Tuberculosis (TB), caused by the Mycobacterium tuberculosis (MTB) bacterium, remains a serious global health issue. In 2019, the World Health Organization (WHO) reported that 1.4 million people died from TB, making it the leading cause of death worldwide. Dokumeds, a firm with over 25 years of experience in infectious disease research, has been actively involved in clinical studies aimed at developing effective treatments for TB.
1. Manifestation of TB
TB can appear in two forms: latent infection or active disease. Active TB typically affects the lungs, and its symptoms include chest pain, persistent coughing, night sweats, weight loss, fatigue, fever, and chills. Pulmonary TB, or lung TB, can spread through actions like coughing, sneezing, or spitting. In some cases, the bacteria can target other organs like the kidneys, lymph nodes, brain, or spleen, leading to what’s called extrapulmonary TB.
A rare and serious form known as Miliary TB occurs when the bacteria spread through the bloodstream, affecting the entire body. The WHO estimates that one-third of the global population has latent TB (meaning they don’t show symptoms). Unfortunately, about 10% of this group is likely to develop active TB, making them capable of spreading the disease during their lifetime.
2. Prevalence of TB
TB is most prevalent in low- and middle-income countries, with more than 90% of cases globally coming from these regions. According to the WHO’s 2020 Global Tuberculosis Report, countries with the highest TB burdens were India (26%), Indonesia (8.5%), China (8.4%), the Philippines (6%), Pakistan (5.7%), Nigeria (4.4%), Bangladesh (3.6%), and South Africa (3.6%). In contrast, just 2.5% of cases were from the European region, and 3% were from the Americas. Limited access to quality healthcare and poor disease management systems contribute to the high rates in heavily affected regions.
Interestingly, the COVID-19 pandemic and related social distancing measures temporarily reduced TB cases, but experts warn this decline is not sustainable. In fact, studies suggest the pandemic could lead to an increase of 6.3 million TB cases between 2020 and 2025, underscoring the urgency for effective healthcare strategies to combat the disease.
3. Barriers to TB Treatment
While TB is treatable, overcoming the disease isn’t always straightforward. Treatment typically involves taking a combination of antimicrobial drugs over a period of up to 24 months. For severe cases, treatment may begin at a hospital. Patients with latent TB only require a single antimicrobial drug at a time.
One of the biggest challenges in treating TB is poor compliance with therapy programs. When patients do not follow their prescribed treatment plans, the bacteria can develop resistance to drugs, making them harder to eliminate. Multi-drug resistant TB (MDR-TB) is one such form and has become a growing public health crisis. Nearly half of the world’s MDR-TB cases are concentrated in China, India, and the Russian Federation.
Currently, the only approved TB vaccine, Bacillus Calmette-érin (BCG), is primarily effective against Miliary TB, especially in children. There is still a long way to go in developing more widespread prevention options.
4. Progress in TB Treatment
Globally, efforts are underway to significantly reduce TB cases. Initiatives like the WHO’s “End TB Strategy” aim to reduce TB occurrences by 90% between 2015 and 2035 by improving prevention, diagnosis, and treatment efforts in affected areas.
At present, there are 14 TB vaccines in various stages of clinical trials (Phases I, II, and III), along with 22 drugs actively being developed to combat the disease. Researchers are also exploring innovative approaches to tackle this widespread health threat.
Dokumeds continues to play a vital role in TB research and innovation. With over a decade of expertise in infectious disease clinical trials, they are involved in developing cutting-edge drugs, such as delamanid, a recent addition to TB treatment options. Dokumeds conducts its research efforts in both Europe and Africa and remains committed to supporting the creation of new, life-saving treatments for TB.
