from a comparison of reaction size distributions among children with and without a BCG scar. RESULTS: The ARTI was estimated to lie between 2.6% and 3.1%, with no significant changes between 1994 and 2001. The close match of the distributions between children tested in 1994 and patients justifies the utilisation of the latter to determine test sensitivity. This new method gave very consistent estimates of prevalence of infection for any induration for values between 15 and 20 mm. Specificity was successfully determined for 1994, but not for 2001. Mixture analysis confirmed the estimates obtained with the new method. CONCLUSION: Djibouti has a high ARTI, and no apparent change over the observation time was found. Using operating test characteristics to estimate prevalence of infection looks promising.

Bayes Theorem↗
PubMed2004

Outcome of tuberculosis retreatment in routine conditions in Cotonou, Benin.

SETTING: National Tuberculosis Programme (NTP), Cotonou, Benin. OBJECTIVE: To study the patient characteristics and outcome of tuberculosis retreatment cases in a well-functioning NTP. METHODS: A retrospective, register-based study of all smear-positive pulmonary tuberculosis cases put on retreatment (2SERHZ/1ERHZ/5R3H3E3) between 1992 and 2001 in Cotonou. For comparison, information on new smear-positive cases in Cotonou in 1999 was entered and analysed. RESULTS: Of 8103 tuberculosis patients registered, 642 were put on retreatment. The analysis is mainly based on the 236 patients whose initial treatment regimen records were available (113 relapses, 84 failures, 39 returns after default). Most of the relapse (57%) and return after default (72%) cases were put on retreatment within 12 months after stopping their initial treatment. Overall, the retreatment results were satisfactory (78% success) and comparable with those of new cases (82%); the failure rates were low (3%), as were those for initial treatment (1%). There were more defaulters from retreatment among those who had already defaulted from initial treatment (21%). Treatment success rates were better among women than men. CONCLUSION: The standardised retreatment regimen is effective in Cotonou, probably because the NTP is functioning well, there are no drug shortages, drug taking is strictly supervised, and a good treatment plan is followed.

Adult↗
PubMed2004

[Tuberculosis control in the world: results and challenges].

The modern tuberculosis control strategy, which focuses on identifying and curing infectious cases, has made remarkable progress in recent years. This strategy, known as DOTS, receives significant support from bilateral and multilateral donors, in particular from the recently created Global Fund against AIDS, Tuberculosis and Malaria. Although case finding rates are still far too low everywhere in the world (45%), cure rates among infectious cases (target 85%) are progressing, but are still too low in Africa (71%). Nevertheless, the spread of the HIV/AIDS epidemic had led to a dramatic increase in the number of tuberculosis cases, even in countries where tuberculosis programmes have been functioning well for several years; in those countries that are heavily affected by HIV/AIDS, tuberculosis seems to be difficult to control if no progress is made in controlling the HIV epidemic. Health services are often too centralised, particularly in the big cities, and all health structures need to be involved in fighting tuberculosis. Treatment possibilities are limited; new research has been initiated to find new anti-tuberculosis drugs, but it is extremely important to take care to avoid the development of resistance to those drugs that are available. The main challenge in vanquishing tuberculosis is still that of development, mainly of the health services, and particularly their human resources. Tuberculosis elimination is necessarily a long-term goal that will require constant effort spanning several decades.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Prevalence of primary and acquired resistance of Mycobacterium tuberculosis to antituberculosis drugs in Benin after 12 years of short-course chemotherapy.

SETTING: Benin National Tuberculosis Programme, West Africa. OBJECTIVE: To measure the prevalence of primary and acquired resistance of Mycobacterium tuberculosis to the antituberculosis drugs isoniazid, rifampicin, ethambutol and streptomycin in Benin from 1994-1995, after 12 years of short-course chemotherapy regimens. METHODS: Prospective study by cluster sampling according to the methodology recommended by the International Union Against Tuberculosis and Lung Disease (IUATLD) and the World Health Organization (WHO). RESULTS: The survey of primary resistance included 333 strains, of which 28 (8.4%) were drug-resistant, one to both rifampicin and isoniazid (multidrug-resistant). For acquired resistance, out of 57 strains tested 26 (45.6%) were resistant, six of which (11%) were multidrug-resistant. CONCLUSION: Despite the considerable increase in the number of tuberculosis cases observed in recent years (52% between 1987 and 1995), direct observation of patients taking their antituberculosis drugs during the intensive phase of treatment has limited the development of drug resistance in Benin.

Adolescent↗
PubMed1999

Requirements for anti-tuberculosis drug tender requests.

As more and more institutions and experts push for the use of fixed-dose combinations (FDC) of anti-tuberculosis drugs, the market will most probably change dramatically in the next few years. Prices should go down, but quality must remain an essential goal for managers in charge of the procurement process. General essential requirements for suppliers submitting for competitive bidding are reviewed, and in particular the WHO certification scheme. Even though the scheme does not dispense with the need to submit drugs to the quality control procedures required in the importing country, it is a very useful tool which should be encouraged in the supply process. Specific requirements for FDCs are discussed, particularly interpretation of the bioavailability tests which are compulsory for rifampicin-containing FDCs.

Adult↗
PubMed1998

Information management in national tuberculosis control programmes and national health information systems.

A good notification system is one of the key elements for the success of national tuberculosis programmes (NTPs). The national health information system (NHIS) in low income countries is often weak and unreliable. When restructuring this system, what circuit should be used to integrate TB data: the NTP or the NHIS? Experience from several countries shows that unlike the NHIS, only the data generated by the NTP are reliable and complete, and arrive rapidly enough to be used for programme management. It is therefore the duty of the NTP to collect this information and transmit it to the NHIS at each level of the health system. These were the conclusions of a seminar held in Cotonou, Benin, organised by the International Union Against Tuberculosis and Lung Disease, which involved the leaders of the NHIS and of NTPs of six West African countries.

Africa↗
PubMed1997

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

SETTING: Laboratories performing sputum smear microscopy for tuberculosis in Benin, Malawi, Nicaragua and Senegal. METHODS: Analysis of computerized laboratory registers to ascertain workload, yield from serial smear examination, and demographic characteristics of examinees. RESULTS: 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. CONCLUSIONS: 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.

Adolescent↗
PubMed1997

Should ethambutol be recommended for routine treatment of tuberculosis in children? A review of the literature.

SETTING: Review of the literature referenced from Medline and other sources on the use of ethambutol in children. OBJECTIVE: The most well-known side effect of ethambutol is its ocular toxicity. Its use among children is thus generally discouraged. The present article summarizes the studies published on this subject. RESULTS: No authors have reported major ocular side effects among children treated with ethambutol. CONCLUSION: For children aged 5 years or more, ethambutol can be recommended at a dosage of 15 mg/kg/day for routine treatment, without taking more precautions than for adults; this should be included in official recommendations. For younger children, ethambutol can also be used without undue fear of side-effects.

Adolescent↗