Antimicrobial resistance, a leading threat to human health, is enabled by unnecessary antibiotic use. Strategies to reduce unnecessary antibiotic use in India, the world’s largest antibiotic consumer, are urgently needed. Although most patients hospitalized in India with acute febrile illness...
Aims: To develop non-sputum, blood-based tools for TB diagnosis and treatment, we urgently need biomarkers that identify active TB (ATB) cases and accurately distinguish them from latent TB infection (LTBI). Such biomarkers, when validated in diverse populations, can be developed into improved...
This is a prospective cross-sectional study which will be conducted at BJGMC in Pune, India. The aim of this study is to see whether Xpert MTB/RIF is useful for early detection of pulmonary tuberculosis, and therefore cost-effective, as compared with sputum microscopy and the gold standard tests...
Since 2004, the National AIDS Control Program of India has been rolling out free antiretroviral therapy. Byramjee Jeejeebhoy Government Medical College (BJGMC), located in Pune, India, is now the largest HIV clinic in India, with over 26,000 adult and pediatric patients registered since 2005. We...
Given the worldwide shortage of PPD TST antigen solutions, it is important to establish the sensitivity of the commercially available SPAN diagnostic TST when compared products used in international settings. This study aims to establish whether the SPAN diagnostic product is bioequivalent to PPDs...
Objective 1: To use novel molecular techniques to characterize the human virome in the circulating blood of patients in clinical settings who presented to an acute care setting with an acute febrile illness and in whom a diagnosis cannot be achieved by conventional methods. Healthy controls will be...
Pregnancy is a state of relative immunosuppression in order to protect the fetus from being rejected. It has also been shown that the Th-1 helper cell response, which is normally necessary for overcoming TB infection, is suppressed in pregnancy. Thus, pregnant women are especially vulnerable to TB...
Mycobacterium tuberculosis (TB) remains the leading cause of death among persons living with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) in southern Africa. Drug-resistant TB remains a growing threat to public health despite advances made in diagnosis and...
A ‘platform’ for evaluating combination HIV prevention & care-HIV counseling & testing is essential to optimize HIV services. In collaboration with the University of Washington and the Integrated Community Based Initiatives (ICOBI) NGO in Uganda, CCGHE has adapted the emocha ® platform to...
To design, implement and evaluate a male-friendly and culturally appropriate guide for increasing access to and use of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) testing and sexual/reproductive healthcare (SRHC) among African American and Latino males.
Dr. Kathleen Page founded and directs the Baltimore City Health Department’s HIV Latino Outreach Program, which provides more than 1000 HIV tests per year to Baltimore's Latino community, and provides linkages to care services for those testing positive.
Comprising clinical trial sites at Johns Hopkins Medicine in Baltimore, Whitman Walker Health in Washington, DC, and the BJGMC-CCGHE collaboration in Pune, India, the Baltimore-Washington-India Clinical Trials Unit (BWI-CTU) is one of only 25 international HIV/TB clinical trial sites funded by the...
Funded by the Fogarty International Center at the National Institutes of Health, the JHU Fogarty program has nearly 20 years of success with providing training, professional development, and mentorship to clinicians and scientists in low and middle income countries. CCGHE's latest efforts in this...
SETTING: The tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are used as supportive evidence to diagnose active tuberculosis (TB). Novel IGRAs could improve diagnosis, but data are lacking in young children . DESIGN: Children (age 5 years or younger) with suspected TB were...
Objectives: Little is known about the prevalence of human immunodeficiency virus (HIV) testing at community organizations or the organizational characteristics associated with testing. The objective of this study was to describe (1) the prevalence of HIV testing at community organizations serving...
The American Journal of Tropical Medicine and Hygiene
After decades of slow progress in diagnostics for acute febrile illness in resource-limited settings, a wave of converging advancements will enable clinicians in resource limited settings to reduce uncertainty for the diagnosis of acute febrile illness.
Background : Cryptococcal meningitis (CM) constitutes a significant source of mortality in resource-limited regions. Cryptococcal antigen (CRAG) can be detected in the blood before onset of meningitis. We sought to determine the cost-effectiveness of implementing CRAG screening using the recently...
Testing and linkage to care are important determinants of hepatitis C virus (HCV) treatment effectiveness. Public health clinics serve populations at high risk of HCV. We investigated their potential to serve as sites for HCV testing, initiation of and linkage to HCV care. Cross-sectional study of...
With declining tuberculosis (TB) incidence in low-prevalence settings, many clinicians are likely unaware that the approach to diagnosing active TB is evolving with newer technologies. Rapid molecular assays are commercially available, and more are likely to enter the market in the coming years...
Background : Recent guidelines advocate early antiretroviral therapy (ART) to decrease human immunodeficiency virus (HIV) morbidity and prevent transmission, but suboptimal engagement in care may compromise impact. We sought to determine the economic and epidemiologic impact of incomplete...
Rationale: Pregnant women with latent tuberculosis infection (LTBI) are at high risk for development of TB, especially if infected with HIV. Objectives: To assess the performance of LTBI tests in pregnant and postpartum women infected with HIV, investigate the immunology behind discordance in...
Abstract Despite significant advancements in hepatitis C virus (HCV) treatments, the majority of individuals infected with HCV remain undiagnosed. We report on senior citizen center-based HCV testing in Baltimore, which revealed a 9.4% prevalence of infection. Our data suggest that community-based...
Objectives : We sought to characterize postimmigration tuberculosis (TB) care for Class B immigrants and refugees at the Baltimore City Health Department TB program (BCHD), and to determine the proportion of immigrants with active TB or latent TB infection (LTBI) in this high-risk population...
WHO: The Use of Lateral-Flow Urine LAM for Diagnosis and Screening of Active TB in People Living with HIV
Background : Tests based on the detection of mycobacterial lipoarabinomannan (LAM) antigen in urine have emerged as potential point-of-care tests for tuberculosis (TB). LAM antigen is a lipopolysaccharide present in mycobacterial cell walls, which is released from metabolically active or...
Background : Sputum smear microscopy for tuberculosis (TB) diagnosis lacks sensitivity in HIV-infected symptomatic patients and increases the likelihood that mycobacterial infections particularly disseminated TB will be missed; delays in diagnosis can be fatal. Given the duration for MTB growth in...
Background : Tuberculosis (TB) prevalence is high in correctional facilities in southern Africa. With support from local South African nongovernmental organizations, the South African Department of Correctional Services initiated a program of systematically screening newly admitted and current...
Background: QuantiFERON-TB Gold In-Tube test (QFT-GIT) can be used as an alternative to tuberculin skin testing (TST) for the targeted testing of latent tuberculosis. Due to many shortcomings with TST, QFT-GIT usage is increasing. QFT-GIT implementation in the inpatient setting remains unclear...
Expert Review of Pharmacoeconomics and Outcomes Research
Tuberculosis remains a global health crisis in part due to underdiagnosis. Technological innovations are needed to improve diagnostic test accuracy and reduce the reliance on expensive laboratory infrastructure. However, there are significant economic challenges impeding the development and...
Despite recent declines in incidence, tuberculosis remains a significant public health problem in the United States, with almost 10 000 new cases each year. As the disease becomes less common in the United States, diagnostic delays occur because of diverse clinical presentations and suboptimal...
Objective : In settings of high HIV prevalence, tuberculosis control and patient management are hindered by lack of accurate, rapid tuberculosis diagnostic tests that can be performed at point-of-care. The Determine TB LAM Ag (TB LAM) test is a lateral flow immunochromatographic test for detection...
International Journal of Tuberculosis and Lung Disease
Background : Drug susceptibility testing (DST) against second-line tuberculosis drugs (SLDs) is essential for improving outcomes among multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) cases. Objective : To evaluate the potential cost-effectiveness of rapid DST for...
Background : Xpert MTB/RIF ('Xpert') and urinary lipoarabinomannan (LAM) assays offer rapid tuberculosis (TB) diagnosis, but have suboptimal sensitivity when used individually in HIV-positive patients. The yield of these tests used in combination for the diagnosis of active TB among HIV-infected TB...
Poster Abstract Session: Oh One World: Infections from Near and Far. Robinson M , Balasubramanian U, Raichur P, Kadam D, Khadse S, Marbaniang I, Kanade S, Sachs J, Basavaraj A, Bharadwaj R, Kinikar A, Kulkarni V, Kagal A, Gupta A, Mave V
Poster Session. TB Diagnostic Challenges: Molecular and Other Techniques. Authors: Girish S, Dharmashle S, Desai S, Kagal A, Bharadwaj R, Chandanwale A, Lokhande R, Kadam DB, DeLuca A, Gupte N, Jain D, Gupta A, Bollinger R, Mave V.
Poster Session: Latent TB Infection: Diagnosis and Treatment. Vaidya A , Tambe S, Bhosale R, Mave V, Elf J, Pradhan N, Nevrekar N, Patil S, Kagal A, Joshi S, Chandanwale A, Gupta A, Mathad J.
CCGHE webcasts Tuberculosis (TB) Noon Conference live and provides a global audience with open access to all live and archived sessions via the CCGHE website. Led by Drs. Maunank Shah, Jonathan Golub, Richard Chaisson, these meetings bring together Johns Hopkins TB researchers and trainees in an...
