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Researchers show way to reduce prevalence, spread of TB in former Soviet Union

Rates of tuberculosis and drug-resistant TB are among the highest in the world in countries of the former Soviet Union. Noting that "tuberculosis doesn’t stop at any border or any locked gate" and that prison inmates often transmit the diseases to the general population upon their release, Stanford professor Jeremy Goldhaber-Fiebert, MD, says there’s a real need to curb TB among among inmates there.

Now Goldhaber-Fiebert and colleagues have found in a study that “a genetic TB and drug-resistance screening tool called GeneXpert is more cost-effective and better at reducing the spread of the disease than other methods currently recommended by the World Health Organization.”

A release provides more details on the GeneXpert test, which can detect TB and drug-resistant strains with a small sample of mucous analyzed by a machine, and the significance of the Stanford study:

By developing computer models of the former Soviet Union's prison populations, the team predicted that using GeneXpert can cut the prevalence of TB among inmates by about 20 percent within four years — provided the screening is combined with standard regimens of drug treatment for infected patients and for those with drug-resistant TB.


"There is a large, direct value to using this technology for screening in prison settings, and there are potentially substantial secondary benefits to the general population of the former Soviet Union and to the world," Goldhaber-Fiebert said.

Douglas K. Owens, a professor of medicine who is one of the paper's co-authors and director of Stanford Health Policy, said the findings could give governments and medical experts the evidence they need to change the way they tackle TB.

"This is the kind of work we hope will inform policymaking about TB control," Owens said. "We've shown there's a more effective approach for trying to catch TB in prisons, and that means a better chance for preventing the disease from spreading."

The findings appear online in PLoS Medicine.

Previously: Coming soon: a faster, cheaper, more accurate tuberculosis test

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