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Chapter 5: Treatment of tuberculosis disease 第五章:肺结核的治疗
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2036504
J. Johnston, R. Cooper, D. Menzies
KEY POINTS • Treatment of drug-susceptible tuberculosis (TB) disease should include 2 effective drugs at all times, and at least 3 effective drugs in the intensive phase (ie, first 2 months of therapy). • Most patients with TB disease should be initiated on a regimen of isoniazid, rifampin, pyrazinamide and ethambutol until results of genotypic or phenotypic drug susceptibility are available. Therapy should be given daily for the first 2 months, then daily when feasible. • Meaningful and culturally appropriate patient engagement, education and support are critical for achieving successful TB treatment. • TB clinicians and programs should provide comprehensive, patient-centred care that uses incentives and enablers to ensure optimal treatment adherence. • All jurisdictions should have capacity to provide daily, in-person, supportive care for people with TB. Support should be tailored to individual needs and may include directly observed therapy. • Regardless of insurance coverage or immigration documentation, people with active TB should be provided with TB medications and appropriate treatment support free of charge. • People at high risk for TB recurrence should be monitored for signs/symptoms of TB recurrence during the first 12-24 months post-therapy. • Pulmonary function testing should be performed in all people completing therapy for pulmonary TB, given the high incidence of respiratory disease in people with TB. • TB programs should ensure that people with TB are linked to a stable primary care provider before the end of TB treatment.
•药物敏感结核(TB)疾病的治疗在任何时候都应包括2种有效药物,在强化阶段(即治疗的前2个月)至少应包括3种有效药物。•大多数结核病患者应开始使用异烟肼、利福平、吡嗪酰胺和乙胺丁醇治疗方案,直到获得基因型或表型药物敏感性的结果。治疗应在前2个月每天给药,可行时每天给药。•有意义且文化上适当的患者参与、教育和支持对于成功治疗结核病至关重要。•结核病临床医生和规划应提供全面的、以患者为中心的护理,利用激励措施和使能手段确保最佳的治疗依从性。•所有司法管辖区都应该有能力为结核病患者提供日常、面对面的支持性护理。支持应根据个人需要量身定制,并可能包括直接观察治疗。•无论是否有保险或移民文件,活动性结核病患者都应免费获得结核病药物和适当的治疗支持。•结核病复发高风险人群应在治疗后的头12-24个月内监测结核病复发的体征/症状。•鉴于结核病患者呼吸道疾病发病率高,应对所有完成结核病治疗的患者进行肺功能检测。•结核病规划应确保结核病患者在结核病治疗结束前与稳定的初级保健提供者联系起来。
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引用次数: 15
Chapter 12: An introductory guide to tuberculosis care to improve cultural competence for health care workers and public health professionals serving Indigenous Peoples of Canada 第12章:结核病护理入门指南,以提高为加拿大土著人民服务的保健工作者和公共卫生专业人员的文化能力
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2041328
J. Dunn, Marlene Larocque, D. V. Van Dyk, Eduardo Vides, F. Khan, T. Wong, Richard P. Long, Gonzalo G. Alvarez
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引用次数: 4
Chapter 10: Treatment of active tuberculosis in special populations 第十章:特殊人群活动性肺结核的治疗
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2039500
R. Cooper, S. Houston, C. Hughes, J. Johnston
adepartment of Medicine, division of infectious diseases, university of alberta, edmonton, alberta, Canada; bschool of public Health, university of alberta, edmonton, alberta, Canada; cfaculty of pharmacy & pharmaceutical sciences, university of alberta, edmonton, alberta, Canada; ddivision of respiratory Medicine, university of British Columbia, Vancouver, British Columbia, Canada; etB services, British Columbia Centre for disease Control, Vancouver, British Columbia, Canada
加拿大阿尔伯塔省埃德蒙顿阿尔伯塔大学传染病学系医学系;加拿大阿尔伯塔省埃德蒙顿阿尔伯塔大学公共卫生学院;加拿大艾伯塔省埃德蒙顿市阿尔伯塔大学药学与制药科学学院;加拿大不列颠哥伦比亚省温哥华市英属哥伦比亚大学呼吸内科;加拿大不列颠哥伦比亚省温哥华市不列颠哥伦比亚省疾病控制中心etB服务
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引用次数: 4
Chapter 1: Epidemiology of tuberculosis in Canada 第一章:加拿大结核病的流行病学
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2033062
A. Mounchili, Reshel Perera, Robyn S. Lee, H. Njoo, James Brooks
• The overall incidence rate of active tuberculosis (TB) disease in Canada is low and has remained unchanged in the last 10 years at around 4.6-5.1 individuals per 100,000 population, with males more affected than females. The rate in 2020 was 4.7 per 100,000 population. • Pronounced disparities in certain population subgroups and geographic regions persist. Foreign-born individuals and Canadian-born Indigenous peoples in particular continue to be disproportionately affected by TB. • The active TB disease incidence rate in Inuit communities has been the highest in Canada for the past two decades, peaking in 2012 at 251.6 individuals per 100,000 population, more than 51 times the overall Canadian incidence rate. In 2020, the incidence rate was 70.3 per 100,000 population, or 15 times the overall Canadian rate. • The rate of active TB disease among First Nations on-reserve populations has gradually decreased since 2009, and leveled off after 2017 at just under 20.0 per 100,000 population, or three times the Canadian incidence rate. Incidence rates among First Nations off-reserve populations have been lower, at about 10.0 per 100,000 population since 2013. • Métis have been less affected among Canadian-born Indigenous peoples, with active TB disease incidence rates that gradually decreased to levels below the overall Canadian rate since 2012, varying between 2.2 and 3.7 per 100,000 population. • Individuals born outside Canada constitute the largest proportion of people reported with active TB disease, with an incidence rate that has remained almost unchanged since 2005, at about 15.0 individuals per 100,000 population. • The Canadian-born, non-Indigenous population is the least affected, with an incidence rate that gradually decreased by 83.3%, from 1.2 per 100,000 population in 2001 to 0.2 per 100,000 population in 2020. • Between 2017 and 2020, 3.5% of individuals who had active TB disease and whose human immunodeficiency virus (HIV) status was known were HIV-positive. • In the last 20 years, on average, 12 TB-related deaths per year were reported in Canadian-born, non-Indigenous populations, compared to about 44 deaths annually for foreign-born populations. • Over the last 12 years, drug-resistant TB was isolated in 9.5% (n = 1,598) of people diagnosed with active TB disease and whose isolates were subjected to susceptibility testing. Of these, 83.2% (n = 1,329) had mono-resistance, primarily to isoniazid (INH) (n = 1,072) and pyrazinamide (PZA) (n = 225). Multidrug resistance (ie, resistance to INH and rifampin) accounted for 3.6% (n = 57), and extensively drug-resistance (ie, resistance to isoniazid and rifampin), plus any fluoroquinolone and at least 1 of 3 injectable second-line drugs (ie, amikacin, kanamycin or capreomycin), was rare and detected only 6 times.
•加拿大活动性结核病的总发病率很低,在过去10年中保持不变,约为每10万人4.6-5.1人,男性比女性受影响更大。到2020年,这一比例为每10万人中4.7人。•某些人口亚群和地理区域的明显差异仍然存在。外国出生的个人,特别是加拿大出生的土著人民,仍然不成比例地受到结核病的影响。•在过去二十年中,因纽特人社区的活动性结核病发病率是加拿大最高的,2012年达到峰值,每10万人中有251.6人,是加拿大总发病率的51倍多。到2020年,发病率为每10万人中有70.3人,是加拿大总体发病率的15倍。•自2009年以来,第一民族保留地人口中活动性结核病的发病率逐渐下降,并在2017年之后趋于稳定,每10万人中有20.0人以下,是加拿大发病率的三倍。自2013年以来,第一民族保留地外人口的发病率较低,约为每10万人10.0人。•在加拿大出生的土著人民中,msamims受到的影响较小,自2012年以来,活动性结核病发病率逐渐降至低于加拿大总体发病率的水平,在每10万人2.2至3.7人之间。•在加拿大境外出生的人在报告的活动性结核病患者中所占比例最大,其发病率自2005年以来几乎保持不变,约为每10万人15.0人。•加拿大出生的非土著人口受影响最小,发病率逐渐下降83.3%,从2001年的每10万人1.2人下降到2020年的每10万人0.2人。•在2017年至2020年期间,3.5%患有活动性结核病且已知其人类免疫缺陷病毒(HIV)状况的个体为艾滋病毒阳性。•在过去20年中,在加拿大出生的非土著人口中,每年平均报告12例与结核病有关的死亡,而在外国出生的人口中,每年约有44例死亡。•在过去12年中,在9.5% (n = 1,598)被诊断患有活动性结核病的人中分离出耐药结核病,并对其分离物进行了敏感性试验。其中,83.2% (n = 1,329)为单耐药,主要是异烟肼(INH) (n = 1,072)和吡嗪酰胺(PZA) (n = 225)。多药耐药(即对INH和利福平耐药)占3.6% (n = 57),广泛耐药(即对异烟肼和利福平耐药),加氟喹诺酮类药物和至少3种注射二线药物中的1种(即阿米卡星、卡那霉素或卷曲霉素)的情况很少,仅检出6次。
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引用次数: 14
Chapter 11: Tuberculosis contact investigation and outbreak management 第11章:结核病接触者调查和疫情管理
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2037909
E. Rea, Jessika Huard, Robyn S. Lee
atuberculosis program, toronto public Health, toronto, ontario, Canada; bdalla lana school of public Health, university of toronto, toronto, ontario, Canada; cdirection régionale de santé publique, Centre intégré universitaire de santé et de services sociaux du Centre-sud-de-l’Île-de-Montréal, Montréal, Québec, Canada; dnunavik regional Board of Health and social services, public Health, Kuujjuaq, Québec, Canada
结核病方案,多伦多公共卫生部,加拿大安大略省多伦多;加拿大安大略省多伦多多伦多大学bdalla lana公共卫生学院;加拿大魁北克省蒙特利尔中南部大学健康和社会服务综合中心区域公共卫生方向;dnunavik区域卫生和社会服务委员会,公共卫生,Kuujjuaq,魁北克,加拿大
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引用次数: 1
Chapter 6: Tuberculosis preventive treatment in adults 第六章:成人结核病预防治疗
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2039498
G. Alvarez, C. Pease, D. Menzies
• Either once-weekly rifapentine and isoniazid for 3 months (3HP), or daily rifampin for 4 months (4R) is recommended. • When rifamycin based regimens cannot be used because they are not tolerated, not feasible or are contraindicated, the 9-month daily isoniazid regimen (9H) is the preferred option. • When the 9H regimen cannot be used, the six-month daily isoniazid regimen (6H) is recommended. • Evaluate for interactions between patients’ baseline medications and the prospective TPT regimen through an up-to-date drug decision support tool prior to treatment initiation.
•推荐每周使用一次利福喷丁和异烟肼,持续3个月(3HP),或每天使用利福平,持续4个月(4R)。•当利福霉素为基础的方案不能使用,因为他们不能耐受,不可行或禁忌,9个月每日异烟肼方案(9H)是首选。•当不能使用9H方案时,建议使用6个月每日异烟肼方案(6H)。•在治疗开始前,通过最新的药物决策支持工具评估患者基线药物与预期TPT方案之间的相互作用。
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引用次数: 5
Chapter 8: Drug-resistant tuberculosis 第八章:耐药结核病
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2039499
S. Brode, R. Dwilow, D. Kunimoto, D. Menzies, F. Khan
adepartment of Medicine, university of toronto, toronto, ontario, Canada; bdept of Medicine, university Health network and Mount sinai Hospital, toronto, ontario, Canada; cdivision of respiratory Medicine, West park Healthcare Centre, toronto, ontario, Canada; dpediatric infectious diseases and Medical Microbiology, Max rady College of Medicine, university of Manitoba, Winnipeg, Manitoba, Canada; edepartment of Medicine, faculty of Medicine & dentistry, university of alberta, Walter Mackenzie Health sciences Centre, edmonton, alberta, Canada; fdepartments of Medicine, epidemiology & Biostatistics, McGill university, Montréal, Québec, Canada; gMcGill international tB Centre, McGill university & Centre for outcomes research & evaluation (Core), research institute of the McGill university Health Centre, Montreal, Québec, Canada; hdept of services spécialisés, ungava tulattavik Health Centre, Kuujjuaq, Québec, Canada; idept of services spécialisés, inuulitsivik Health Centre, puvirnituq, Québec, Canada
加拿大安大略省多伦多市多伦多大学医学系;加拿大安大略省多伦多大学卫生网络和西奈山医院医学部;加拿大安大略省多伦多西公园保健中心呼吸内科;加拿大曼尼托巴省温尼伯市曼尼托巴大学Max rady医学院儿科传染病与医学微生物学;加拿大艾伯塔省埃德蒙顿,阿尔伯塔大学医学与牙科学院医学部,沃尔特·麦肯齐健康科学中心;1加拿大麦吉尔大学医学、流行病学与生物统计学系;加拿大蒙特利尔麦吉尔大学健康中心研究所麦吉尔大学国际结核病中心和成果研究与评估中心(Core);加拿大魁省Kuujjuaq的ungava tulattavik保健中心的服务深度spsamcialisamas;服务构想:加拿大魁魁省魁魁省魁魁省伊努利茨维克保健中心
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引用次数: 2
Chapter 14: Prevention and control of tuberculosis transmission in healthcare settings 第14章:卫生保健机构中结核病传播的预防和控制
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2043677
B. Johnston, T. Ogunremi, K. Defalco, N. Savard, Stephanie W. Smith
provides key information related to ventilation and does not replace information found in the relevant standards and guidelines. for further details, consult the complete guidelines and/or standards. adapted from tables in the CdC, 49 Csa 50 and asHrae 51 documents.
提供与通风有关的关键信息,不能取代相关标准和指南中的信息。欲了解更多细节,请参阅完整的指南和/或标准。改编自CdC, 49 Csa 50和asHrae 51文件中的表格。
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引用次数: 0
Chapter 7: Extra-pulmonary tuberculosis 第七章:肺外结核
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2036073
L. Barss, W. Connors, D. Fisher
• Samples (fluid and tissue) for extra-pulmonary tuberculosis (TB) should be sent for acid-fast bacilli smear, mycobacterial culture and nucleic acid amplification test. Tissue biopsy should be sent in sterile saline for these mycobacterial tests as well as in formalin for histopathologic assessment. Drug susceptibility testing should be requested for positive culture samples. • If the specimen is insufficient for all testing, mycobacterial culture should be prioritized given it has the highest diagnostic yield and allows for gold-standard phenotypic drug testing. • Every person with presumed extra-pulmonary TB should also be assessed for pulmonary TB to assess infectiousness and potentially assist with diagnosis.
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引用次数: 10
Chapter 13: Tuberculosis surveillance and tuberculosis infection testing and treatment in migrants 第13章:移徙者的结核病监测和结核病感染检测和治疗
IF 0.8 Q3 RESPIRATORY SYSTEM Pub Date : 2022-03-24 DOI: 10.1080/24745332.2022.2035544
C. Greenaway, Tanya Diefenbach-Elstob, K. Schwartzman, V. Cook, G. Giovinazzo, H. Njoo, A. Mounchili, J. Brooks
adepartment of Medicine, McGill university, Montréal, Québec, Canada; bdivision of infectious diseases, sMBd-Jewish General Hospital, Montréal, Québec, Canada; cMcGill international tB Centre, Montréal, Québec, Canada; dCentre for Clinical epidemiology, lady davis institute, Jewish General Hospital, Montréal, Québec, Canada; eMontreal Chest institute, Montreal, Quebec, Canada; fresearch institute of the McGill university Health Centre, Montreal, Quebec, Canada; gBritish Columbia Centre for disease Control, Vancouver, British Columbia, Canada; hfaculty of Medicine, university of British Columbia, Vancouver, British Columbia, Canada; iMigration Health Branch, immigration, refugees and Citizenship Canada, Government of Canada, ottawa, ontario, Canada; jinfectious disease prevention and Control Branch, public Health agency of Canada, ottawa, ontario, Canada; kantimicrobial resistance division, public Health agency of Canada, ottawa, ontario, Canada
a麦吉尔大学医学系,加拿大;加拿大魁魁省蒙特拉西亚市犹太总医院传染病科;cMcGill国际结核病中心,montracei, quacei, Canada;d临床流行病学中心,犹太总医院戴维斯夫人研究所,加拿大,魁魁省;蒙特利尔胸科研究所,蒙特利尔,魁北克,加拿大;加拿大魁北克省蒙特利尔麦吉尔大学保健中心研究所;g不列颠哥伦比亚省疾病控制中心,加拿大不列颠哥伦比亚省温哥华;加拿大不列颠哥伦比亚省温哥华,不列颠哥伦比亚大学医学院;加拿大政府移民、难民和加拿大公民事务部移民保健处,加拿大安大略省渥太华;加拿大公共卫生署传染病预防和控制处,加拿大安大略省渥太华;加拿大公共卫生署抗微生物药物耐药性处,加拿大安大略省渥太华
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引用次数: 7
期刊
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine
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