Navigation Links
Two Ways to Tackle Tuberculosis
Date:6/3/2009

International screening program and new drug show promise in studies

WEDNESDAY, June 3 (HealthDay News) -- In the minds of most Americans, tuberculosis is a disease of the past.

However, statistics show it's still a major global health problem.

That's why two studies in the June 4 issue of the New England Journal of Medicine are important -- one describes an international effort to detect tuberculosis (TB) among immigrants and refugees coming to the United States, the other reports on highly promising results of a new drug to treat the disease.

According to the World Health Organization, there are nearly 9 million new TB cases and perhaps 1.5 million deaths from the disease annually. Even in the United States, the U.S. Centers for Disease Control and Prevention tallied up 13,293 new cases of TB in 2007.

The research on the new screening program is important because "a substantial portion of newly diagnosed cases in the United States is among foreign-born individuals," explained study author John A. Painter, a team leader for immigrant, refugee and migrant help at the CDC. The TB rate in that group is 9.8 times higher than among U.S.-born individuals -- 20.6 cases per 100,000 people versus 2.1 per 100,000 people for the native-born. Nearly 58 percent of the new TB cases in the United States in 2007 were diagnosed in the foreign-born group.

"The effort to identify persons with tuberculosis in this group is crucial in controlling the disease in the United States," Painter said.

The disease is not always easy to detect in a screening program, he said. "Someone may be infected with TB without having an active disease," Painter said. "One standard technology is a sputum smear. You look under a microscope for the disease. Unfortunately, it is not very sensitive. A new technique is to culture a specimen for six to eight weeks, which allows detection of even a low-level infection. This is more recent and somewhat more involved. It is not universally done. We are focusing on countries where there is a high rate and a large number of cases."

Those countries include Vietnam, the Philippines and China, Painter said.

In many cases, infection does not mean active disease, since the TB bacteria can lie dormant for years, he explained. "Ten percent of those who are infected will develop active TB in their lifetimes," Painter said.

So, follow-up exams often are required when an immigrant or refugee enters the United States. "Overseas screening can identify a large number of people at high risk for tuberculosis," said Yecai Liu, a CDC medical statistician who contributed to the report. "To maximize the benefit of the overseas program depends on local control programs. We have an active outreach policy, with a home visit and telephone calls recommended."

Treatment follows detection, and the other journal report describes promising results of a new drug tested in a controlled trial of individuals with a virulent form of the disease, called multidrug-resistant tuberculosis.

This is not the most dangerous form of TB. That title is held by a strain called extensively drug-resistant TB. There was an international public health scare in 2007 when an Atlanta lawyer was believed to have flown overseas for a European honeymoon with the extensively drug-resistant version of the disease, a fear that turned out to be unfounded.

But the multidrug-resistant form is deadly enough so that a new drug to fight it would be welcome.

The drug, designated TMC207, was discovered at the Belgian research laboratory of Tibotec, a subsidiary of the American drug company Johnson & Johnson. It has a unique strategy for attacking the tuberculosis bacterium, said Dr. David F. McNeeley, global medical leader for clinical development at Tibotec.

"All existing medications have different ways of attacking," McNeeley said. "Some interrupt protein synthesis, some interfere with DNA replication, some interrupt cell wall construction."

The new drug cripples the activity of ATP synthase, an enzyme that plays a key role in biological energy metabolism. It does that only in the TB bacterium, not in other cells.

The journal report describes a trial in which 47 people with multidrug-resistant tuberculosis were given either the usual cocktail of TB drugs and TMC207, or the usual cocktail and a placebo. After eight weeks, the TB bacteria was not found in 48 percent of those getting TMC207, compared to 9 percent of those getting conventional treatment.

That trial is just the first step in testing the effectiveness of TMC207, McNeeley said. "We are now enrolling another 150 patients to get six months' treatment," he said. "When those results come in, we will be able to decide what else to do with the drug."

It's impossible to say now whether TMC207 will ever be front-line treatment for tuberculosis, McNeeley said. "We still are in the early stage of development," he noted.

More information

Learn about tuberculosis and its treatment from the U.S. Centers for Disease Control and Prevention.



SOURCES: John A. Painter, team leader, immigrant, refugee and migrant health, U.S. Centers for Disease Control and Prevention, Atlanta; Yecai Liu, medical statistician, CDC; David F. McNeeley, M.D., global medical leader, clinical development, Tibotec, Yardley, Pa.; June 4, 2009, New England Journal of Medicine


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. The Year of Affordable Healthcare Brings Together San Francisco Community Groups to Tackle Healthcare Crisis
2. Technology Leaders, Patient Groups and Community Advocates Launch Effort to Tackle Chronic Disease Crisis in Washington State
3. WPSU Debuts New Series; 1st Show Tackles Neuroscience and the Military
4. Midbrook Tackles Medical Decontamination
5. In Two Weeks, Top CEOs From U.S. and Aboard Tackle Obamas Health Reform Plans at 6th Annual World Health Care Congress, April 14-16, Washington
6. New Online Program Helps Parents Tackle Childhood Obesity
7. Cooperative Exchange Meeting to Tackle Stimulus Package Effects
8. Bioengineered proteins: Trial confirms new way to tackle cancer
9. EXT Life Sciences Announces New Biotech Treatment that Tackles Root Cause of Graying Hair
10. Hampton Roads Ventures Tackles U.S. Healthcare Crisis Community by Community
11. Bill Clinton, Health Groups to Tackle Childhood Obesity
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Two Ways to Tackle Tuberculosis
(Date:6/27/2016)... California (PRWEB) , ... June 27, 2016 , ... "FCPX ... fully customizable inside of Final Cut Pro X," said Christina Austin - CEO of ... unique style. Final Cut Pro X users can now reveal the media ...
(Date:6/26/2016)... , ... June 27, 2016 , ... Quality metrics are ... in many ways they remain in the eye of the beholder, according to experts ... publication of The American Journal of Managed Care. For the full issue, click ...
(Date:6/26/2016)... Clarkston, Michigan (PRWEB) , ... June 26, 2016 ... ... respect to fertility once they have been diagnosed with endometriosis. These women need ... but they also require a comprehensive approach that can help for preservation of ...
(Date:6/25/2016)... ... 2016 , ... First Choice Emergency Room , the largest network of ... Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased to ... said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/24/2016)... Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... surgery procedures that most people are unfamiliar with. The article goes on to state ... procedures, but also many of these less common operations such as calf and cheek ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Revolutionary technology includes multi-speaker listening to conquer ... in advanced audiology and hearing aid technology, has today ... world,s first internet connected hearing aid that opens up ...      (Photo: http://photos.prnewswire.com/prnh/20160622/382240 ) , ... , TwinLink™ - the first dual communication ...
(Date:6/23/2016)... Research and Markets has announced the addition ... States, China, Japan, Brazil, United Kingdom, Germany, France, Italy, ... Surgical Procedure Volumes: Global ... surgical procedure volume data in a geographic context. The ... of growth drivers and inhibitors, including world population growth, ...
(Date:6/23/2016)... 23, 2016  The National Pharmaceutical Council (NPC) ... health policy research organization as its newest member.  ... senior vice president and chief scientific officer, Mallinckrodt ... the NPC Board of Directors. ... has joined us in support of our efforts ...
Breaking Medicine Technology: