Tuberculosis
Tuberculosis

Tuberculosis (TB) is another disease that infects people across the globe. Tuberculosis spreads through the air when people who are infected with it cough, sneeze, or speak. People infected by TB often have no symptoms of the disease. It is only when a person’s immune system is compromised that he or she develops symptomatic TB. Symptoms include a lingering cough, fever, weight loss, night sweats, loss of appetite, and fatigue.

Tuberculosis is most prevalent in areas with high population density. As economies become more industrial and less rural, urban populations grow and the conditions improve for the spread of TB. The disease is most common in poor areas, where multiple families share housing and work in buildings with poor ventilation; in refugee camps, where people are forced to live together (it is estimated that as many as 50 percent of the world’s refugees are infected with TB); and among homeless populations (T.B. is a global peril, 2002).

Tuberculosis is not only found in poor and distant countries; it is a public health concern in the United States as well. According to the CDC, 9.951 new TB cases were reported in the United States in 2012. This represents a drop of 6.1 percent since 2011 (CDC, 2012) 

TB is not only a problem in areas with high concentrations of people, like cities; it is also a problem in schools, where children spend a lot of time close together in classrooms, and among people with compromised immune systems. Individuals with HIV/AIDS are particularly vulnerable to catching fatal cases of TB.In fact, 24 percent of TB deaths [are] HIV associated (World Health Organization, n.d.). (See The Link between TB and HIV.)

Estimated TB incidence, prevalence and mortality, 2011

 

Incidence1

Prevalence2 

Mortality 

WHO region

No. in thousands

% of global total

 

No. in thousands

 

No. in thousands

Africa

2300

26.1%

 

2500

 

220

 

The Americas 

260

3%

330

 

21

 

Eastern Mediterranean 

660

7.5%

 

1000

 

99

 

Europe 

380

4.3%

 

500

 

45

 

South-East Asia 

3500

39.7%

 

5000

 

480

 

Western Pacific

1700

19.3%

 

2500

 

130

 

Global total

8800

100%

 

11830

995

 

1Incidence is the number of new cases arising during a defined period.

2Prevalence is the number of cases (new and previously occurring) that exists at a given point in time.

3Pop indicates population.

http://www.who.int/tb/publications/global_report/2011/en/index.html

On the whole: TB can be cured, but treatment typically involves taking at least four different medicines over a 6-12 month period. Many TB patients are not able to follow this treatment routine, and health care systems in developing countries, in particular, often lack the staff and resources necessary to monitor TB patients effectively.

From a public health perspective, poor or incomplete treatment of diseases like TB can be more damaging than no treatment at all. Poor treatment can encourage the development of new strains of a treatable disease that are resistant to available medicines. As with malaria, a strain of TB has become drug-resistant. This strain has been labeled “MDR-TB” (multiple drug-resistant tuberculosis). This form of TB is much more difficult and costly to treat. While the typical six-month treatment for regular TB can cost $10, treatment for MDR-TB can cost $20,000 and take several years.

The strategy for treating TB recommended by the WHO is called DOTS. DOTS combines political commitment, detection, drug supplies, and monitoring services to treat and prevent the disease. According to the WHO, DOTS can produce a 95 percent cure rate, even in poor countries. In July 2001, the WHO, a non-governmental organization called Doctors without Borders, and Harvard University Medical School launched an effort to provide poor countries with affordable drugs that are effective in treating MDR-TB. The plan calls for some countries to receive medicines at prices reduced by as much as 94 percent.

In 2007, this combined effort led to its first huge success. The first Doctors without Borders patient, N.L. from Armenia, completed treatment of MDR-TB. According to Doctors without Borders Field News (November 6, 2007), “Up until two years ago, there was no medical treatment for such strains of TB in Armenia due to the complexity of the treatment, which takes at least two years, including several months of hospitalization.” Doctors without Borders are expecting many more such positive results. Says Robert Parker, MSF head of mission in Armenia: “We are now able to respond honestly to the recurrent question from our patients: ‘Does this treatment work?’ ‘Has anyone ever been cured with this treatment?‘”

TUBERCULOSIS FACTS

  • An estimated 1.3 – 1.6 million people died from TB in 2010.
  • Less than nine million new cases of TB develop worldwide every year
  • One person is infected with TB every second.
  • TB is contagious and spreads through the air (e.g. sneezing, coughing, etc.)
  • Left untreated, each person with active TB will infect 10-15 more people each year.
  • 1 in 10 people infected with TB will become sick with active TB.
  • People with HIV are at much greater risk to become sick, once infected with TB.
  • Over 1.5 million TB cases occur every year in Sub-Saharan Africa.
  • TB is the second leading cause from infectious disease worldwide (HIV is number one)

 

 

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