The effect of incarceration on TB treatment outcomes.

BACKGROUND: TB notifications in Latin American prisons have more than doubled over the past two decades; however, treatment outcomes and their determinants among incarcerated individuals in this region are not well understood.METHODS: Newly diagnosed drug-susceptible TB cases reported to Brazil´s Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação, SINAN) between January 2015 and December 2017 were included. Multivariate logistic regression was used to assess socio-economic and clinical factors associated with treatment success among incarcerated individuals.RESULTS: Incarcerated individuals (n = 17,776) had greater treatment success than non-incarcerated individuals (n = 160,728; 82.2% vs. 75.1%; P < 0.0001), including after adjusting for demographic and clinical risk factors (adjusted odds ratio aOR 1.27, 95% CI 1.19-1.34). These differences were partially mediated by increased use of directly observed therapy among incarcerated individuals (DOT) (61% vs. 47%; P < 0.001), which was associated with greater efficacy in the incarcerated population (aOR 2.56 vs. aOR 2.17; P < 0.001). DOT was associated with improved treatment success among incarcerated subpopulations at elevated risk of poor outcomes.CONCLUSION: TB treatment success among incarcerated individuals in Brazil is higher than non-incarcerated individuals, but both fall below WHO targets. Expanding the use of DOT and services for socially and medically vulnerable individuals may improve outcomes in carceral settings.

Siderophore production and iron-regulated envelope proteins of Helicobacter pylori.

All Helicobacter pylori strains tested produced extracellular siderophores, detected by a modified Universal Detection medium, but growth on this medium was poor. By using the iron chelating compound, 2,2'-dipyridyl, outer membrane proteins of 78 and 40 kDa were detected in some, but not all strains examined. No direct binding of lactoferrin or transferrin (the mechanism used by Neisseria to obtain iron) could be demonstrated for H. pylori. Some other techniques for the study of iron-limitation on bacteria were found to be unsuitable for H. pylori.