Editorial Analysis 20 May

20th May, 2024 Editorial Analysis

Daily Editorial Analysis

Editorial Analysis based on “The challenge of extra-pulmonary TB ” which was published in The Hindu.

Introduction:

Just as we have an undercount of the people infected with TB, the public health challenge of extra-pulmonary TB (EPTB) may be larger than our current estimates.
As per The World Health Organization (WHO) reports over 10 million new cases of TB is reported every year and India alone accounts for 27% of the global TB burden.
Despite being a preventable and curable disease, 5 million people die from TB each year – making it the world’s top infectious killer.
Most of the people who fall ill with TB live in low- and middle-income countries, but TB is present all over the world. About half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa.
While the most common form of tuberculosis (TB), which is pulmonary TB, infects the lungs, some 20% of TB infections develop in the lymph nodes, brain, gut, eyes, or other organs.
Some of these organs have immune privileges in the body. This means that extra-pulmonary infections can persist even after the TB infection in the lungs is resolved.

Tuberculosis:

TB is a bacterial infection that mainly affects the lungs and can also affect any part of the body.
Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis.
The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain.
Only 10% of infected individuals develop active tuberculosis disease, while the rest successfully contain the infection in a latent state.
Tuberculosis (TB) - Symptoms, Types, Causes, Risk factors & Prevention.

Types of tuberculosis disease

Tuberculosis can be classified into different clinic-pathological types depending on various factors based on:

Three types of tuberculosis arise when the disease is classified according to the sequence of events following the first exposure, such as:

Primary tuberculosis - Occurs in persons exposed to Mycobacterium tuberculosis for the first time.
Progressive primary tuberculosis - Arises when there is impaired immunity. It is most commonly seen in infants, adolescents and the elderly.
Post-primary tuberculosis - Generally seen in adults due to endogenous reactivation or exogenous reinfection in a previously sensitised (infected and treated) patient who has retained some degree of acquired immunity.

Based on the location of the infection, two types of tuberculosis are seen, such as:

Pulmonary tuberculosis - tuberculosis is seen in the lungs
Extrapulmonary tuberculosis - Occurs in organ systems other than the lungs. The most common sites are lymph nodes, pleura, bone and joints, urogenital tract, and meninges.

Types of drug-resistant TB

Mono-resistance: resistance to one first-line anti-TB drug only
Poly-resistance: resistance to more than one first-line anti-TB drug, other than both isoniazid and rifampicin
Multidrug resistance (MDR): resistance to at least both isoniazid and rifampicin
Extensive drug resistance (XDR): resistance to any fluoroquinolone, and at least one of three second-line injectable drugs (capreomycin, kanamycin and amikacin), in addition to multidrug resistance
Rifampicin resistance (RR): resistance to rifampicin detected using phenotypic or genotypic methods, with or without resistance to other anti-TB drugs. It includes any resistance to rifampicin, in the form of mono-resistance, poly-resistance, MDR or XDR.

Read about INDIA TB REPORT 2024

Status of TB in India and Initiatives taken by India:

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