Tuberculosis con resistencia a fármacos: nuevas definiciones de la OMS y su implicación en la Normativa de SEPAR / Drug Resistant Tuberculosis: New WHO Definitions and Their Implication in the SEPAR Guideline

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24 de marzo. Hacia el fin de la tuberculosis sin dejar a nadie atrás / No disponible

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Treatment guidelines for latent tuberculosis infection.

The treatment of latent tuberculosis infection (LTBI) has been established as valid for patients at high risk for developing active tuberculosis. Treatment of LTBI is also considered an important strategy for eliminating tuberculosis (TB) in Japan. In recent years, interferon-gamma release assays have come into widespread use; isoniazid (INH) preventive therapy for HIV patients has come to be recommended worldwide; and there have been increases in both types of biologics used in the treatment of immune diseases as well as the diseases susceptible to treatment. In light of the above facts, the Prevention Committee and the Treatment Committee of the Japanese Society for Tuberculosis have jointly drafted these guidelines. In determining subjects for LTBI treatment, the following must be considered: 1) risk of TB infection/ development; 2) infection diagnosis; 3) chest image diagnosis; 4) the impact of TB development; 5) the possible manifestation of side effects; and 6) the prospects of treatment completion. LTBI treatment is actively considered when relative risk is deemed 4 or higher, including risk factors such as the following: HIV/AIDS, organ transplants (immunosuppressant use), silicosis, dialysis due to chronic renal failure, recent TB infection (within 2 years), fibronodular shadows in chest radiographs (untreated old TB), the use of biologics, and large doses of corticosteroids. Although the risk is lower, the following risk factors require consideration of LTBI treatment when 2 or more of them are present: use of oral or inhaled corticosteroids, use of other immunosuppressants, diabetes, being underweight, smoking, gastrectomy, and so on. In principle, INH is administered for a period of 6 or 9 months. When INH cannot be used, rifampicin is administered for a period of 4 or 6 months. It is believed that there are no reasons to support long-term LTBI treatment for immunosuppressed patients in Japan, where the risk of infection is not considered markedly high. For pregnant women, HIV-positive individuals, heavy drinkers, and individuals with a history of liver injury, regular liver function tests are necessary when treatment is initiated and when symptoms are present. There have been reports of TB developing during LTBI treatment; therefore, attention should be paid to TB development symptoms. When administering LTBI treatment, patients must be educated about side effects, the risk of developing TB onset, and the risks associated with discontinuing medication. Treatment outcomes and support for continuation of treatment are evaluated in cooperation with health centers. As stipulated by the Infectious Diseases Control Law, doctors are required to notify a health center when an individual develops TB. Based on this notification, the health center registers the patient, sends a public health nurse to visit the patient and give instructions, and provides medication adherence support. The patient applies at a health center for public expenses for medical care at a designated TB care facility. Pending approval in a review by an infectious disease examination council, the patient's copayment is reduced.

[Prospects for the renovation of the medical system for tuberculosis and human resource development in the near future].

The status of tuberculosis (TB) in Japan was changed to decline and decreased dramatically after The World War II with the great nationwide efforts. Along with the decrease of TB people's attentions to tuberculosis has been reducing significantly, including the medical personnel. In the 1990s, TB returned to increase again, then Emergency Declaration against TB by Minister of Health and Welfare in 1999 drew the public attentions to TB again. Unfortunately, however, there have been many hospitals that cannot deal with TB properly. On the other hand, non-tuberculous mycobacteriosis (NTM) is increasing recently, which bothers many physicians or pulmonologists. "Japanese Respiratory Society" (JRS) was founded as "Japan Society of Chest Diseases" derived from "Japanese Society for Tuberculosis" (JSTB) in 1961, when almost all the members were the members of both the Societies. Now, after 50 years of JRS foundation, only one in four members of JRS may join to JSTB. However, the needs for training opportunities about TB and NTM do exist indeed, which is suggested by the fact that "Tuberculosis course", the joint program with JSTB, held in every annual JRS meeting has been filled with a lot of standing audience. In order to support these needs for training about TB, JSTB began the Certification System for TB and NTM in 2011. More than 1,000 certified physicians were born so far. In addition, the decreased number of JSTB members has returned to increase significantly. The most important challenge is to make a future countermeasure against TB and NTM, and also to promote the development of human resources based on the current situation and forecast of TB. This symposium was planned along the theme of this congress, "TB control for the next generation" in response to the wishes of the Congress President Dr. Yamagishi. On behalf of the Ministry of Health, Labour and Welfare, Dr. Yoshizawa talked about the future measures and challenges, and the human resource development for the future, based on the current situation of the medical system for tuberculosis. Dr. Fujita, the chairman of the committee of the certification system, talked about the JSTB Certification System, and the prospect of the human resource development. Dr. Nagai talked about the training opportunities for TB and NTM such as the "Educational seminar" in the annual meeting of JSTB or the "Tuberculosis course" in the annual meeting of JRS. Nurse and the Public health nurse are also the important members of the medical team for TB. Ms. Nagata talked about the human resources development of nurse responsible for tuberculosis care. Finally, Dr. Kudo, who originally proposed the JSTB Certification System as the chairman of the future planning committee, addressed the history and the foresights of the near future medical care system for TB as a special remark. We wish all the members may share the prospects of future medical care for TB and NTM, which may help for improving the future medical system.

Promoción y fortalecimiento de la participación y organización social de las personas afectadas con tuberculosis y la comunidad para disminuir la tuberculosis: Sistematización de la experiencia en Lima y Callao / Promotion and strengthening of social organization and participation of those affected with tuberculosis and the community to reduce TB: systematization of experience in Lima and Callao

La presente publicación recoge las experiencias de las acciones de cuatro actividades implementadas en el desarrollo del objetivo 1 del programa de prevención y control de la tuberculosis. Para ello se ha considerado tres ejes temáticos: 1. Promoción y fortalecimiento de los agentes comunitarios de salud para la prevención y control de la tuberculosis; 2. Capacitación y apoyo para la generación de ingresos a pacientes con tuberculosis y/o sus familiares y 3. Formación de promotores educativos pares en la lucha contra la tuberculosis(AU)

Promoción y fortalecimiento de la participación y organización social de las personas afectadas con tuberculosis y la comunidad para disminuir la tuberculosis: Sistematización de la experiencia en Lima y Callao / Promotion and strengthening of social organization and participation of those affected with tuberculosis and the community to reduce TB: systematization of experience in Lima and Callao

La presente publicación recoge las experiencias de las acciones de cuatro actividades implementadas en el desarrollo del objetivo 1 del programa de prevención y control de la tuberculosis. Para ello se ha considerado tres ejes temáticos: 1. Promoción y fortalecimiento de los agentes comunitarios de salud para la prevención y control de la tuberculosis; 2. Capacitación y apoyo para la generación de ingresos a pacientes con tuberculosis y/o sus familiares y 3. Formación de promotores educativos pares en la lucha contra la tuberculosis

Situación epidemiológica actual de la tuberculosis en la Ciudad de Nueva York / No disponible

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[Phthisiobacteriological service in the Republic of Sakha]. / Sostoianie ftiziobakteriologicheskoí sluzhby v Respublike Sakha.

The paper shows it expedient to decentralize the bacteriological service system by setting up a wide net of laboratory rooms at district antituberculosis dispensaries, as shown in the Republic of Sakha (Yakutia). The establishment of a branched network of bacteriological rooms and the introduction of procedures of centralized preparation of yolk culture media as an intermediate products allowed the cohort of tuberculosis and risk groups to be bacteriologically studied to a greater extent.