2022
Neighbourhood prevalence-to-notification ratios for adult bacteriologically-confirmed tuberculosis reveals hotspots of underdiagnosis in Blantyre, Malawi
Khundi M, Carpenter JR, Corbett EL, Feasey HRA, Soko RN, Nliwasa M, Twabi H, Chiume L, Burke RM, Horton KC, Dodd PJ, Cohen T, MacPherson P. Neighbourhood prevalence-to-notification ratios for adult bacteriologically-confirmed tuberculosis reveals hotspots of underdiagnosis in Blantyre, Malawi. PLOS ONE 2022, 17: e0268749. PMID: 35605004, PMCID: PMC9126376, DOI: 10.1371/journal.pone.0268749.Peer-Reviewed Original ResearchConceptsCase notification ratesPrevalence surveyNotification ratioNeighbourhood prevalenceTB case notification ratesXpert MTB/RIFCase-finding interventionsTrue disease burdenChest X-ray screeningTB prevalence surveyTB surveillance systemMTB/RIFDiagnosis of tuberculosisSputum smear microscopyTB clinicTB patientsRespiratory infectionsTB prevalenceDisease burdenNotification ratesSmear microscopyX-ray screeningTuberculosisPrevalenceUrban tuberculosis
2021
Development of a Treatment-decision Algorithm for Human Immunodeficiency Virus–uninfected Children Evaluated for Pulmonary Tuberculosis
Gunasekera KS, Walters E, van der Zalm MM, Palmer M, Warren JL, Hesseling AC, Cohen T, Seddon JA. Development of a Treatment-decision Algorithm for Human Immunodeficiency Virus–uninfected Children Evaluated for Pulmonary Tuberculosis. Clinical Infectious Diseases 2021, 73: e904-e912. PMID: 33449999, PMCID: PMC8366829, DOI: 10.1093/cid/ciab018.Peer-Reviewed Original ResearchConceptsPulmonary tuberculosisClinical evidenceXpert MTB/RIFBaseline clinical evaluationChest radiographic resultsRapid treatment initiationNational Tuberculosis ProgrammeTreatment decision algorithmsEvidence-based algorithmMTB/RIFDiagnosis of tuberculosisChest radiographicAntituberculosis treatmentProspective cohortRadiographic resultsTreatment initiationTuberculosis casesTuberculosis ProgrammeClinical evaluationCase definitionTreatment decisionsGlobal burdenChildhood mortalityChildren EvaluatedRapid clinical diagnosis
2020
Risk factors for recurrent tuberculosis after successful treatment in a high burden setting: a cohort study
Cudahy PGT, Wilson D, Cohen T. Risk factors for recurrent tuberculosis after successful treatment in a high burden setting: a cohort study. BMC Infectious Diseases 2020, 20: 789. PMID: 33097000, PMCID: PMC7585300, DOI: 10.1186/s12879-020-05515-4.Peer-Reviewed Original ResearchConceptsM. tuberculosis infectionRecurrent tuberculosisSuccessful treatmentTuberculosis recurrenceHazard ratioSmear gradeTuberculosis infectionRisk factorsSmear-positive pulmonary tuberculosisCox proportional hazards modelSputum smear gradeRepetitive unit-variable number tandem repeat (MIRU-VNTR) typingHigh-burden settingsRisk of recurrenceProportional hazards modelSuccessful treatment completionRecurrent diseaseCohort studyPulmonary tuberculosisBurden settingsClinical presentationRecurrent episodesInitial episodeNumber tandem repeat typingTreatment completionYield, Efficiency, and Costs of Mass Screening Algorithms for Tuberculosis in Brazilian Prisons
da Silva Santos A, de Oliveira R, Lemos EF, Lima F, Cohen T, Cords O, Martinez L, Gonçalves C, Ko A, Andrews JR, Croda J. Yield, Efficiency, and Costs of Mass Screening Algorithms for Tuberculosis in Brazilian Prisons. Clinical Infectious Diseases 2020, 72: 771-777. PMID: 32064514, PMCID: PMC7935388, DOI: 10.1093/cid/ciaa135.Peer-Reviewed Original ResearchConceptsXpert MTB/RIFMTB/RIFChest radiographySputum Xpert MTB/RIFHigh TB burden countriesFourth-generation assaysScreening algorithmTB burden countriesSputum testingTB casesTB screeningBurden countriesProspective studySputum testSymptom assessmentChest radiographsScreening testPositivity thresholdMass screeningTuberculosisMore casesDiagnostic algorithmDiagnostic testsMajor causeScreening strategy
2019
Transmissibility and potential for disease progression of drug resistant Mycobacterium tuberculosis: prospective cohort study
Becerra MC, Huang CC, Lecca L, Bayona J, Contreras C, Calderon R, Yataco R, Galea J, Zhang Z, Atwood S, Cohen T, Mitnick CD, Farmer P, Murray M. Transmissibility and potential for disease progression of drug resistant Mycobacterium tuberculosis: prospective cohort study. The BMJ 2019, 367: l5894. PMID: 31649017, PMCID: PMC6812583, DOI: 10.1136/bmj.l5894.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAntitubercular AgentsChildChild, PreschoolContact TracingDisease ProgressionFemaleFollow-Up StudiesHumansIncidenceInfantInfant, NewbornIsoniazidKaplan-Meier EstimateMaleMicrobial Sensitivity TestsMiddle AgedMycobacterium tuberculosisPeruProspective StudiesRifampinSputumTuberculin TestTuberculosis, Multidrug-ResistantTuberculosis, PulmonaryYoung AdultConceptsDrug-sensitive tuberculosisMultidrug-resistant tuberculosisHousehold contactsProspective cohort studySensitive tuberculosisTuberculosis infectionResistant tuberculosisCohort studyTuberculosis diseaseHigh riskDrug-resistant Mycobacterium tuberculosisIncident tuberculosis diseasePhenotypic drug resistanceDistrict Health CenterResistant Mycobacterium tuberculosisDrug-susceptible strainsDrug resistance profilesActive diseasePulmonary tuberculosisDisease progressionGuideline producersHealth centersIndex patientsEffective treatmentPatients
2016
Smear positivity in paediatric and adult tuberculosis: systematic review and meta-analysis
Kunkel A, Abel zur Wiesch P, Nathavitharana RR, Marx FM, Jenkins HE, Cohen T. Smear positivity in paediatric and adult tuberculosis: systematic review and meta-analysis. BMC Infectious Diseases 2016, 16: 282. PMID: 27296716, PMCID: PMC4906576, DOI: 10.1186/s12879-016-1617-9.Peer-Reviewed Original ResearchConceptsPercentage of childrenSmear positivityPooled percentageInverse variance heterogeneity modelPediatric TB casesSmear-positive TBNational TB ProgrammeBurden of TBGlobal Health databasesSputum smear microscopyActive TBAdult tuberculosisPositive TBTB casesTB programsAdult casesPROSPERO databaseSputum smearInclusion criteriaSmear microscopyHealth databasesSystematic reviewAdultsChildrenTuberculosisRapid Drug Susceptibility Testing of Drug-Resistant Mycobacterium tuberculosis Isolates Directly from Clinical Samples by Use of Amplicon Sequencing: a Proof-of-Concept Study
Colman RE, Anderson J, Lemmer D, Lehmkuhl E, Georghiou SB, Heaton H, Wiggins K, Gillece JD, Schupp JM, Catanzaro DG, Crudu V, Cohen T, Rodwell TC, Engelthaler DM. Rapid Drug Susceptibility Testing of Drug-Resistant Mycobacterium tuberculosis Isolates Directly from Clinical Samples by Use of Amplicon Sequencing: a Proof-of-Concept Study. Journal Of Clinical Microbiology 2016, 54: 2058-2067. PMID: 27225403, PMCID: PMC4963505, DOI: 10.1128/jcm.00535-16.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChildChild, PreschoolFemaleGenotyping TechniquesHigh-Throughput Nucleotide SequencingHumansMaleMicrobial Sensitivity TestsMiddle AgedMycobacterium tuberculosisPharmaceutical PreparationsPilot ProjectsSequence Analysis, DNASpecimen HandlingSputumTime FactorsYoung AdultConceptsDrug-resistant tuberculosisPatient sputum samplesDrug resistance profilesSputum samplesDrug-resistant Mycobacterium tuberculosis isolatesPhenotypic drug susceptibility testing resultsDrug susceptibility testing resultsEvidence-based treatment plansResistance profilesMajor global health concernRapid drug susceptibility testingMycobacterium tuberculosis isolatesNext-generation sequencingClinical samplesAmplification of resistanceDrug susceptibility testingTargeted Next-Generation SequencingMycobacterium tuberculosis DNAGlobal health concernSusceptibility testing resultsSame clinical samplePhenotypic DSTInfectious causesTreatment outcomesTuberculosis isolatesWithin-Host Heterogeneity of Mycobacterium tuberculosis Infection Is Associated With Poor Early Treatment Response: A Prospective Cohort Study
Cohen T, Chindelevitch L, Misra R, Kempner ME, Galea J, Moodley P, Wilson D. Within-Host Heterogeneity of Mycobacterium tuberculosis Infection Is Associated With Poor Early Treatment Response: A Prospective Cohort Study. The Journal Of Infectious Diseases 2016, 213: 1796-1799. PMID: 26768249, PMCID: PMC4857469, DOI: 10.1093/infdis/jiw014.Peer-Reviewed Original ResearchConceptsMonths of treatmentMycobacterium tuberculosis infectionTuberculosis infectionTreatment responsePoor early treatment responseProspective cohort studyInitiation of treatmentM. tuberculosis infectionRepetitive units-variable numberEarly treatment responsePersistent culture positivityCohort studyClinical managementCulture positivityHigher oddsInfectionTuberculosisPrevalenceTreatmentMonthsResponsePatientsKwaZulu-NatalHost heterogeneityPositivity
2014
Magnitude and sources of bias in the detection of mixed strain M. tuberculosis infection
Plazzotta G, Cohen T, Colijn C. Magnitude and sources of bias in the detection of mixed strain M. tuberculosis infection. Journal Of Theoretical Biology 2014, 368: 67-73. PMID: 25553967, PMCID: PMC7011203, DOI: 10.1016/j.jtbi.2014.12.009.Peer-Reviewed Original ResearchConceptsMixed infectionsM. tuberculosis infectionIncidence of TBOutcome of treatmentPopulation-level interventionsFraction of casesTuberculosis infectionMinority strainsActual prevalenceInfected individualsInfectionStudy designMycobacterium tuberculosisPrevalenceSputumTuberculosisDistinct strainsDifferent strainsSources of biasPrevious studiesPatientsSpecific reasonsIncidenceIndividualsAssessment of the patient, health system, and population effects of Xpert MTB/RIF and alternative diagnostics for tuberculosis in Tanzania: an integrated modelling approach
Langley I, Lin HH, Egwaga S, Doulla B, Ku CC, Murray M, Cohen T, Squire SB. Assessment of the patient, health system, and population effects of Xpert MTB/RIF and alternative diagnostics for tuberculosis in Tanzania: an integrated modelling approach. The Lancet Global Health 2014, 2: e581-e591. PMID: 25304634, DOI: 10.1016/s2214-109x(14)70291-8.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioHigh incremental costIncremental costLED fluorescence microscopyCost-effectiveness ratioPay thresholdsFull rolloutContext of TanzaniaCost-effective optionHealth policy formulationPolicy formulationDifferent diagnostic optionsIntegrated modelling approachModelling approachAdditional costHealth systemCostAlternative diagnosticsIntegrated modelXpert MTB/RIFPopulation effectsMTB/RIFPresumptive tuberculosis casesWillingnessUse of Xpert
2012
Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation
Menzies NA, Cohen T, Lin HH, Murray M, Salomon JA. Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation. PLOS Medicine 2012, 9: e1001347. PMID: 23185139, PMCID: PMC3502465, DOI: 10.1371/journal.pmed.1001347.Peer-Reviewed Original ResearchConceptsMultidrug-resistant TBCost-effectiveness ratioInitial diagnosisXpert MTB/RIF testMTB/RIF testXpert MTB/RIFIntroduction of XpertTB natural historyTB-HIV coinfectionMultidrug-resistant tuberculosisHigh HIV prevalenceMTB/RIFHealth system costsImplementation of XpertHealth impactsPopulation health impactCost-effectiveness resultsLong-term transmission dynamicsWorld Health OrganizationAntiretroviral therapyTB casesTB deathsTB morbidityHIV prevalenceRIF testThe impact of new tuberculosis diagnostics on transmission: why context matters
Lin HH, Dowdy D, Dye C, Murray M, Cohen T. The impact of new tuberculosis diagnostics on transmission: why context matters. Bulletin Of The World Health Organization 2012, 90: 739-747. PMID: 23109741, PMCID: PMC3471051, DOI: 10.2471/blt.11.101436.Peer-Reviewed Original ResearchConceptsNew tuberculosis diagnosticsNew diagnostic toolsPatient lossHuman immunodeficiency virus (HIV) infectionTuberculosis diagnosticsSmear-negative pulmonary tuberculosisDiagnostic toolImmunodeficiency virus infectionTreatment success rateSmear-negative casesIncidence of tuberculosisEpidemiology of tuberculosisPatient defaultPulmonary tuberculosisTuberculosis careDiagnostic pathwayTuberculosis transmissionSymptomatic individualsVirus infectionSmear microscopyTuberculosisAnnual declineDiagnosisAbsolute changeSuccess rateOutcomes among tuberculosis patients with isoniazid resistance in Georgia, 2007-2009.
Gegia M, Cohen T, Kalandadze I, Vashakidze L, Furin J. Outcomes among tuberculosis patients with isoniazid resistance in Georgia, 2007-2009. The International Journal Of Tuberculosis And Lung Disease 2012, 16: 812-6. PMID: 22507372, PMCID: PMC3786434, DOI: 10.5588/ijtld.11.0637.Peer-Reviewed Original ResearchMeSH KeywordsAdultAntitubercular AgentsChi-Square DistributionDrug Resistance, BacterialDrug Therapy, CombinationEthambutolFemaleGeorgia (Republic)HumansIsoniazidLogistic ModelsMaleMicrobial Sensitivity TestsMiddle AgedMultivariate AnalysisMycobacterium tuberculosisPredictive Value of TestsPyrazinamideRetrospective StudiesRifampinRisk AssessmentRisk FactorsSputumTime FactorsTreatment OutcomeTuberculosisConceptsPulmonary tuberculosisPrevious treatmentOutcomes of patientsPulmonary TB patientsSubset of patientsRetrospective record reviewForms of tuberculosisFirst-line drugsHigh TB ratesDrug-resistant formsLower ratesLow tuberculosisTB patientsTuberculosis patientsOptimal management strategyTreatment regimenRecord reviewTB ratesTreatment successTreatment outcomesCountry of GeorgiaPatientsIsoniazid resistanceTuberculosisDrug resistance
2011
A modelling framework to support the selection and implementation of new tuberculosis diagnostic tools [State of the art series. Operational research. Number 8 in the series]
Lin HH, Langley I, Mwenda R, Doulla B, Egwaga S, Millington KA, Mann GH, Murray M, Squire SB, Cohen T. A modelling framework to support the selection and implementation of new tuberculosis diagnostic tools [State of the art series. Operational research. Number 8 in the series]. The International Journal Of Tuberculosis And Lung Disease 2011, 15: 996-1004. PMID: 21740663, DOI: 10.5588/ijtld.11.0062.Peer-Reviewed Original ResearchConceptsDiagnostic strategiesHealth systemTB transmission dynamicsDiagnosis of tuberculosisHealth system requirementsDiagnostic toolHealth system componentsPolicy makersNew diagnostic strategiesHealth care infrastructureNovel diagnostic toolPatient outcomesDifferent epidemiologyJoint modelling frameworkModelling frameworkTest characteristicsCare infrastructureTransmission dynamicsRational choiceTuberculosisTechnological innovationStrategy decisionsDifficult decisionsMakersRecent introduction