Latent Tuberculosis

The Truman Doctrine was a United States foreign policy established by President Harry S. Truman (1945-1953) in 1947. The policy stated that the US would provide military and financial support to Greece and Turkey to prevent them from falling to communism. This started a policy of “containment” which would persist for many years to come. After World War II left most of the world devastated, the US and the Soviet Union emerged as the two global superpowers and despite being allies during the war, the two became adversaries when their goals for Europe after the war conflicted. Greece had been embroiled in a Civil War between it’s standing government and a communist party vying for power, and Great Britain, who had long supported Greece, was unable to support them any further, and asked the US for it’s support. In Turkey, Soviet leader Josef Stalin demanded partial control of the Dardanelles, a strait in Turkey connecting the Black Sea and the Mediterranean which possessed significant strategic value. The policy makers of the Truman Doctrine decided that support must go to both Greece and Turkey, as support given to just one of the two would be futile as if one nation fell, the other would fall soon. This idea of one nation’s fall to communism leading to another’s fall to communism became known as the “Domino Theory”. The Truman Doctrine was a significant change in US foreign policy, and set the tone for US relations in Europe and the rest of the world for most of the Cold War.

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

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 (TB) is an infectious killer worldwide. However, over 95% of TB deaths occur in developing countries (WHO). TB is found to be a curable disease when appropriate medications and treatment are taken. Using the biomedical system is not sufficient to eradicate TB because medical interventions will fail if social determinates aren’t taken into considerations. The biomedical system is a key component in diminishing TB because it allows for diagnosis and control. Social determinants of health play a huge role in shaping one’s health. Three main social determinants that acts as a barrier in curing and preventing TB are income, food insecurity and access to health care.

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.

Active disease is diagnosed with chest x-ray, skin or blood tests and sputum smears. Cat scans and MRI’s can also be used for diagnosing. Treatment for active non-resistant TB consists of the use of a two drug therapy, generally isoniazid and rifampicin. Cure rate for this strain of TB can be over 90%. Treatment for active TB is done for a minimum of six months. As a result of individuals incompletely finishing their recommended dose of anti-tubercular

TB is a major cause of mortality and morbidity globally that boils down to one small, single infection. TB can be classified into 2 stages; Latent TB and Active TB. In Latent TB, the bacteria remain in the body in an inactive or dormant state. A person will not have any symptoms because their immune mechanism has stopped the bacteria from growing. Latent TB can remain in a dormant state for year (Zager et al, 2009). However this disease can easily change to Active TB. This change mainly occurs due to the rapid increase of Mycobacterium TB within an individual when a person becomes ill or their immune system is compromise. Ninety percent of the time, those who are infected with

INTRODUCTION: Treatment with Isoniazid (INH) has been proven effective in preventing activation of latent tuberculosis (TB) into clinical disease. The recommendation of INH treatment ranges between 6 to 12 months of continuous therapy (1, 2). The most common side effects of INH are gastrointestinal adverse events. Prospective clinical trials have shown the risk of INH-induced hepatitis, mostly with gradual increased levels of AST and ALT.

Current treatment of this disease is a complex, long process. Because of TBs notorious background of being resistant to many drugs, treatment usually consists of an antibiotic regimen lasting upwards of 6-12 months. Treatment also varies from individual to individual. Age, health, TB form, and location of infection all impact the type of treatment one is given to aide in curing the disease (MayoClinic, 2014). Regardless, treatment of this disease is not an easy task for many reasons. Compliance and patients tolerance to such a strict medication regimen for a prolonged period of time is a huge variable which decreases the likeness of successful treatment related to increased occurrences of medication side effects and missed dosages. According to World Health Organization

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.

As this disease is most prevalent in developing countries, losing money is hugely impactful on society. The living conditions in these places are very poor, helping TB to spread faster and without having the opportunity to spend this money on cleaner water and sustainable living for its inhabitants, it leads to a global pandemic. Treatment for TB is not only costly, but also very lengthy and leads to people pulling out of the workforce for long amounts of time. This is expected in the next ten years, to cost the world’s poorest countries up to $3 trillion and is responsible for a production decrease of about 4-7% in some countries’ GDP. Tuberculosis is very threatening to society today, as treatment is very expensive for people living in these

Treatment for TB is often a success, but it is a long process. It usually takes 6 to 9 months to treat TB. In some cases, it can take up to 2 years. Active TB is treated with a combination of antibiotics typically prescribed for 6 months; if, at that point, the TB is still active, the treatment is extended for a period consisting of two to three months to a full year of treatment. If the TB bacteria are resistant to the most commonly prescribed antibiotics known as multidrug-resistant TB, then treatment may be extended to a

Although Africa and other developing nations lead in the number of those infected with tuberculosis, the infected population in the world is currently estimated to be at around one third of the

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.

The prevalence of multi-drug resistant tuberculosis has not only impacted India it has impacted other countries like Africa. Multi-drug resistant tuberculosis is when the regular medicine such as isoniazid and rifampicin one of the two anti-tuberculosis drugs used, the resistance can occur either through not following the proper treatment guidelines or from a drug resistant bacteria, tuberculosis can be caused from Mycobacterium Tuberculosis a bacteria that causes tuberculosis which attacks the lungs. Tuberculosis occurs through droplet infection and is extremely contagious, due the nature of being multi-drug resistant (MDR-TB) and extensively drug resistant (XDR-TB) many of the medications are expensive and hard to come by.