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Chao Gao, Cuiting Peng, Yaojie Shi, Xinyu You, Kai Ran, Lu Xiong, Ting-hong Ye, Lidan Zhang, Ningyu Wang, Yongxia Zhu, Kun Liu, Weiqiong Zuo, Luoting Yu, Yuquan Wei. . (2016) Benzothiazinethione is a potent preclinical candidate for the treatment of drug-resistant tuberculosis. 6:1.
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New diagnostics and therapeutics are urgently needed; most of the methods used currently were developed decades ago. Today, we have rapid nucleic acid–based tests for drug-resistant tuberculosis, sound models for laboratory expansion and for treatment delivery, and several drug candidates in the pipeline. To tackle tuberculosis, we also need an equity plan that takes seriously the biosocial complexity of a lethal airborne infection that has stalked us for centuries. The global AIDS effort of the past decade has shown how much can be accomplished in global health when effective diagnosis and care are matched with funding and political will. Stinting on investments or on bold action against tuberculosis — in all its forms — will ensure that it remains a leading killer of people living in poverty in this decade and the next.
Sarcoidal granulomas can involve any organ, but in more than 90% of patients, clinical sarcoidosis is manifested as intrathoracic lymph-node enlargement, pulmonary involvement, skin or ocular signs and symptoms, or some combination of these findings.
, , , et al. Using treatment failure under effective directly observed short-course chemotherapy programs to identify patients with multidrug-resistant tuberculosis. 2000;4:108-114
Drug resistance is well established as an inevitable outcome of antibiotic use; the fault lines of the MDR tuberculosis pandemic are largely man-made. The contours of global efforts against tuberculosis have always been mediated by both biologic and social determinants, and the reasons for the divergence in the rates of tuberculosis and drug resistance between rich and poor countries are biosocial. As case rates dropped in wealthy countries, funding for research and implementation programs dried up, even though tuberculosis remained the world's leading infectious killer of young adults throughout the 20th century. Tuberculosis “control” in the 1990s was defined by the legacy of selective primary health care: targeted, “cost-effective” interventions packaged together, in the case of tuberculosis, as the DOTS strategy. Such protocols helped standardize tuberculosis treatment around the world — a process that was sorely needed — but they hamstrung practitioners wishing to address diagnostic and therapeutic complexities that could not be addressed by the use of sputum-smear microscopy and short-course chemotherapy or other one-size-fits-all approaches.
, , , et al. Feasibility and cost-effectiveness of standardised second-line drug treatment for chronic tuberculosis patients: a national cohort study in Peru. 2002;359:1980-1989
By the end of the 1990s, facing mounting evidence that MDR tuberculosis could be treated effectively in resource-poor settings, a multi-institutional mechanism — the Green Light Committee — was created to encourage and learn from pilot projects for treating MDR tuberculosis. This coincided with a grant from the Bill and Melinda Gates Foundation to scale up treatment of MDR tuberculosis in Peru and elsewhere and to change global policy.
, , , et al. Acquisition of drug resistance in multidrug-resistant Mycobacterium tuberculosis during directly observed empiric retreatment with standardized regimens. 2005;9:818-821