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Multiple and Extensively Drug-Resistant Tuberculosis (M & XDR TB) and HIV
Slide 1.

Gerald Friedland
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Multiple Drug Resistant MDR TB First-Line TB Drugs
Slide 3.

Extensively Drug Resistant XDR TB Second-Line Drugs
Slide 4.

Worldwide Emergence of XDR TB, 2000-4
Slide 5.

Global Estimates
Slide 6.

Countries with XDR-TB Confirmed cases
Slide 7.

49 cases XDR TB in US 1993-2006
Slide 8.

KwaZuluNatal-Tugela Ferry-2001-2005
Slide 9.

Tugela Ferry
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Medical Setting-COSH
Slide 12.

Outcomes in TB/HIV Integration Study-12 mos
Slide 13.

Outcomes in TB/HIV Integration Study-12 mos
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XDR TB Patient Characteristics (n=53)
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Nosocomial Transmission of XDR TB
Slide 19.

Hospital Acquired XDR-TB
Slide 20.

Further Support for Nosocomial Transmission and Exogenous Superinfection
Slide 21.

Updated Figures from Tugela Ferry
Slide 22.

Is MDR & XDR TB Widespread in South Africa and Beyond?
Slide 23.

Cumulative Number of Health Care Facilities with >= 1 Case of XDR-TB
Slide 24.

Evolution of Drug Resistance in KZN Strain Family
Slide 25.

Etiology of XDR TB Epidemic in KwaZuluNatal
Slide 26.

Future Projections Tugela Ferry (2007-2012)
Slide 27.

What Can Be Done in the Short Term to Reduce the Impact of XDR TB Epidemic?
Slide 28.

XDR TB Cases Averted over the Next Five Years
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Efficacy of Rapidly Available Strategies to Reduce Nosocomial Transmission
Slide 30.

M/XDR TB Is A Wake Up Call
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TF CARES Tugela Ferry Care and Research Collaboration
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HIV-related MDR-TB Outbreaks in Industrialized Countries, 1988-1995
Slide 34.

The KZN Strain
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The KZN Strain IS 6110 Fingerprint
Slide 36.

Sequential Spoligotypes from Patient Developing XDR TB SpoIDB4 Shared-Type (ST) Classifications
Slide 37.

Genotyping of M/XDR Isolates from Tugela Ferry
Slide 38.

Adhesion to and Invasion of A549 Cells by Different Strains of M.Tuberculosis
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Survival of Different Strains of M.Tuberculosis in Whole Human Blood
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KZN Strain
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MDR/XDR TB Two Case Studies
Slide 42.

Two Case Studies MDR/XDR TB
Slide 43.

Natural Ventilation for the Prevention of Airborn Contagion
Slide 44.

Old Fashioned vs. Modern Facilities: ACH, Absolute Ventilation, Risk of TB Infection
Slide 45.

Susceptibility Pattern
Slide 46.

Reinfection with XDR TB
Slide 47.

Exogenous Re-Infection
Slide 48.