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
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The topics of the HERMES Syllabus our training is covering are the following:
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.20.3 - The entire module C with special emphasis on C.1.1, C1.5, C1.6, C1.8, C1.10 - 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.3.8 - The entire module E with special emphasis to: E.1.2, E.1.12, E.1.20, E.1.21 - 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
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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.
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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
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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 molecularanalysis 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.
StructureThe 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
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Role plays
WP 7: Training and dissemination
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Institute Marius Nasta, Bucharest: an ideal venue bridging East and West…
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Croatia 2013: the ideal venue bridging East and West…
TB PAN-NET/ERS School course:TB elimination: dream or reality
