In individuals with tuberculosis-infection – until recently referred to as latent tuberculosis infection – the risk of progression to active tuberculosis (reactivation) varies strongly. Among those... Show moreIn individuals with tuberculosis-infection – until recently referred to as latent tuberculosis infection – the risk of progression to active tuberculosis (reactivation) varies strongly. Among those at increased risk of reactivation are patients with an impaired immune system, e.g. due to immunosuppressive therapy. Therefore, prior to planned immunosuppression, patients are screened for tuberculosis-infection and subsequently treated in case of infection. Current screening methods include the Mantoux test, Interferon-γ release assays (i.e., the QuantiFERON-TB Gold Plus and T-SPOT.TB) and chest X-ray. However, despite screening, cases of reactivation continue to occur – in part due to the lack of a gold standard test for tuberculosis-infection. Therefore, the aims of this thesis were to increase the diagnostic sensitivity for tuberculosis-infection prior to immunosuppression. Using various (novel) methods we showed that approximately two-thirds of all QuantiFERON-TB Gold Plus results just below the manufacturer’s cut-off (in the borderline range) are caused by Mycobacterium tuberculosis-infection, which now warrants preventive treatment in patients with such a result. Furthermore, we quantified the diagnostic accuracy of chest X-ray for tuberculosis-infection and showed that using a novel ultra-low dose CT scanning technique, sensitivity for tuberculosis-infection could be significantly increased by three-fold compared to chest X-ray. Show less
This PhD-thesis considers how living in prolonged displacement in the Global South is a mediated experience. I connect literature situated in the fields Forced Migration Studies and Non-media... Show moreThis PhD-thesis considers how living in prolonged displacement in the Global South is a mediated experience. I connect literature situated in the fields Forced Migration Studies and Non-media-centric Media Studies to comprehend how forced migrants can be understood as connected migrants. There has been valuable research on the intersections of migration and mediation. Little attention has been given however to situated and mediated experiences of forced migrants, for whom uncertainty is often the norm. I consider how the interaction between mediated and situated practices constitute everyday experiences of living in legal and social uncertainty. I draw upon ethnographic fieldwork conducted from January to September 2015 on the mediated practices of Iraqi refugees, living in Jordan’s capital Amman. Refugee protection in Jordan is formalised as temporary and restricts the rights to work and to integrate further into Jordan’s society. Among the Iraqi refugees in Jordan, this reinforces the experience of waiting. Experiences of waiting also relates to limited opportunities for legalised onwards travelling and to ongoing warfare in Iraq. Forced migrants are digitally connected migrants. In the case of Iraqi refugees in Jordan, perpetual uncertainty about one’s legal and social place in the world seems to reinforce the need for connections to places and people elsewhere. Living in uncertainty is a deeply affective terrain that is continuously (re)constituted through situated and mediated interactions and practices. There are major structural barriers that prohibit 'progress' in the lives of Iraqi refugees in Jordan. The use and interplay of media and technologies enables some efforts to overcome these and perform important social and subjective functions for the aspirations, identity-construction and home-making practices of refugees, especially since their place in the world continues to be uncertain. Show less
