Elimination of tuberculosis

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Elimination of tuberculosis is the effort to reduce the number of tuberculosis (TB) cases to less than one per 1 million population, contrasted with the effort to completely eradicate infection in humans worldwide. [1] The goal of tuberculosis elimination is hampered by the lack of rapid testing, short and effective treatment courses, and completely effective vaccine. [2] The WHO as well as the Stop TB Partnership aim for the full elimination of TB by 2050—requiring a 1000-fold reduction in tuberculosis incidence. [3] As of 2017, tuberculosis has not been eliminated from any country. [4]

Contents

Feasibility

Prospects for tuberculosis control and elimination in a hypothetical high-burden country, starting in 2015 Prospects for tuberculosis control and elimination.jpg
Prospects for tuberculosis control and elimination in a hypothetical high-burden country, starting in 2015

Tuberculosis has been a curable illness since the 1940s when the first drugs became available, although multidrug-resistant and extensively drug-resistant TB present an increasing challenge. [5] According to a 2017 article in International Journal of Infectious Diseases , tuberculosis eradication is possible if enough technology, funding, and political will were available, but the characteristics of the disease do not make it easy to eradicate. So far, tuberculosis has not been eliminated from any country. [4] According to European Respiratory Review, tuberculosis eradication is not considered possible due to the lack of a completely effective vaccine and large reservoir of people infected with latent tuberculosis. [1]

According to a 2013 review, tuberculosis elimination will require not just treating active tuberculosis but also latent cases, and eliminating tuberculosis by 2050 worldwide is not possible, although great reductions in infections and deaths are possible. [3] Addressing poverty is a further requirement for eliminating tuberculosis. People who are poor are disproportionately affected by tuberculosis because the disease is made worse by inadequate housing and malnutrition, and poverty can make it difficult to get treatment. The WHO has estimated that eliminating poverty would reduce tuberculosis incidence by 84 percent. [6] [7] [8] [9]

Elimination strategies

Globally

In 2014, the World Health Organization launched the End TB Strategy with the goal of reducing tuberculosis deaths by 95% and incidence by 90% before 2035. [2] As of 2020, the world was not on track to meet those goals. [10] The WHO, as well as the Stop TB Partnership, are now aiming for the full elimination of TB by the year 2050, which will require a 1000-fold reduction in the incidence of the disease. [3]

India

In 2017, the Indian government announced its intention to eliminate tuberculosis in the country by 2025. The previous year, it accounted for 27 percent of tuberculosis cases and 29 percent of deaths worldwide, making it the highest burden country for both tuberculosis and multidrug-resistant tuberculosis. [11] [12]

Related Research Articles

<span class="mw-page-title-main">Tuberculosis</span> Infectious disease

Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis. Around 10% of latent infections progress to active disease which, if left untreated, kill about half of those affected. Typical symptoms of active TB are chronic cough with blood-containing mucus, fever, night sweats, and weight loss. Infection of other organs can cause a wide range of symptoms.

<span class="mw-page-title-main">Yaws</span> Medical condition

Yaws is a tropical infection of the skin, bones, and joints caused by the spirochete bacterium Treponema pallidum pertenue. The disease begins with a round, hard swelling of the skin, 2 to 5 cm in diameter. The center may break open and form an ulcer. This initial skin lesion typically heals after 3–6 months. After weeks to years, joints and bones may become painful, fatigue may develop, and new skin lesions may appear. The skin of the palms of the hands and the soles of the feet may become thick and break open. The bones may become misshapen. After 5 years or more, large areas of skin may die, leaving scars.

<i>Mycobacterium bovis</i> Species of bacterium

Mycobacterium bovis is a slow-growing aerobic bacterium and the causative agent of tuberculosis in cattle. It is related to Mycobacterium tuberculosis, the bacterium which causes tuberculosis in humans. M. bovis can jump the species barrier and cause tuberculosis-like infection in humans and other mammals.

<span class="mw-page-title-main">Diagnosis of tuberculosis</span> Methods for diagnosing tuberculosis

Tuberculosis is diagnosed by finding Mycobacterium tuberculosis bacteria in a clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it.

<span class="mw-page-title-main">Management of tuberculosis</span> Disease treatment

Management of tuberculosis refers to techniques and procedures utilized for treating tuberculosis (TB), or simply a treatment plan for TB.

<span class="mw-page-title-main">Global health</span> Health of populations in a global context

Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.

Diseases of poverty, also known as poverty-related diseases, are diseases that are more prevalent in low-income populations. They include infectious diseases, as well as diseases related to malnutrition and poor health behaviour. Poverty is one of the major social determinants of health. The World Health Report (2002) states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with existing interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition. Poverty increases the chances of having these diseases as the deprivation of shelter, safe drinking water, nutritious food, sanitation, and access to health services contributes towards poor health behaviour. At the same time, these diseases act as a barrier for economic growth to affected people and families caring for them which in turn results into increased poverty in the community. These diseases produced in part by poverty are in contrast to diseases of affluence, which are diseases thought to be a result of increasing wealth in a society.

<span class="mw-page-title-main">Extensively drug-resistant tuberculosis</span> Tuberculosis that is resistant to the most effective drugs

Extensively drug-resistant tuberculosis (XDR-TB) is a form of tuberculosis caused by bacteria that are resistant to some of the most effective anti-TB drugs. XDR-TB strains have arisen after the mismanagement of individuals with multidrug-resistant TB (MDR-TB).

<span class="mw-page-title-main">Multidrug-resistant tuberculosis</span> Medical condition

Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications (drugs): isoniazid and rifampicin. Some forms of TB are also resistant to second-line medications, and are called extensively drug-resistant TB (XDR-TB).

<span class="mw-page-title-main">FIND, the global alliance for diagnostics</span> Swiss global health nonprofit organization

FIND is a global health non-profit based in Geneva, Switzerland. FIND functions as a product development partnership, engaging in active collaboration with over 150 partners to facilitate the development, evaluation, and implementation of diagnostic tests for poverty-related diseases. The organisation's Geneva headquarters are in Campus Biotech. Country offices are located in New Delhi, India; Cape Town, South Africa; and Hanoi, Viet Nam.

<span class="mw-page-title-main">African meningitis belt</span> Region of Africa with high rate of incidence of meningitis

The African meningitis belt is a region in sub-Saharan Africa where the rate of incidence of meningitis is very high. It extends from Senegal to Ethiopia, and the primary cause of meningitis in the belt is Neisseria meningitidis.

<span class="mw-page-title-main">Alimuddin Zumla</span> British-Zambian physician

Sir Alimuddin Zumla,, FRCP, FRCPath, FRSB is a British-Zambian professor of infectious diseases and international health at University College London Medical School. He specialises in infectious and tropical diseases, clinical immunology, and internal medicine, with a special interest in HIV/AIDS, respiratory infections, and diseases of poverty. He is known for his leadership of infectious/tropical diseases research and capacity development activities. He was awarded a Knighthood in the 2017 Queens Birthday Honours list for services to public health and protection from infectious disease. In 2012, he was awarded Zambia's highest civilian honour, the Order of the Grand Commander of Distinguished services - First Division. In 2023, for the sixth consecutive year, Zumla was recognised by Clarivate Analytics, Web of Science as one of the world's top 1% most cited researchers. In 2021 Sir Zumla was elected as Fellow of The World Academy of Sciences.

There are a number risk factors for tuberculosis infection; worldwide the most important of these is HIV. Co-infection with HIV is a particular problem in Sub-Saharan Africa, due to the high incidence of HIV in these countries. Smoking more than 20 cigarettes a day increases the risk of TB by two to four times while silicosis increases the risk about 30 fold. Diabetes mellitus is also an important risk factor that is growing in importance in developing countries. Other disease states that increase the risk of developing tuberculosis are Hodgkin lymphoma, end-stage renal disease, chronic lung disease, malnutrition, and alcoholism. A person's genetics also play a role.

<span class="mw-page-title-main">Tuberculosis in India</span> Health issue in India

Tuberculosis in India is a major health problem, causing about 220,000 deaths every year. In 2020, the Indian government made statements to eliminate tuberculosis from the country by 2025 through its National TB Elimination Program. Interventions in this program include major investment in health care, providing supplemental nutrition credit through the Nikshay Poshan Yojana, organizing a national epidemiological survey for tuberculosis, and organizing a national campaign to tie together the Indian government and private health infrastructure for the goal of eliminating the disease.

<span class="mw-page-title-main">Oriol Mitjà</span> Catalan researcher

Oriol Mitjà i Villar is a Catalan-born Spanish researcher and consultant physician in internal medicine and infectious diseases with expertise in poverty-related tropical diseases. He has conducted research at the Lihir Medical Centre in Papua New Guinea since 2010 on new diagnostic and therapeutic tools to eradicate yaws. He was awarded the Princess of Girona Award in the scientific research category. Currently at the Germans Trias i Pujol Research Institute, Mitjà is conducting research on SARS-CoV-2 coronavirus disease (COVID-19) and strategies to control the infection at a community level.

Zarir Udwadia is an Indian pulmonologist and researcher. His work on drug resistant tuberculosis has led to improvements in India's National Tuberculosis Control Programme. Udwadia was the only Indian invited by the WHO to be part of the TB ‘Guidelines Group’, which formulated the 4th edition of the TB Guidelines, published in 2010. He was also the only doctor to be named among India's best strategists.

<span class="mw-page-title-main">Diabetes in India</span>

India has an estimated 100 million people formally diagnosed with diabetes, which makes it the second most affected in the world, after China. Furthermore, 700,000 Indians died of diabetes, hyperglycemia, kidney disease or other complications of diabetes in 2020. One in six people (17%) in the world with diabetes is from India. The number is projected to grow by 2045 to become 134 million per the International Diabetes Federation.

<span class="mw-page-title-main">Etheldreda Nakimuli-Mpungu</span> Ugandan Mental health programme developer

Etheldreda Nakimuli-Mpungu is a professor, researcher, epidemiologist and psychiatrist at the Department of Psychiatry in the Faculty of Medicine, Makerere University in Uganda. Her research is particularly focused on supportive group psychotherapy as a first-line treatment for depression in people with HIV. She is one of only five recipients of the Elsevier Foundation Award for Early Career Women Scientists in the Developing World in Biological Sciences, as well as listed at one of the BBC's 100 Women in 2020.

<span class="mw-page-title-main">Catharina Boehme</span> Medical scientist

Catharina Boehme is the Assistant Director-General for External Relations and Governance of the World Health Organization. She previously served as WHO Chef de Cabinet, and is known for her work in developing diagnostic tests for diseases such as tuberculosis and for advocating for increased testing for the COVID-19 disease.

<span class="mw-page-title-main">Ethel Maciel</span> Brazilian epidemiologist and PhD

Ethel Leonor Noia Maciel is a Brazilian PhD, epidemiologist, nurse, and current Secretary of Health Surveillance and Environment, an internal secretary of Brazil's Ministry of Health and the Chairperson for the Tuberculosis Research Network from World Health Organization. She is a researcher in infectious diseases with a special focus on tuberculosis.

References

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