I thought it was gone.' m or CDC labs. Further, the emphasis on new tools in the Global Plan to Stop TB 2006–2015 [149], along with the creation of product development partnerships such as the Foundation for Innovative New Diagnostics (FIND), AERAS, and Global Alliance for TB Drug Development, may have inspired research on new diagnostics and drugs. WebMD does not provide medical advice, diagnosis or treatment. The second most frequent research priority on TB/HIV included recommendations to conduct studies investigating XDR-TB and HIV co-infection, identifying a comprehensive definition of IRIS (immune reconstitution inflammatory syndrome), and investigating sputum processing methods with direct smears in settings with high and low HIV prevalence. Signs of this potentially fatal complication. It's not horribly common. An exploratory qualitative study of funding strategy among five high-profile public health research funding organisations showed limited involvement from end users/policymakers in the prioritisation of research questions for funding [12]. Studies called for the need to develop studies that detect resistance from smear positive specimens, determine the accuracy of colorimetric methods, line-probe assays, phage-based assays for rapid screening and nitrate reductase assay (NRA), and find the clinical usefulness of rapid diagnosis of rifampicin-resistant TB. The search was limited to systematic reviews and meta-analyses published between January 1, 2005 and July 1, 2010, in order to focus on contemporary TB literature and identify research priorities of greatest relevance to current TB control. No, Is the Subject Area "Tuberculosis diagnosis and management" applicable to this article? Gerberding says the CDC has been in touch with 74 U.S. citizens and residents on the Air France/Delta flight, including all 26 passengers who were believed to be sitting in the high-risk rows around Speaker's seat. In recognition of this need, a TB resolution adopted at the World Health Assembly in May 2018 requested WHO to develop a global strategy for TB research and innovation, “to make further progress in enhancing cooperation and coordination in respect of tuberculosis research and development” [13]. In total, 137 systematic reviews, with 141 research questions, were included in this review. Our systematic search showed that a fairly high number of systematic reviews were published on TB during the period of 2005 to 2010. We considered a study to be a systematic review or meta-analysis if the authors identified the study as such, or if the title or abstract contained the words “systematic review” or “meta-analysis”. The classification categories were subdivided into major tuberculosis research areas as described in Table 2. Immunological diagnostics were focused mainly on testing and evaluating interferon-gamma release assays (IGRAs). Among the 13 Cochrane reviews, 9 of them focused on “evaluation of treatments and therapeutic interventions”. Citation: Nicolau I, Ling D, Tian L, Lienhardt C, Pai M (2012) Research Questions and Priorities for Tuberculosis: A Survey of Published Systematic Reviews and Meta-Analyses. When people get sick with tuberculosis, their symptoms may include fever, night sweats, cough, appetite loss, weight loss, bloody phlegm, and loss of energy. "That means not just walking past them in Hartsfield Airport in Atlanta," she adds. For more information about PLOS Subject Areas, click Medical and Research Center: "About Tuberculosis." She recalls the case of a surgeon who operated on a patient who was later found to have TB and who was also exposed to TB while working in Africa. Conflict of interest: T. Kasaeva has nothing to disclose. No. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Center. "The most common test is called the tuberculin skin test, or PPD. The search was not limited to English and the last search was performed on August 18, 2010. The research priorities determined were mainly focused on the discovery and evaluation of bacteriological TB tests, drug-resistant TB tests and immunological tests, with special focus on IGRA tests. Other important topics of future research were genetic susceptibility to TB and disease determinants attributed to HIV/TB. Although several systematic reviews identified areas for further research, the questions themselves were often framed in a generic way, rather than in a highly focused manner with specific recommendation for action. ", Hamilton also warns that "if our regular TB cases aren't managed appropriately and aggressively, they can become drug resistant. Wrote the paper: IN MP. While the world has committed to ending the TB epidemic by 2030, actions and investments don’t match the political rhetoric. Findings from our survey have informed the development of the International Roadmap for TB Research by the TB Research Movement. The reviewers independently piloted the forms until there were no major disagreements in the data extraction process. "But it's better to do that than to expose a lot of people.". Another frequently cited priority was designing trials to evaluate the optimal duration of TB treatment, the influence of level of immunosuppression on effectiveness of TB drugs, and the combination of anti-TB chemoprophylaxis with antiretroviral therapy. "He wasn't horribly sick because he felt like going on his honeymoon and he was what's called 'smear negative.' No, Is the Subject Area "Tuberculosis drug discovery" applicable to this article? Because these research questions are limited in scope to needs identified during guideline development processes, the majority of the questions highlight gaps at the policy/implementation interface (figure 1). Evidence obtained from well-designed, large scale multidisciplinary studies with robust testing of interventions are therefore needed to improve the strength of future guidance. The findings of our review need to be interpreted along with a recent systematic review by Rylance and colleagues [6] on 33 articles with research agendas on TB. Design and branding are copyright ©ERS 2019. When TB bacteria keep growing, eventually "you can see it under a microscope, and that's associated with easily infecting other people," Hamilton says. The National Institute for Health Research Public Health Research Programme (NIHR PHR Programme) in the UK, for example, includes public health decision makers in its decision-making committee, and subsequently, the research it funds has been shown to align with priorities highlighted in national guidelines [11]. The objectives of our systematic review were as follows: (1) to identify all systematic reviews and meta-analyses pertaining to any aspect of tuberculosis from 2005 to 2010, and (2) to assess, compile and rank the research priorities that were identified. For this reason, “Intensified research and innovation” has been identified as one of the three essential pillars of the End-TB Strategy. In the most common category, “Detection, screening and diagnosis”, the top research priority was the evaluation of bacteriological TB diagnostic tests in 14/50 (28.0%) reviews. They may also be a source of questions for future research. Their scope is, however, limited, since systematic reviews themselves are influenced by current hot topics or new technologies. This need is most apparent when responding to complex epidemics such as tuberculosis (TB). Yes At a time when there are many competing demands on limited resources, the WHO and its partners, countries, civil society and affected communities have a joint responsibility to ensure that TB research investments help achieve the goals and targets of the End TB Strategy and the SDGs. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Research questions and priorities for tuberculosis: a survey of published systematic reviews and meta-analyses. One reviewer extracted data and a second reviewer independently extracted data from a random subset of included studies. Approximately 91% (124) of all reviews were not Cochrane reviews. Systematically linking such research questions to public health goals requires collaboration among funders, researchers and end users to ensure that funded research represents value for money, not only through the generation of new knowledge but also by contributing to health and economic outcomes. This exercise was useful to describe the landscape of TB research and the overarching TB research themes arising from systematic reviews and meta-analyses conducted over the last 5 years. BCG: bacille Calmette–Guerin; LTBI: latent TB infection; MDR-TB: multidrug-resistant TB; Hr-TB: isoniazid-resistant TB. [6]). Also, tests for extra-pulmonary TB came up as a frequently cited priority in the Detection of TB category. "He had TB," Hamilton says. Briefly, the research roadmap was developed through a priority ranking exercise conducted by a multidisciplinary group of 50 research experts, a multidisciplinary Delphi consultation, a series of systematic reviews and an open web-based survey [4].Among the systematic reviews that were commissioned, one was focused on all the TB research agendas that have been published from 1998 to 2010 [6]. "What that means is that when he coughed up a specimen to give to the doctors to test for TB, the laboratory looked under the microscope [and] they didn't see any TB bacteria. The infected part of Speaker's lung has been described as roughly the size of a tennis ball, notes the National Jewish Medical and Research Center. There are several ways of accomplishing that. Yes “I'd call it part of the overall treatment of the difficult cases of tuberculosis," with more antibiotic treatment after the operation, Pomerantz says. Charité, Campus Benjamin Franklin, Germany, Received: April 23, 2012; Accepted: June 26, 2012; Published: July 27, 2012. There's a newer blood test called QuantiFERON that tells us about the same information. None of the reviews identified more than five research priorities. Research priorities are identified in the areas of epidemiology; fundamental research; R&D of new diagnostics, drugs and vaccines; and operational and public health research. The search strategy included the following keywords and MeSH terms: [‘tuberculosis’ (explode) OR ‘Mycobacterium tuberculosis’(explode) OR ‘tuberculosis’.ti,ab. "So it is true that it's not that far away. Considering the need for well-funded, timely and high quality research for policy, funders should capitalise on opportunities to strengthen participation of policymakers and other end users in generating priority-driven research funding streams. Speaker's father-in-law is Robert Cooksey, a research microbiologist in the CDC's division of tuberculosis elimination.

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