24 March 2011, World TB Day

By Eugene Moodubelle
Bellevision Media Network

24 March 2011: World TB Day, falling on March 24th each year, is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of several million people each year, mostly in developing countries. March 24th commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus. At the time of Koch’s announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Koch’s discovery opened the way towards diagnosing and curing TB.  World Tuberculosis (TB) Day was announced in 1982, on the 100th anniversary  of Dr Koch’s discovery of the cause and cure of TB.

 

 

Today, about one-third of the world’s population is infected with Mycobacterium tuberculosis (Mtb), the bacterium that causes TB. Most people have no symptoms because the bacterium is inactive, or latent, but individuals with symptoms of active TB disease can infect others. According to World Health Organization (WHO) estimates, in 2009 more than 14 million people had active TB, leading to 1.7 million deaths, or 4,600 deaths each day. Among people infected with the bacteria, those who have certain other conditions, such as HIV/AIDS and diabetes, are more likely to develop active TB and to die from it. Because of this deadly synergy, TB has become the leading cause of death among people with HIV/AIDS.

 

Although TB control programs have led to a decline in cases worldwide, the emergence and spread of drug-resistant strains of Mtb challenge the way we currently approach TB diagnosis and treatment. Extensively drug-resistant TB, while relatively rare, has been confirmed in 58 countries, including the United States, and likely is present in many more. It has become necessary not just to identify the infection but also to determine the proper therapy for patients at the earliest stages of disease.

 

 

Recent developments have created confidence that TB control strategies can be improved to stay abreast of the changing nature of the pandemic. For the first time in decades, a robust pipeline of candidate TB drugs, vaccines, diagnostics, and treatment and prevention strategies are being evaluated in clinical trials. WHO recently endorsed a diagnostic test that enables health care providers to identify drug-resistant TB directly from patient specimens within about two hours rather than waiting months for a conclusive diagnosis. Drugs are being developed that, when combined in novel ways, may significantly improve the way we treat patients with TB. Vaccines are being developed that may one day prevent the disease, even in persons who are already infected with Mtb.

 

While such advances are crucial to improve patient care, a true transformation in the fight against TB can occur only if we simultaneously deepen our understanding of TB as a disease. For example, a noninvasive means to determine whether an individual is containing the infection or progressing to active disease — what’s called a biomarker — would be of enormous benefit to patient care and for conducting clinical trials of therapies and vaccines. Additionally, although 90 percent of people infected with Mtb never develop active disease, latent TB infection remains largely mysterious. 

 

The relevance of World TB Day  cannot be more reinstated on the curable communicable disease in a country like India. Out of sheer ignorance, TB is still considered a fatal disease and the struggle to eradicate the disease and to open the closed mindset of the society has become an everyday battle for patients and medical practitioners alike.