Tuberculosis In ThailandBy Junior Sethasathien
What is tuberculosis(TB)?
•An infectious disease that mainly affects the lungs
•Cause by a bacteria
•Spread through microscopic droplets which are released into the air by coughing and sneezing
Causes
•Mainly caused by a non-motile bacillus called Mycobacterium Tuberculosis
•Humans are the only known reservoirs of M. tuberculosis
•Other TB causing mycobacteria includes: M. bovis, M.microti, M.africanum, M.canetti
Risk FactorsMost people who are infected with TB do not develop active TB. However, there are certain factors which increases the risk that the latent TB will develop into the active TB• HIV (50 670 TB patients with known HIV status)• Diabetes• Alcohol• Tobacco • Certain cancers• Chemotherapy• Immunosuppressant
Epidemiology
Epidemiology
SymptomsLatent TB• No symptoms• Not contagious
Active TB• Coughing (lasting 3 weeks or more or with blood)• Chest pain• Unintentional weight loss• Fatigue • Fever • Night sweats• Chills• Loss of appetite
Without treatment
Can spread to other parts of the body through the bloodstream (15-20% of the active cases)•Spinal pain (Pott disease)•Lymph nodes (swelling)•Joint damage•Tuberculous Meningitis•Liver and Kidney problems•Heart Disorders(cardiac tamponade)-rare
TestsTuberculin Skin Test• patient is injected with a small amount of
tuberculin and must return within 48-72 hours to check the results of the skin test (if positive, a raised, hard area, or swelling is found)
TB blood Test (IGRAs = interferon-gamma release assays)• Measures how the immune system to reacts to
the bacteria that causes TB
Treatment Less resistant Active TB
Latent: May only need 1 type of drug depending on the strain of TBActive: Several types of drugs at onceAt least 6-9 MonthsCommon drugs• Isoniazid• Rifampin• Ethambutol• Pyrazinamide
Combination of antibiotics and injectable medications • fluoroquinolones • Amikacin• Kanamycin• Capreomycin
At least 20-30 Months
Vaccine• Bacille Calmette-Guerin (BCG) vaccine
• Partially affective
• Provides some protection against severe form of paediatric TB
• Not completely protective against infants and Adult Pulmonary TB
• Use of BCG makes the Tuberculin skin test a false positive
Future Development• Several new anti-TB drugs are in the advanced
phases of clinical trials
• A new platform called the GeneXpert Omni is in development which would be used for testing TB and rifampicin-resistant TB
• 15 vaccines candidates are in clinical trials whom are focused on adolescents and adults
Bibliography • In search of a new paradigm for protective immunity to TB Cláudio Nunes-
Alves, Matthew G. Booty, Stephen M. Carpenter, Pushpa Jayaraman, Alissa C. Rothchild & Samuel M. Behar Nature Reviews Microbiology 12, 289–299 (2014)
• van Soolingen D, et al. (1997). "A novel pathogenic taxon of the Mycobacterium tuberculosis complex, Canetti: characterization of an exceptional isolate from Africa".International Journal of Systematic Bacteriology 47 (4): 1236–45Sdfsdf
• Teo, SS; Shingadia, DV (June 2006). "Does BCG have a role in tuberculosis control and prevention in the United Kingdom?". Archives of Disease in Childhood 91 (6): 529–31
• http://www.mayoclinic.org/diseases-conditions/tuberculosis/basics/definition/con-20021761
• http://www.cdc.gov/tb/topic/vaccines/• http://www.cdc.gov/tb/topic/testing/• http://apps.who.int/iris/bitstream/10665/44241/1/9789241598866_eng.pdf• http://www.who.int/tb/publications/global_report/
gtbr2015_executive_summary.pdf?ua=1