CONCEPT – TUBERCULOSIS (TB)

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 CONCEPT – TUBERCULOSIS (TB)

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• What is TB : Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) bacteria. It generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, so it is latent tuberculosis. TB when compared with other diseases caused by a single infectious agent, is the second biggest killer, globally.
• History : In the 18th and 19th centuries, a tuberculosis epidemic rampaged throughout Europe and North America, before the German microbiologist Robert Koch discovered the microbial causes of tuberculosis in 1882. Following Koch's discovery, the development of vaccines and effective drug treatment led to the belief that the disease was almost defeated. Indeed, at one point, the United Nations, predicted that tuberculosis (TB) would be eliminated worldwide by 2025. However, in the mid-1980s, TB cases began to rise worldwide, so much so, that in 1993, the World Health Organization (WHO) declared that TB was a global emergency; the first time that a disease had been labeled as such.
• Two types of TB : 

1. Latent TB - the bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active.
2. Active TB - the bacteria do cause symptoms and can be transmitted to others.

• About one-third of the world's population is believed to have latent TB. There is a 10 percent chance of latent TB becoming active, but this risk is much higher in people who have compromised immune systems, i.e., people with HIV or people who smoke.
• From infection to disease : About 10% of latent infections progress to active disease which can kill if left untreated. Symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss. 
• Spread through air : Tuberculosis is spread through the air when people who have active TB in their lungs cough, spit, speak, or sneeze.  People with latent TB do not spread the disease. Diagnosis of latent TB relies on the tuberculin skin test (TST) or blood tests.
• Treatment : It requires the use of multiple antibiotics over a long period of time. Antibiotic resistance is a growing problem with increasing rates of multiple drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). The majority of TB cases can be cured when the right medication is available and administered correctly. The precise type and length of antibiotic treatment depend on a person's age, overall health, potential resistance to drugs, whether the TB is latent or active, and the location of infection (i.e., the lungs, brain, kidneys). People with latent TB may need just one kind of antibiotics, but with active TB (particularly MDR-TB) will need  multiple drugs.
• The biggest killer disease : Presently, one-quarter of the world's population is thought to be infected with TB, and new infections occur in about 1% of the population each year. In 2017, there were more than 10 million cases of active TB which resulted in 1.6 million deaths. This makes it the number one cause of death from an infectious disease. More than 95% of deaths occurred in developing countries, and more than 50% in India, China, Indonesia, Pakistan, and the Philippines.

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