Disease in the News – Tuberculosis
HCS/245
June 25, 2013
Tynan Weed
Tuberculosis
Tuberculosis, TB (tubercle bacillus) or MTB (mycobacterium tuberculosis) is a widespread, and in numerous cases fatal, communicable disease produced by a variety of forms of mycobacteria. The disease is distributed within the air when individuals who are infected with active TB infection sneeze, cough, or pass on breathing fluids throughout the air. Generally infections are asymptomatic, meaning they feel or show no symptoms, and dormant, but then again approximately one in ten dormant infections in the long run move on to the active disease. If left untouched, active TB is fatal to more than half of those infected.
The characteristic warning
…show more content…
Despite the accessibility of inexpensive and successful treatment, tuberculosis still accounts for millions of cases of active disease and deaths worldwide. The disease unreasonably has an effect on the neediest persons in both high-income and developing countries. However, recent improvements in diagnostics, drugs, vaccines and enhanced implementation of present interventions have increased the outlooks for enhanced clinical care and global tuberculosis restriction.
Claims
Currently there are new drug classes that are in investigative trials. Of these, two classes (nitroimidazoles and oxazolidinones) and two medications (bedaquiline and SQ-109) have new methods of action for tuberculosis. Phase 2 trials of bedaquiline added to existing therapy for multidrug-resistant tuberculosis have shown a substantial increase in the rate of sputum-culture conversion at 8 weeks of therapy. Phase 3 trials of each drug are underway, and manufacturers have applied for accelerated marketing approvals by regulatory agencies. Accelerated approval was recently granted by the Food and Drug Administration for the use of bedaquiline in multidrug-resistant tuberculosis.
Several studies of combination drugs are being conducted or are being planned, although these trials face barriers that include pharmacokinetic interactions, the reliance on clinical rather than surrogate end points, and the relatively low financial incentive for drug companies to perform
Tuberculosis has long been a disease that the human culture has been dealing with which entails significant morbidity and mortality worldwide. With dealing with such a horrific disease over the years, discoveries and evolution on the appropriate ways to contain, diagnose, and challengingly treat the disease has changed. One of the most concerning complications of this worldwide public health issue is the ability for it to quickly spread in high populated areas while becoming ever more resistant to forms of treatment not available in all locations around the world. This is a serious public
Complicating the issue of TB’s global spread, is the disease’s mutation into multi-drug resistant strains. The evolution of the bacteria is due to improper or incomplete treatment regimens. Due to TB’s ability to manifest itself in latent and active forms, there are two main sets of treatment options. Both must be strictly adhered to or the patient runs the risk of further infection and death. In terms of treating latent tuberculosis the goal is prevention and elimination. According to the Centers for Disease Control, there are four standard regimens for treating latent tuberculosis. The first is a nine-month regimen of Isoniazid taken either once daily or twice a week. The second is a shorter regiment, six months, of Isoniazid with a smaller dose, yet also taken once daily or twice a week. The third regimen lasts three months and is a combination of Isoniazid and Rifapentine taken once a week. The fourth regiment lasts four months and is completed through daily doses of Rifampin (CDC, 2012).
TB is still proven to be a top killer around the world, and with more cases of drug resistant TB being reported daily, the cost of treating and preventing this disease will continue to be on the rise.
“Tuberculosis (TB), a multisystem disease with myriad presentations and manifestations, is the most common cause of infectious disease–related mortality worldwide. Although TB rates are decreasing in the United States, the disease is becoming more common in many parts of the world. In addition, the prevalence of drug-resistant TB is increasing worldwide. TB is caused by M tuberculosis, a slow-growing obligate aerobe and a facultative intracellular parasite. The organism grows in parallel groups called cords (as seen in the image below). It retains many
While tuberculosis was never completely eliminated, there was a significant drop in cases and death rates, as a result of the BCG vaccine and new anti-tubercular drugs in the 1950’s.
Tuberculosis is a deadly disease that is now affecting our world and the people living in it in a horrible way. Due to many factors such as poverty, HIV/AIDS, and lack of health care, many third world and developing countries have been left very vulnerable to tuberculosis. It is affecting a large part of these countries and is leading them deeper into poverty and sickness. The effort to help these countries against tuberculosis has only been slightly effective against this widespread and destructive disease.
Tuberculosis has been part of human history for a long time but how long is a long time? Recent research using genetic data has allowed us to know that the tuberculosis progenitor has been on this planet for about 3 million years affecting even our earlier ancestors (Gutierrez et al, 2005). Additionally this research showed that the bacilli from tuberculosis are capable of mixing sections of their genome with other strains and giving the pathogen a composite assembly, which resulted from ancient horizontal exchanges before its clonal expansion. This quality provided tuberculosis a big advantage that even now a days allows the organism to evade, adapt and create resistance to treatments that were once successful. In order to fix current and
Tuberculosis is a disease of an infectious nature caused by a bacterium known as mycobacterium tuberculosis. The disease spreads through the air. People with the disease can spread it to susceptible people through coughing, sneezing, talking or spitting. It mainly affects the lungs and other parts such as the lymph nodes and kidneys can also be affected. The symptoms for TB are fatigue, coughing, night sweats, weight loss and fever. One third of the population of the world is affected with mycobacterium tuberculosis. The rate of infection is estimated to be one person per second. About 14 million people in the world are infected with active tuberculosis. Drug resistant TB has been recorded to be a serious public health hazard in many countries. Resistant strains have developed making it difficult to treat the disease. TB has caused millions of death mainly in people living with HIV/AIDS ADDIN EN.CITE Ginsberg19981447(Ginsberg, 1998)1447144717Ginsberg, Ann M.The Tuberculosis Epidemic: Scientific Challenges and OpportunitiesPublic Health Reports (1974-)Public Health Reports (1974-)128-13611321998Association of Schools of Public Health00333549http://www.jstor.org/stable/4598234( HYPERLINK l "_ENREF_3" o "Ginsberg, 1998 #1447" Ginsberg, 1998). The World Health Organization came up with the DOTS (Directly Observed, Therapy, Short course) strategy. The approach involves diagnosing cases and treating patients with drugs for about 6-8
Once believed to be easily treated and prevented, Tuberculosis (TB) has recently been making a steady comeback. Previous to modern medicine, TB claimed millions of victims, spreading from person to person like wildfire. Around the 17th-18th centuries, the “White Plague” took the lives of 1 in 5 adults (20%) in Europe and North America (Iseman, 1994). However, as technological advances progressed, this seemingly ferocious viral disease became a primal, insignificant thing of the past. But, in the nature of all bacteria, TB has, in the recent years, mutated to become progressively drug resistant. Why is Tuberculosis coming back with a vengeance? Well, the answer’s quite simple. TB has done an amazing job of standing in the corner and
Tuberculosis, the white plague as used to be called once upon a time is still one of the deadliest bacterial killers affecting almost all parts, all corners of the globe. Though successful anti-tubercular antibiotic regimens and effective vaccine are available for decades and being used in the battle against Koch’s bacillus, Mycobacterium tuberculosis, the causative agent of this chronic multi organ granulomatous disease, our strand in the battle continuously seems to be in the losing side. Moreover the increasing prevalence of HIV-AIDS and diabetes mellitus is being proved to be providing predisposition to tuberculosis. As witnessed by the WHO, which has estimated that, in the year 2012, 8.6 million people have developed tuberculosis and 1.3 million have died of the disease including 320000 deaths of HIV-TB co-infected people (Global tuberculosis report 2013. World Health Organization; 2013). Long term antibiotic therapy and that too associated with several side effects and discomforts have diminished patient compliance with the anti-tubercular chemotherapy. This fact in turn has raised the new deadlier MDR-TB and XDR-TB strains. The whole scenario is a matter of panic and questioning the effectiveness of anti-tubercular antibiotics, immunologic efficacy of century old BCG vaccine and all other medical advents.
Tuberculosis is one of the major causes of death from many infectious diseases (3). Out of 9 million people who are infected with mycobacteria, about 2 million deaths occur from tuberculosis every year (3). Unfortunately, the prevalence of tuberculosis is in a continuous increase due to increased number of Human immunodeificnecy virus (HIV) patients, bacterial resistance to anti-tuberculous drugs, and growing number of recreational drug users (3). The pathogen responsible for bacterial infection, potentially causing tuberculosis, is mycobacterium tuberculosis (MTB) (2). Persons with adequate immune system can control the bacterial infection so mycobacteria remain dormant for a long time (11). In a typical tuberculous granuloma, mature
For thousands of years’ tuberculosis, has been a continuous epidemic. The disease itself continually finds way to become resistant to the drugs found to fight against it. Mainly affecting developing countries, and those with less access to health care the infection continues to be a clear and present danger. Educating the people on tuberculosis and the way to prevent it, along with the risks factors associated with the disease may help save many lives. The vaccine needs to be more readily available to make sure the people are protected. This paper explains the basics of tuberculosis along with its risk factors, prevalence, assessment, and prevention techniques centered around the global aspect of this disease. Within the paper there are two journal articles along with other internet sources that will more thoroughly explain what tuberculosis is, how to prevent it, and how to treat it. The first article Tuberculosis: a clear and present danger by Lowth (2016) essentially summarizes everything there is to know about tuberculosis including the risks and symptoms of the infection. While the other article Tuberculosis: Which drug regimen and when by Hall, J., &Elliot, C (2015) focuses on the treatment of the two different types of Tuberculosis along with the interventions and complication involved.
The world health organisation (WHO) (2015b) reports that 95% of these deaths are in resource poor areas. This essay will focus on Sub-Saharan Africa, an area with a wide proportion of resource poor settings. WHO (2015d) estimated around 3.2million people in Africa to have TB, with a mortality rate of 450,000. Ethiopia, Kenya, Tanzania, Uganda and the Democratic Republic of the Congo were in the top 25 countries in the
Tuberculosis is among the fatal diseases that are spread through the air. It’s contagious, meaning that it spreads from one infected individual to another, and at times it spreads very fast. In addition to being contagious, the disease is an opportunist infection as it takes advantage of those with weak defense mechanism, and especially the ones with terminal diseases like HIV and AIDS. Tuberculosis is therefore among the major concerns for the World Health Organization due to its contagious nature (World Health Organization 1).
India, the second most populous country with over 1.31 billion people, has the highest burden of tuberculosis (TB) in the world, accounting for 20% of the global incidence of TB, and an even higher share of global incidence of multi–drug resistant (MDR) TB. With an estimated 2 million new cases of TB and 5, 00,000 TB-related deaths in India annually, those who got diagnosed with different forms of DR-TB were 35,385 cases but only 20,753 people started on multidrug-resistant TB (MDR-TB) treatment in 2013. The National Tuberculosis Program was launched in 1962, but suffered heavily continuing TB led mortality. Acknowledging this reality, a Revised National Tuberculosis Control Programme (RNTCP) was launched by the Government of India in 1997, however even today it does not comply with World Health Organization (WHO) recommendations.