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STOP-TB한국사무국 소식

지난 15일 세계보건기구(WHO)는 MDR/RR-TB환자를 위한 치료 옵션의 주요 개선 사항을 포함하는 DR-TB치료에 대한 업데이트된 지침 및 지원 운영 핸드북을 발표했습니다. 이 지침에서 WHO는 MSF’s TB-PRACTECAL clinical trial의 결과를 반영하여, MDR/RR-TB환자와 FQ에 추가적인 내성이 있는 환자(pre-XDR-TB)에게 full oral 6개월 BPaLM regimen의 사용을 권장하였습니다. 국내에서도 DR-TB치료법의 세계적 변화에 따라 국내 지침에 적용을 위한 정보수집 및 근거 마련을 위하여 ‘2023년 결핵 치료 및 진단 개선 민간위탁사업 수행기관’을 모집한다고 최근 밝혔습니다. 이와 같이 국내에서도 빠른 시일 이내에 9개월 (MDR-END regimen) 혹은 6개월 full oral regimen이 환자들의 치료에 공헌하는 날이 빨리 오기를 기원해 봅니다.

The World Health Organization released updated guidelines and a supporting operational handbook on the treatment of drug-resistant TB featuring major improvements in treatment options for people with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB). The guidelines include two new recommendations - one for the use of a novel all-oral 6-month regimen, composed of bedaquiline, pretomanid, linezolid and moxifloxacin (BPaLM) in people with MDR/RR-TB or MDR/RR-TB with additional resistance to fluoroquinolones, and another for a 9-month all-oral regimen in people with MDR/RR-TB and in whom resistance to fluoroquinolones has been excluded.

The Stop TB Partnership released aManual on selection and use of interferon-gamma release assays (IGRAs) for testing for TB infection, developed jointly with the United States Agency for International Development (USAID) and endorsed by the Global Laboratory Initiative (GLI). The manual provides an overview of the recommended use of IGRAs as a class of in-vitro tests for the detection of TB infection and describes their performance, steps for use and implementation considerations.

The TB Vaccine Advocacy Roadmap (TB Vax ARM) and the Stop TB Partnership Working Group on New TB Vaccines announced a new advocacy fellowship program, set to take place in February 2023. The program will convene six fellows representing TB affected communities, advocates, and early career researchers from high TB burden countries for an online skill building and co-learning program to help cultivate a new generation of TB vaccine R&D advocates. Learn more about this opportunity and find out how to apply here . The deadline for applications is 31 December 2022.

The World Health Organization (WHO) released a document summarizing the results of the WHO-commissioned full value proposition for new TB vaccines. The assessment was commissioned to provide early evidence for national and global decision-makers involved in TB vaccine development and implementation with the goal to accelerate development of effective vaccines against TB and their rapid introduction into countries.

Treatment Action Group (TAG) and the Stop TB Partnership released the annual report Tuberculosis Research Funding Trends, 2005-2021 , presenting new data on 2021 funding for TB research and development (R&D) and analyzing trends in investment since 2005. The report highlights that despite reaching US$1 billion in spending in 2021, funding for TB R&D is a mere fraction of what’s needed to achieve the United Nations Sustainable Development Goal of ending TB as a pandemic by 2030.

Six TB vaccine candidates, developed by five different research institutions, are now being tested in three countries: South Korea, France and Australia. This is the first phase of the US$1.7 million head-to-head vaccine trial, funded by the Bill and Melinda Gates Foundation, set to conclude in September 2023. A maximum of three candidates will progress to phase two. Source: James Cook University

TB is among the top five causes of death in women of childbearing age around the world but little is known about the true burden of maternal TB. Because TB in pregnancy is difficult to diagnose due to the similarity of TB symptoms and those of pregnancy, experts stress it is important to integrate active TB case-finding in antenatal care to ensure early diagnosis and treatment of infected mothers. Read the full story at Spotlight.

Tests that identify which drugs someone’s TB is resistant to are critical to ensuring that people are not treated with drugs that do not work for them, especially given the significant side effects associated with some of the drugs. The race is on to develop quick and affordable resistance tests for all commonly used TB drugs. Read the full story at Spotlight.

Children and some people living with HIV find it difficult or impossible to cough up the sputum needed for TB testing. Blood, urine, and saliva are all candidates for TB tests that do not rely on sputum, as increasingly is stool. While all these have pros and cons and while the evidence base is still evolving, there seems to be a compelling case for the wider use of stool samples. Read the full story at Spotlight.

The International Union Against Tuberculosis and Lung Disease (The Union) offers a wide range of comprehensive, free online courses delivered by leading experts. The training and education programs are designed to improve overall lung health, and better manage TB in low-resource settings. Full details about the courses are available here.

Researchers have developed a novel genome assembly tool that could spur the development of new treatments for TB and other bacterial infections. The new tool, which has created an improved genome map of one TB strain, should do likewise for other strains and other types of bacteria, according to researchers whose findings appeared in Nature Communications.

Researchers discovered a new form of altered drug susceptibility — dubbed antibiotic resilience — that enables Mycobacterium tuberculosis to survive antibiotic treatment. The study results could help inform future therapeutics and reduce treatment failure in TB patients.

A study explored the development of an electrochemical phenotype biosensor capable of determining metabolic profile, allowing this way TB treatment to be tailored on an individual patient basis, minimizing adverse drug reactions and improving quality of life in TB patients.

Undernutrition, a deficiency of macronutrients and micronutrients, is the leading risk factor for TB globally, however its impact on treatment outcomes is poorly defined. In a new study , researchers found that severe undernutrition greatly increases the risk of unfavorable outcomes like death, treatment failure and relapse for persons undergoing treatment for TB.

Scientists, studying how a common TB vaccine works, discovered that it induces a previously unknown mechanism in the gut that triggers a systemic immune alert, which then causes changes in the innate immune system in the lung to fend off not just TB, but a broad range of respiratory pathogens.

Researchers reported that a powerful imaging tool, called microCT, can be used to create a three-dimensional, or 3D, atlas of the spectrum of lung lesions in both TB and COVID-19, at near-microscopic levels, giving unexpected insights into the unseen microarchitecture of the lesions within the context of the whole lung.

The International Union Against Tuberculosis and Lung Disease released the December 2022 issue of the International Journal of Tuberculosis and Lung Disease (IJTLD). It includes TB-related research publications.

The International Union Against Tuberculosis and Lung Disease released the December 2022 issue December 2022 issue of Public Health Action, a peer-reviewed open access journal. It includes TB-related research publications.

RESIST-TB released its November 2022 newsletter with the latest research publications on drug-resistant TB.