Browsing by Author "Migliori, Giovanni Battista"

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    Current use and acceptability of novel diagnostic tests for active tuberculosis : a worldwide survey
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2017-09-03) Amicosante, Massimo; D’Ambrosio, Lia; Munoz, Marcela; Mello, Fernanda Carvalho de Queiroz; Tebruegge, Marc; Chegou, Novel N.; Seghrouchni, Fouad; Centis, Rosella; Goletti, Delia; Bothamley, Graham; Migliori, Giovanni Battista; TB Diagnostic Survey Working Group
    Objective: To determine the current use and potential acceptance (by tuberculosis experts worldwide) of novel rapid tests for the diagnosis of tuberculosis that are in line with World Health Organization target product profiles. Methods: A multilingual survey was disseminated online between July and November of 2016. Results: A total of 723 individuals from 114 countries responded to the survey. Smear microscopy was the most commonly used rapid tuberculosis test (available to 90.9% of the respondents), followed by molecular assays (available to 70.7%). Only a small proportion of the respondents in middle- and low-income countries had access to interferon-gamma-release assays. Serological and lateral flow immunoassays were used by more than a quarter (25.4%) of the respondents. Among the respondents who had access to molecular tests, 46.7% were using the Xpert assay overall, that proportion being higher in lower middle-income countries (55.6%) and low-income countries (76.6%). The data also suggest that there was some alignment of pricing for molecular assays. Respondents stated they would accept novel rapid tuberculosis tests if available, including molecular assays (acceptable to 86.0%) or biomarker-based serological assays (acceptable to 81.7%). Simple biomarker-based assays were more commonly deemed acceptable in middle- and lowincome countries. Conclusions: Second-generation molecular assays have become more widely available in high- and low-resource settings. However, the development of novel rapid tuberculosis tests continues to be considered important by tuberculosis experts. Our data also underscore the need for additional training and education of end users.
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    MDR/XDR-TB management of patients and contacts : challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network
    (Elsevier, 2020-03) Migliori, Giovanni Battista; Tiberi, Simon; Zumla, Alimuddin; Petersen, Eskild; Chakaya, Jeremiah Muhwa; Wejse, Christian; Torrico, Marcela Munoz; Duarte, Raquel; Alffenaar, Jan Willem; Schaaf, H. Simon; Marais, Ben J.; Cirillo, Daniela Maria; Alagna, Riccardo; Rendon, Adrian; Pontali, Emanuele; Piubello, Alberto; Figueroa, Jose; Ferlazzo, Gabriella; García-Basteiro, Alberto; Centis, Rosella; Visca, Dina; D’Ambrosio, Lia; Sotgiu, Giovanni
    The continuous flow of new research articles on MDR-TB diagnosis, treatment, prevention and rehabilitation requires frequent update of existing guidelines. This review is aimed at providing clinicians and public health staff with an updated and easy-to-consult document arising from consensus of Global Tuberculosis Network (GTN) experts. The core published documents and guidelines have been reviewed, including the recently published MDR-TB WHO rapid advice and ATS/CDC/ERS/IDSA guidelines. After a rapid review of epidemiology and risk factors, the clinical priorities on MDR-TB diagnosis (including whole genome sequencing and drug-susceptibility testing interpretations) and treatment (treatment design and management, TB in children) are discussed. Furthermore, the review comprehensively describes the latest information on contact tracing and LTBI management in MDR-TB contacts, while providing guidance on post-treatment functional evaluation and rehabilitation of TB sequelae, infection control and other public health priorities.