TB ELIMINATION: DREAM OR REALITY?

Transcription

1 ersnet.org/school TB ELIMINATION: DREAM OR REALITY? 29 May 1 June 2013 Dubrovnik, Croatia SCHOOL COURSE 2013 Educational Material 2013 Educational Material April 2013 Barcelona, Spa Thank you for viewing this document. SCHOOL COURSE We would like to remind you that this material is the property of the author. It is provided to you by the ERS for your personal use only, as submitted by the 2013 author. Edu 2013 by the author

2 Introduction, learning objectives and revision of training material Prof. Giovanni Battista Migliori WHO Collaborating Centre for Control of Tuberculosis and Lung Diseases Fondazione Salvatore Maugeri, Care and Research Institute via Roncaccio 16, 21049, Tradate (VA), Italy Tel ; Fax Aims: The course aims, learning objectives, target audience, educational methods and training materials Summary: The introduction will briefly summarise the background of the course, and the context in which ERS has organised it in collaboration with TB PAN-NET, as well as the course aims, learning objectives, target audience, educational methods and training materials. Educational aims: At the end of the training the participant will be able to: Discuss the global training needs Apply key epidemiological concepts to the clinical practice Discuss the principles behind control and elimination strategies Evaluate the TB elimination programme in own Country Use new tool to diagnose tuberculosis (TB) infection and disease Treat latent TB infected individuals and drug-susceptible TB cases (adults and children)according to the last scientific evidence Apply the principles underlying treatment of multi-drug resistant (MDR-) and extensively drug-resistant(xdr-) TB cases Manage adverse events of MDR- and XDR-TB treatment Design clinical trials for new drugs aimed at treating TB infection and disease Identify the priority areas for research to reach TB elimination Discuss the career opportunities in respiratory medicine in the TB elimination phase The following topics will be covered: Global training needs Clinical epidemiology to reach elimination New drugs for TB infection and disease: developing clinical trials New diagnostics for TB infection and disease: developing clinical trials Treatment and clinical management of adult susceptible, MDR- and XDR- TB (including discussion of true cases provided by both facilitators and participants) Control, elimination and related research priorities (including practical exercises) Career opportunities in TB control and elimination 7

3 The topics of the HERMES Syllabus our training is covering are the following: Module A1: A.1.5 Microbiology A.1.7 Pharmacology A.1.8 Pathology A.1.9 Immunology and defense mechanisms The entire module B4, Tuberculosis: B.4.1 Pulmonary TB B.4.2 Extrapulmonary TB B.4.3 TB in the immunocompromised host B.4.4 Latent tuberculosis infection B.4.5 Non -tuberculous mycobacterial diseases In addition: B.1, B.7, B.10, B.11, B.14, B.15, B.16.3, B.20.2; B The entire module C with special emphasis on C.1.1, C1.5, C1.6, C1.8, C The entire module D.2 with special emphasis to: D.2.3, D.2.4, D.2.5, D.2.11, D.2.15, D.2.22 and D.2.23 and D.3.1, D.3.8, D The entire module E with special emphasis to: E.1.2, E.1.12, E.1.20, E The entire module F - H1 - L1,L2,L3,L7,L8,L9 Target audience: Clinicians in training with an interest in Respiratory Medicine/Infectious Diseases, Microbiology specialists, Clinical Immunologist, Clinical Epidemiologists, Internal Medicine specialists, Public health specialists Format: the course includes: 1. Keynote lectures on: 1. TB PANNET Project: update and findings 2. Global training needs 3. TB disease and infection: epidemiology, control and elimination in the EU and the US 4. New drugs for TB disease and infection: designing clinical trials 5. New diagnostics for TB infection and disease: designing clinical trials 6. Treatment and clinical management of TB (including MDR/XDR and TB-HIV) 2. Exercises on: 1. Evaluation of national TB elimination programmes (group exercise and reporting in plenary) 2. Designing trials for new drugs to treat TB infection and disease (group exercise and reporting in plenary) 3. Designing trials for new diagnostics for TB infection and disease (class exercise) 3. Case presentations for guided group discussions by course members: Selected cases will be prepared for panel discussion, through the using of the voting pad, prepared by participants and facilitators 8

4 4. Brainstorming session on research priorities to reach TB elimination 5. Panel discussion and career opportunities in respiratory medicine Senior faculty members will discuss with participants career opportunities in respiratory medicine based on own experience These courses will be designed to be interactive. There will be a variety of teaching formats: lectures, exercise sessions, case presentations, and career advice sessions. Participants will be able: 1. to understand the TB PANNET project and its role in filling global training gaps in collaboration with ERS 2. to apply new epidemiological and immunological concepts to the clinical practice based on the last available evidence. For example they will be able to identify and use correctly new diagnostics and new drugs based on evidence based, validated algorithms; 3. to understand how to design clinical trials for new drugs and diagnostics for TB infection and disease; 4. to use traditional methods (e.g. microbiology; imaging, bronchoscopy) and new methods (IGRAs, rapid assays for drug resistance including Gene Xpert and Lipa) to diagnose TB infection and disease having in mind what the sensitivity, the specificity and the cost of each test are and having used them in practice; 5. to prescribe correct treatment regimens for TB infection and disease according to the evidence-based guidelines in force; 6. to understand the principles underlying the construction of a second-line regimen for MDR/XDR-TB cases, and construct a combined therapeutic regimen for TB-HIV co-infected individuals; 7. to adequately manage serious and non-serious adverse events occurring in TB patients under treatment; 8. to manage and treat contacts of TB cases; 9. to understand the principles behind control and elimination strategies and to evaluate critically own national TB elimination programmes; 10. to identify the priorities for TB research towards elimination; 11. to understand the career opportunities in respiratory medicine. 9

5 Course presentation GB Migliori WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate Italy Background (1) The TB emergency is far to be solved world-wide New opportunities for international collaboration had been made available The lack of human resources available for TB control and research is still a global (and European) problem Background (2) ERS & TB PAN-NET are committed to give a contribution to this fight We have gathered here the best possible team of facilitators to make this training an ideal platform for young physicians interested in TB research and control 10

6 TB PAN-NET: Pan European network for study and clinical management of drug resistant tuberculosis European consortium of 27 expert partners in the field of drug resistant tuberculosis. Funded by the European Commission (FP7) Duration: from January 2009 to December 2013 The aim is to coordinate activities to limit the spread of MDR strains by supporting high quality epidemiological and molecular analysis as well as training on MDR-TB. Consortium outputs will assist governments in the development and implementation of appropriate health and social policies to limit and control the spread of MDR-TB within the member states of the EU. Structure The project is built around eight different work packages: WP1: Molecular epidemiology of drug-resistant strains in selected metropolitan settings in Western and Eastern Europe WP2: Characterization of novel mutations involved in drug-resistant phenotype and virulence markers WP3: Development and standardization of EQA for drug-resistant TB and expansion of capability for culture-based and molecular-based techniques for drug-resistant TB WP4: Development of integrated sites for clinical and diagnostic trials of new drug applications, new diagnostics, and development of markers for treatment success, and identify clinical and social factors, including HIV as markers of resistance WP5: Training on TB clinical management, control and research (FSM, Italy) WP6: TBNET: Clinical research on TB drug-resistance in Europe WP7: Dissemination and information sharing (ERS) WP8: Management WP 5: Deliverable 5.6: Final course materials 11

7 Role plays WP 7: Training and dissemination 12

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9 Institute Marius Nasta, Bucharest: an ideal venue bridging East and West 14

10 Croatia 2013: the ideal venue bridging East and West TB PAN-NET/ERS School course: TB elimination: dream or reality May 27- June 1, 2013 Dubrovnik, Croatia A top team of facilitators! I Abubakar D. Cirillo L. D Ambrosio M. Dara V. Katalinic D. Manissero L. Reichmann G. Sotgiu J.P. Zellweger The local organiser! Vera Katalinic 15

11 Enjoy your Course, enjoy Dubrovnik!! Thank you! Hvala! Mulţumiri/Mulţumesc Grazie Gracias Merci Danke Spaciba 16