An overview on Tuberculosis

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Tuberculosis (TB) is an infectious disease caused by bacteria “Mycobacterium Tuberculi”. This bacterium was first discovered by German Physician Robert Koch who received Nobel Prize for this discovery. TB mostly affects the lung but it can also affect any organ of the body. Many years ago, TB was referred as “consumption” because patients would waste away due to lack of effective treatment. But now-a-days TB can be cured successfully. One third of the world’s population is thought to have been infected with M. tuberculi and new infections occur at a rate of about one per second. In 2007, there were an estimated 13.7 million chronic active cases and in 2010, there were 8.8 million new cases and 1.5 million deaths, mostly in developing countries. In addition more people are being infected with TB because their immune systems are compromised due to higher rates of AIDS. The distribution of tuberculosis is not uniform across the globe. About 80% of the population in Asian and African countries is suffered from TB while only 5-10% of the U.S. population is suffered.

The World Health Organization declared TB as a global health emergency in 1993 and in 2006, the stop TB partnership developed a global plan to stop tuberculosis that aims to save 14 million lives between its launch and 2015.

Symptoms:

TB can affect any part of the body but most commonly occurs in the lungs. General symptoms of TB are: fever, night sweats, chills, loss of appetite, weight loss and fatigue.

Diagnosis:

Diagnosis of TB based on sign and symptoms is difficult. A definitive diagnosis should be made by testing of clinical samples (sputum). TB can also be sometimes diagnosed by imaging, tuberculin skin test or Interferon Gamma Release Assay (IGRA).

Prevention:

Prevention of TB primarily depends on vaccination of infants. BCG (Bacillius Calmette Gaerin) is the only currently available vaccine for TB.

Treatment:

Tuberculosis can be successfully treated with combination of anti tuberculosis drugs:

First line drug: These drugs have high anti tubercular activity as well as low towicity.

  • Isoniazide
  • Rifampin
  • Pyrazinamide
  • Ethambutol
  • Streptomycin

Second line drug: these drugs have either low anti tubercular activity or high toxicity or both

  • Thiacetazone
  • Para aminosalicylic acid
  • Thionamide
  • Cycloserine
  • Kanamycin
  • Amikacin
  • Capreomycin

Newer drug:

  • Ciprofloxacin
  • Ofloxacin
  • Clarithromycin
  • Azithromycin
  • Rifabutin
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