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AdvancedSpecial charactersHelpHeadingLevel 2Level 3Level 4Level 5FormatInsertLatinLatin extendedIPASymbolsGreekGreek extendedCyrillicArabicArabic extendedHebrewBanglaTamilTeluguSinhalaDevanagariGujaratiThaiLaoKhmerCanadian AboriginalRunesÁáÀàÂâÄäÃãǍǎĀāĂ㥹ÅåĆćĈĉÇçČčĊċĐđĎďÉéÈèÊêËëĚěĒēĔĕĖėĘęĜĝĢģĞğĠġĤĥĦħÍíÌìÎîÏïĨĩǏǐĪīĬĭİıĮįĴĵĶķĹĺĻļĽľŁłŃńÑñŅņŇňÓóÒòÔôÖöÕõǑǒŌōŎŏǪǫŐőŔŕŖŗŘřŚśŜŝŞşŠšȘșȚțŤťÚúÙùÛûÜüŨũŮůǓǔŪūǖǘǚǜŬŭŲųŰűŴŵÝýŶŷŸÿȲȳŹźŽžŻżÆæǢǣØøŒœßÐðÞþƏəFormattingLinksHeadingsListsFilesDiscussionReferencesDescriptionWhat you typeWhat you getItalic''Italic text''Italic textBold'''Bold text'''Bold textBold & italic'''''Bold & italic text'''''Bold & italic textDescriptionWhat you typeWhat you getReferencePage text.<ref>[https://www.example.org/ Link text], additional text.</ref>Page text.[1]Named referencePage text.<ref name="test">[https://www.example.org/ Link text]</ref>Page text.[2]Additional use of the same referencePage text.<ref name="test" />Page text.[2]Display references<references />↑ Link text, additional text.↑ Link text== Prevention == [[File:Notice Do not spit - National Association for the Prevention of Tuberculosis Dublin Branch.jpg|thumb|Tuberculosis public health campaign in Ireland, c. 1905]] Tuberculosis prevention and control efforts rely primarily on the vaccination of infants and the detection and appropriate treatment of active cases.<ref name=Lancet11/> The [[World Health Organization]] (WHO) has achieved some success with improved treatment regimens, and a small decrease in case numbers.<ref name=Lancet11/> Some countries have legislation to involuntarily detain or examine those suspected to have tuberculosis, or [[Involuntary treatment|involuntarily treat]] them if infected.<ref>{{cite journal | vauthors = Coker R, Thomas M, Lock K, Martin R | title = Detention and the evolving threat of tuberculosis: evidence, ethics, and law | journal = The Journal of Law, Medicine & Ethics | volume = 35 | issue = 4 | pages = 609–15, 512 | date = 2007 | pmid = 18076512 | doi = 10.1111/j.1748-720X.2007.00184.x | s2cid = 19924571 }}</ref> === Vaccines === {{Main|Tuberculosis vaccines|BCG vaccine}} The only available [[vaccine]] {{as of|2021|lc=yes}} is [[bacillus Calmette-Guérin]] (BCG).<ref name=McS2011>{{cite journal | vauthors = McShane H | title = Tuberculosis vaccines: beyond bacille Calmette-Guerin | journal = Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences | volume = 366 | issue = 1579 | pages = 2782–89 | date = October 2011 | pmid = 21893541 | pmc = 3146779 |doi-access=free | doi = 10.1098/rstb.2011.0097 }}</ref><ref>{{cite web |title=Vaccines {{!}} Basic TB Facts |url=https://www.cdc.gov/tb/topic/basics/vaccines.htm |date=16 June 2021 |publisher=CDC |access-date=30 December 2021 |archive-date=30 December 2021 |archive-url=https://web.archive.org/web/20211230115301/https://www.cdc.gov/tb/topic/basics/vaccines.htm |url-status=live }}</ref> In children it decreases the risk of getting the infection by 20% and the risk of infection turning into active disease by nearly 60%.<ref>{{cite journal | vauthors = Roy A, Eisenhut M, Harris RJ, Rodrigues LC, Sridhar S, Habermann S, Snell L, Mangtani P, Adetifa I, Lalvani A, Abubakar I | display-authors = 6 | title = Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis |doi-access=free | journal = BMJ | volume = 349 | page= g4643 | date = August 2014 | pmid = 25097193 | pmc = 4122754 | doi = 10.1136/bmj.g4643 }}</ref> It is the most widely used vaccine worldwide, with more than 90% of all children being vaccinated.<ref name=Lancet11/> The immunity it induces decreases after about ten years.<ref name=Lancet11/> As tuberculosis is uncommon in most of Canada, Western Europe, and the United States, BCG is administered to only those people at high risk.<ref>{{cite web|url=https://www.cdc.gov/tb/topic/vaccines/|title=Vaccine and Immunizations: TB Vaccine (BCG)|publisher=Centers for Disease Control and Prevention|year=2011|access-date=26 July 2011|url-status=dead|archive-url=https://web.archive.org/web/20111117140855/http://www.cdc.gov/tb/topic/vaccines/|archive-date=17 November 2011}}</ref><ref>{{cite web|title=BCG Vaccine Usage in Canada – Current and Historical|url=http://www.phac-aspc.gc.ca/tbpc-latb/bcgvac_1206-eng.php|work=Public Health Agency of Canada|access-date=30 December 2011|date=September 2010|url-status=dead|archive-url=https://web.archive.org/web/20120330042719/http://www.phac-aspc.gc.ca/tbpc-latb/bcgvac_1206-eng.php|archive-date=30 March 2012}}</ref><ref name=UK06>{{cite journal | vauthors = Teo SS, Shingadia DV | title = Does BCG have a role in tuberculosis control and prevention in the United Kingdom? | journal = Archives of Disease in Childhood | volume = 91 | issue = 6 | pages = 529–31 | date = June 2006 | pmid = 16714729 | pmc = 2082765 | doi = 10.1136/adc.2005.085043 }}</ref> Part of the reasoning against the use of the vaccine is that it makes the tuberculin skin test falsely positive, reducing the test's usefulness as a screening tool.<ref name=UK06/> Several vaccines are being developed.<ref name=Lancet11/> Intradermal MVA85A vaccine in addition to BCG injection is not effective in preventing tuberculosis.<ref>{{cite journal | vauthors = Kashangura R, Jullien S, Garner P, Johnson S | title = MVA85A vaccine to enhance BCG for preventing tuberculosis | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | pages = CD012915 | date = April 2019 | issue = 4 | pmid = 31038197 | pmc = 6488980 | doi = 10.1002/14651858.CD012915.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> === Public health === Public health campaigns which have focused on overcrowding, public spitting and regular sanitation (including hand washing) during the 1800s helped to either interrupt or slow spread which when combined with contact tracing, isolation and treatment helped to dramatically curb the transmission of both tuberculosis and other airborne diseases which led to the [[Tuberculosis elimination|elimination of tuberculosis]] as a major public health issue in most developed economies.<ref>{{cite journal | vauthors = Clark M, Riben P, Nowgesic E | title = The association of housing density, isolation and tuberculosis in Canadian First Nations communities | journal = International Journal of Epidemiology | volume = 31 | issue = 5 | pages = 940–945 | date = October 2002 | pmid = 12435764 | doi = 10.1093/ije/31.5.940 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Barberis I, Bragazzi NL, Galluzzo L, Martini M | title = The history of tuberculosis: from the first historical records to the isolation of Koch's bacillus | journal = Journal of Preventive Medicine and Hygiene | volume = 58 | issue = 1 | pages = E9–E12 | date = March 2017 | pmid = 28515626 | pmc = 5432783 }}</ref> Other risk factors which worsened TB spread such as malnutrition were also ameliorated, but since the emergence of HIV a new population of immunocompromised individuals was available for TB to infect. The World Health Organization (WHO) declared TB a "global health emergency" in 1993,<ref name="Lancet11" /> and in 2006, the Stop TB Partnership developed a [[Global Plan to Stop Tuberculosis]] that aimed to save 14 million lives between its launch and 2015.<ref>{{cite web|url=http://www.stoptb.org/global/plan/|title=The Global Plan to Stop TB|publisher=[[World Health Organization]] (WHO)|year=2011|access-date=13 June 2011|url-status=live|archive-url=https://web.archive.org/web/20110612030924/http://www.stoptb.org/global/plan/|archive-date=12 June 2011}}</ref> A number of targets they set were not achieved by 2015, mostly due to the increase in HIV-associated tuberculosis and the emergence of multiple drug-resistant tuberculosis.<ref name="Lancet11" /> A [[tuberculosis classification]] system developed by the [[American Thoracic Society]] is used primarily in public health programs.<ref>{{cite book| vauthors = Warrell DA, Cox TM, Firth JD, Benz EJ |title=Sections 1–10|year=2005|publisher=Oxford Univ. Press|location=Oxford [u.a.]|isbn=978-0-19-857014-1|page=560|url=https://books.google.com/books?id=EhjX517cGVsC&pg=PA560|edition=4. ed., paperback|url-status=live|archive-url=https://web.archive.org/web/20150906210011/https://books.google.com/books?id=EhjX517cGVsC&pg=PA560|archive-date=6 September 2015}}</ref> In 2015, it launched the [[End TB Strategy]] to reduce deaths by 95% and incidence by 90% before 2035. The goal of tuberculosis elimination is hampered by the lack of rapid testing, of short and effective treatment courses, and of [[tuberculosis vaccine|completely effective vaccines]].<ref>{{cite journal | vauthors = Uplekar M, Weil D, Lonnroth K, Jaramillo E, Lienhardt C, Dias HM, Falzon D, Floyd K, Gargioni G, Getahun H, Gilpin C, Glaziou P, Grzemska M, Mirzayev F, Nakatani H, Raviglione M | display-authors = 6 | title = WHO's new end TB strategy | journal = Lancet | volume = 385 | issue = 9979 | pages = 1799–1801 | date = May 2015 | pmid = 25814376 | doi = 10.1016/S0140-6736(15)60570-0 | s2cid = 39379915 }}</ref> The benefits and risks of giving anti-tubercular drugs in those exposed to MDR-TB is unclear.<ref>{{cite journal | vauthors = Fraser A, Paul M, Attamna A, Leibovici L | title = Drugs for preventing tuberculosis in people at risk of multiple-drug-resistant pulmonary tuberculosis | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD005435 | date = April 2006 | volume = 2006 | pmid = 16625639 | pmc = 6532726 | doi = 10.1002/14651858.CD005435.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> Making HAART therapy available to HIV-positive individuals significantly reduces the risk of progression to an active TB infection by up to 90% and can mitigate the spread through this population.<ref>{{cite journal | vauthors = Piggott DA, Karakousis PC | title = Timing of antiretroviral therapy for HIV in the setting of TB treatment | journal = Clinical & Developmental Immunology | volume = 2011 | pages = 103917 | date = 27 December 2010 | pmid = 21234380 | pmc = 3017895 | doi = 10.1155/2011/103917 | doi-access = free }}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. 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