Significant Advances in Tuberculosis Management

Tuberculosis (TB) remains a major global health problem that affects a lot of people worldwide. It is a serious contagious disease that primarily affects the lungs, in addition to other parts of the body such as the brain, kidneys, and spine. It is transmitted when an infected person sneezes, coughs, or speaks. Its symptoms can include a persistent cough, chest pain, weight loss, fever, night sweats, fatigue, and other symptoms acknowledged by the physician. TB can be active or latent, depending on the presence or absence of symptoms. Active TB is the common and infectious TB that develops symptoms; these symptoms can take weeks or even months to build, while Latent TB is the non-infectious TB that shows no symptoms at all.

The first documented case of TB in humans dates back to 460 BCE in ancient Greece, where Hippocrates described the symptoms of the disease. However, it was not until the 19th century that TB became a major public health concern in Europe and North America, with the rise of industrialization and urbanization leading to overcrowding and poor living conditions that facilitated the spread of the disease. The bacterium that causes TB, MYCOBACTERIUM TUBERCULOSIS, was first identified by Robert Koch in 1882. This discovery led to the development of new diagnostic tools and treatments for the disease in the early 20th century.

In 2019, the World Health Organization (WHO) recorded an estimated 10 million people worldwide affected by TB, 1.4 million of whom died from the disease and 465,000 cases of multidrug-resistant TB (MDR-TB) worldwide. TB is particularly common in low- and middle-income countries, where factors such as poor living conditions, malnutrition, and limited access to healthcare contribute to its spread.

There has been a renewed global effort to fight TB in recent years. This has included increased funding for research and development of new drugs, vaccines, and diagnostic tools, as well as initiatives aimed at improving TB control and prevention. Also, there has been a growing recognition of the importance of targeting high-risk groups, such as people living with HIV/AIDS, prisoners, and those living in poverty or overcrowded conditions, as these groups are more likely to contact the said disease easily.

 Initially, the diagnosis of TB has been based on a combination of clinical symptoms, chest X-ray, laboratory tests, and culture. However, these tests are inaccurate and can be time-consuming and expensive. In recent years, there has been a significant evolution in TB diagnostics. New molecular diagnostic tests have been developed that are more accurate and faster than initial methods. These tests can detect TB infection even before symptoms develop, and can also identify drug-resistant strains of TB.

The treatment of TB has humbly improved in recent years. New drugs and vaccines have been produced that give promising results and have fewer side effects than initial drugs. These drugs can be used to treat both drug-sensitive and drug-resistant TB. The evolution of TB diagnostics and treatment has made it possible to more effectively control the disease. 

 Here are some of the notable advances in TB diagnostics and treatment in recent years:

●         The development of rapid molecular diagnostic tests that can detect TB infection in a matter of hours.

●         The production of new drugs that are more effective and have fewer side effects than older drugs.

●         The development of shorter treatment regimens that are more likely to be completed by patients.

●         The innovation of new strategies to prevent the spread of TB, such as vaccination and contact tracing.

These advances have made it possible to more effectively control TB and save lives. However, there is still a need for further research and development. In particular, there is a need for new drugs that are more effective against drug-resistant strains of TB. There is also a need for new strategies to prevent the spread of TB in populations that are at high risk of infection.

Overall, while TB remains a significant global health challenge, advances in diagnostics and treatment, along with continued research, development, and renewed global effort to combat the disease, offer hope for improved outcomes for patients and reduced transmission of TB in the future. More important of it all, is a world free of TB disease.

By: Abdulrahmon Moradeyo

REFERENCE

1.         World Health Organization (WHO). Global Tuberculosis Reports, 2022.  https://www.who.int/teams/global-tuberculosis-programme/tb-reports

2.         Parums, Dinah V. “Editorial: Updates from the World Health Organization (WHO) on Global Treatment Recommendations for Drug-Susceptible and Multidrug-Resistant Tuberculosis.” Medical Science Monitor, 9 Aug. 2021, medscimonit.com/abstract/full/idArt/934292.

3.         “Epidemiology of Tuberculosis and Progress toward Meeting Global Targets - Worldwide, 2019.” Centers for Disease Control and Prevention, 25 Mar. 2021, www.cdc.gov/mmwr/volumes/70/wr/mm7012a4.htm.

4.         Schito, M., Migliori, G. B., Fletcher, H. A., McNerney, R., Centis, R., Bates, M., Kibiki, G., Kapata, N., Corrah, T., Bomanji, J., Vilaplana, C., Johnson, D., Mwaba, P., Maeurer, M., & Zumla, A. (2015). Perspectives on Advances in Tuberculosis Diagnostics, Drugs, and Vaccines. Clinical Infectious Diseases, 61(suppl_3), S102-S118. https://doi.org/10.1093/cid/civ609