Tuberculosis remains one of the public health challenges of the 21st century in developing countries. Although most Americans feel that TB is a disease of the past, TB claims a valuable human life, every six seconds//, worldwide. Nearly one-third of the population is infected with mycobacterium tuberculosis, the causative organism. India deserves the credit of housing the maximum number of TB patients and has the highest record of TB-related deaths.
Although we now know the cause of the disease, what drugs to give, which is the best drug regimen, the emergence of drug resistant strains of the bacteria and co infection with HIV/AIDS pose a significant problem in combating the AIDS epidemic, particularly in India and Africa.
Indian scientists and researchers from university of Florida have joined hands in unraveling the mystery the associated with a protective protein, which they believe would boost the immune system to fight against the bacteria. Furthermore, it could enable easy and quick recovery of infected patients in addition to protecting individuals against TB.
The normal physiological levels of the protective protein called heme oxygenase 1 could be reduced by alcohol consumption, according to Veena Antony, one of the researchers involved in the study. The study focuses on the link between TB and alcoholism and is being funded by the National Institutes of Health. TB and HIV infected individuals in India would be extensively studied.
Although developed countries have a relatively lower incidence of tuberculosis, increased tendency for individuals in developing countries to migrate to developed countries, more specifically United States, could spread the problem across the American soil, if unattended to.
One of the main challenges in successful treatment of TB is encouraging patients to strictly adhere to the complete course of treatment, without interruption. When the patients do not stick to their
drug regime, the TB bacterium learns to outwit the TB antibiotics, making the drugs ineffective, eventually leading to resistant TB infection. When the bacterium becomes resistant to two or more drugs and is called multidrug-resistant TB or MDR-TB. The development of drug resistant strains of the bacterium and MDR-TB adds concern about effective treatment as this form of TB is much more difficult to cure.
The management of co-infection of TB and HIV/AIDS poses yet another challenge. TB is an HIV related opportunistic infection. One in three HIV-infected people worldwide are co-infected with the TB bacterium. HIV/AIDS and TB form a lethal combination and is called as the devastating pair. In today’s scenario with nearly 3 million co-infected with HIV and TB, TB is the leading cause of mortality among those with HIV infection. HIV infection converts latent TB into active transmissible TB and TB bacteria accelerate the progression of AIDS in the patient. Therefore, everyone diagnosed with TB should be tested for HIV and vice-versa.
Although tuberculosis can affect any region of the body, the lungs are most commonly affected, leading to painful coughing and other respiratory problems. One single patient with active TB infection can infect hundred others. Highway truck drivers in India are particularly at increased risk of contracting HIV and TB due to irresponsible sexual behavior. This is one of the main reasons for collaboration between the University of Florida and Post Graduate Institute of Medical Education and Research in India.
The researchers also intend to initiate an international training program that would enable researchers in India to gain knowledge about sophisticated techniques used in combating the TB epidemic, over there. Let us hope that this collaborative research would help in laying the TB monster to rest, at least in India.
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