Friday, January 28, 2011

What are the problems involved in eradicating tuberculosis from the world

What are the problems involved in eradicating tuberculosis from the world?

Infectious Diseases - 2 Answers
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1 :
There are lots of problems in eradicating TB from the world. Firstly, you'd have to identify all the people infected. This is difficult because TB can remain dormant in your lungs for years, and you wouldn't know about it until it becomes active. You could give a skin test, but this will not show positive in people who are immunosuppressed (ie if they also have AIDS), or will always be positive in people who have had the TB vaccine (which is why we don't give the TB vaccine in the US, since it eliminates our only means of screening for TB and only prevents dissemination out of the lungs....something that rarely happens in the US anyway) During this latent stage, TB is very resistant to drug treatment, so just identifying and treating TB cases won't be effective. Also, since mycoplasma tuberculosis (the causative agent of TB) grows so slowly, the therapy for TB takes months and months. Many patients aren't compliant with this, since the drugs used to treat TB often have bad side effects. People often stop taking drugs when they don't "feel" sick anymore. This leads to resistant strains of TB. The other problem is that the cost of these drugs is extremely high. To treat all people infected with TB in some endemic areas would be more than their government could afford, and would divert a lot of money away from HIV infections if the US were to try to help. I hope that helps explain the problem a bit. While the there are serious setbacks from a scientific point of view, there are also a lot of socioeconomic and political factors at play. Such is the world.
2 :
My dissertation is actually on M. tuberculosis. The short version of the answer to this questions is: - 1 in 3 people are affected - most of those are in the thrid world - Some Tb has become resistant to the frontline drugs (MDR-TB) - Some MDR-Tb has become resistant to second line drugs (XDR-Tb) - Treatment lasts for over 6 months, and doesn't gaurentee 100% clearance of the bacteria from the body - Partly because the M. tuberculosis can infect the macrophages (which are White blood cells), and stay "hidden" from the antibiotics - Its not so much of a problem in the west because we have drugs, so there isn't the political will. Hope that helps. Check out this WHO site

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