Identifying patients at high risk of tuberculosis recurrence

Identifying patients at high risk of tuberculosis recurrence

Global summit on TUBERCULOSIS AND LUNG DISEASE
September 20-21, 2017 | Philadelphia, USA

Ruxana T Sadikot

Emory University, USA

Abstract:

Several studies have been done in relation to recurrence of tuberculosis (TB) following completion of treatment. However, recurrence of TB is still a major problem from a public health perspective in high-burden countries, where no special attention is being given to this issue. Disease recurrence is an important indicator of the efficacy of antituberculosis treatment. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 25%. This variability is not only a reflection of regional epidemiology of recurrence but differences in the definitions used by the TB control programs. In addition to treatment failure related to medication adherence, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include: malnutrition; human immunodeficiency virus; substance abuse including tobacco use; comorbidity such as diabetes, renal failure and systemic diseases, especially immunosuppressive states; and environmental exposure such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being discovered. Information on temporal and geographical trends of TB cases as well as genotyping might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and defining host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

Biography:

Ruxana T Sadikot is a Professor of Medicine at the Emory University in Atlanta and serves as the Section Chief of Pulmonary and Critical Care Medicine at the Atlanta VA Medical Center. Her research career has focused on defining the lung immune response and mechanism of lung injury. In particular her research is focused on defining the role of transcription factors, lipid mediators (prostaglandins) and super immunoglobulin receptor TREM-1 in macrophages in resistant infections. Her clinical research focus is bronchiectasis and infections including tuberculous and non-tuberculous mycobacteria and P. aeruginosa. She has published extensively on these topics in high impact peer reviewed journals and book chapters. She serves on the Editorial Board Member of Clinical Respiratory Medicine, Biomedical Research International and Annals of American Thoracic Society. She has mentored several graduate students, residents, post-doctoral fellows and junior faculty through her career.

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