Tuberculosis

Tuberculosis

TB

Facts about Tuberculosis

  • About one third of the world’s population is infected with tuberculosis (TB) bacteria. Only a small proportion of those infected will become sick with TB
  • A person living with HIV is about 26 to 31 times more likely to develop active TB
  • TB is curable, but kills 5000 people every day.

Research scope in Tuberculosis

  • Molecular techniques for more precise diagnosis of TB at DOTS centers are missing which can be used to improve clinical outcomesmore
  • In a high tuberculosis burdened country like India, rapid, cost-effective, and reliable diagnostic tools for tuberculosis are an urgent need of the hour to prevent inappropriate treatment strategies and further spread of resistance.more
  • Isoniazid (INH) has been a first-line drug for treatment of tuberculosis for more than 40 years and some patients develop hepatitis that can be severe in rare cases or after overdose. The mechanisms underlying INH hepatotoxicity are not known….more
  • The potential role of trimethoprim-sulfamethoxazole (SXT) for the treatment of multidrug resistant/extensively drug resistant TB might be explored in further clinical evaluationsmore
  • Research on the role of Ayurveda in the management of TB is very scanty and mostly limited to adjunct or supportive therapymore
  • Thioridazine alters the cell envelope permeability of Mycobacterium tuberculosis and could open novel perspectives of future drug administration regimens in combinational therapymore

Treatment for Tuberculosis

  • Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries....more
  • Pediatric tuberculosis: new guidelines and recommendations.more
  • Steroids could be effective in reducing mortality for all forms of tuberculosis, including pulmonary tuberculosis...more
  • Centre- + family-based DOT had the highest success rates compared with centre-based DOT (OR 20.9, 95%CI 5.0-88.3)...more
  • Chinese herbal medicine (CHM) as an adjuvant to anti-TB chemotherapy may have beneficial effect for MDR-TB...more
  • Ginger was found to be effective as an anti-inflammatory and antioxidant supplement along with anti-TB therapy...more
  • Video directly observed therapy (VDOT) resulted in successful anti-tuberculosis treatment outcomes while maximizing health department resources...more
  • Meropenem/clavulanate is more effective than imipenem/clavulanate in treating M/XDR-TB patients...more

Prevention of Tuberculosis

  • Antiretroviral therapy is strongly associated with a reduction in the incidence of tuberculosis...more
  • Guidelines for the prevention and management of Mycobacterium tuberculosis infection...more
  • Screening and preventive therapy for tuberculosis...more
  • Tuberculin skin test (TST) may underestimate risk for infection with TB in children...more
  • BCG protects against M tuberculosis infection as well as progression from infection to disease...more
  • HIV-infected adults with substance abuse (tobacco smoking, khat chewing and alcohol) should be prioritised for TB screening...more

Risk factors for Tuberculosis

  • HIV coinfection is the most potent immunosuppressive risk factor for developing active TB disease...more
  • Smoking, diabetes mellitus, anti-TNFα drugs and new immunosuppressive treatments represent important common risk factors for Tuberculosis (TB)...more
  • The main risk factors for TB development were malnutrition (HR 37.5), no treatment of latent TB infection (HR 25) or <6 months of treatment (HR 5.38), age 0-10 years (HR 7.87), being a household contact (HR 8.47) and having a tuberculin skin test induration of >or=5 mm (HR >or=4.99)...more
  • Infection with the human immunodeficiency virus, non-White race/ethnicity, and foreign birthplace were each associated with a sixfold or greater increase in risk of TB...more
  • Gastric cancer patients shows a higher risk for TB...more
  • Excessive alcohol consumption (OR 2.27, 95%CI 1.69-3.06), homelessness (OR 2.87, 95%CI 2.04-4.02), previous incarceration (OR 2.21, 95%CI 1.71-2.86) are strong risk factors for TB...more
  • Risk factors associated with non-adherence to TB therapy are illiteracy (39%), difficulty in accessing health facility (57%), and non-government DOT centre (43%)...more
  • TB remains a very important occupational risk for health care workers (HCWs) in low- and middle-income countries (LMICs)...more
  • 4-fold increased risk of TB infection in patients diagnosed with rheumatoid arthritis (RA)...more

Systematic reviews

  • Therapies containing rifamycins for 3 months or more were efficacious at preventing active TB, potentially more so than isoniazid alone...more
  • Low serum vitamin D levels are associated with higher risk of active tuberculosis...more
  • BCG vaccine significantly reduces the risk of TB by 50%…more
  • Linezolid appears be a useful drug, albeit associated with significant adverse events, and should be considered in the treatment of complicated DR-TB...more
  • Increased risk of active TB in end-stage renal disease (ESRD) compared to the general population...more
  • Systematic review and metaanalysis on community based interventions in tuberculosis care in developing countries...more

Treatment with Medicinal Herbs

  • Drosera, Round-leaved sundew – Dose – 1-2 g dry leaf as tea 3x/day; 0.5-2 ml liquid leaf extract (1:1 in 25% ethanol) 3x/day; 0.5-1.0 ml herb tincture (1:5 in 60% alcohol) 3x/day; 3 g/day; steep 1-2 drug 10 min. in 1 cup boiled water, 3-4 x/day 
  • Bloodroot (Sanguinaria canadensis) – Dose – 0.06-0.5 g rhizome 3x/day; alcohol) 3x/day; 0.3-2 ml tincture (1:5 in 60% alcohol0 x/day; 0.5 g powered root; 0.5-1.5 ml liquid root extract 
  • Caper (capparis spinosa L.) – Dose – Food farmacy; brandy, honey, or wine decoctions for liver ailment
  • Blackberry (Rubus spp.) – Dose – 1-2 tsp chopped leaf/cup water, up to 6 x/day; 4 tsp (~4.4 g) leaf in hot tea; 1.5 g leaf/cup tea, 2-3 x/day; 1-2 tsp powered bark/cup water; up to 2 tsp tincture/day; 1500 mg root tea up to 3x/day; 20-30 grains powered root bark; 2-4 ml liquid root extract

Reference: Handbook of Medicinal Herbs (2006)

Herbals

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