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HRB Clinician Scientist on TB is extending influence internationally

20 December 2016

HRB Clinician Scientist Professor Joe Keane, is influencing the global fight against TB...

For the first time in 17 years, the Centre for Disease Control in the United States has updated guidelines on TB diagnostics. It is a response to control the growth of tuberculosis and multiple-drug-resistant tuberculosis in particular.

HRB Clinician Scientist Prof Joe Keane, Trinity College and St James’s Hospital is the only Irish representative among the small group of scientists who have contributed to these international guidelines which aim to tackle growing TB epidemic globally.

According to Prof Keane, we are seeing an increasing number of multidrug resistant tuberculosis (MDR-TB) cases in Ireland, which reflects the pattern seen in Europe, primarily because of the movement of people from countries of high tuberculosis (TB) prevalence.

“Tuberculosis has never gone away from Ireland. It is crucial that we do not become complacent about the spread of TB both globally and here at home in Ireland. These new guidelines, which took eight years to produce, will help in detecting TB, MDR-TB and latent TB infection – which will support disease elimination.”

The guidelines were published by the American Thoracic Society (ATS), Infectious Diseases Society of America (IDSA) and the Centre for Disease Control and Prevention in the Journal for Clinical Infectious Diseases.  They recommend that doctors should employ newer tests for patients at risk of latent TB and active tuberculosis Infection. They recommend that doctors shouldn’t overlook active TB diseases diagnosis even though it has less of a problem in certain countries than the developing world.

The new guidelines are available to download at:  cid.oxfordjournals.org/content/early/2016/12/08/cid.ciw694.full

TB spreads through the air and can be a challenging disease to diagnose and treat. Many people can have latent TB, meaning they are infected with the bacteria Mycobacterium tuberculosis, but are asymptomatic and can’t spread the infection to others. Only 5 to 10 percent of people with latent infection ultimately go on to develop the disease itself, about half of those within two years of being infected. Treatment varies depending on whether the TB is latent or becomes active, and directly observed therapy (DOTS) is recommended for patients with this disease.

TB most often affects the lungs, but can affect other parts of the body such as the kidney, spine and brain. Those at higher risk of developing the disease include people with HIV and others with weakened immune systems, those with diabetes, smokers and others who are taking immune-suppressing medications called TNF blockers.

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