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How The Spread Of Tuberculosis Can Be Controlled

2154 words - 9 pages

How can the mortality rate due to tuberculosis be reduced?

Tuberculosis case reports and rates by age group and sex, UK, 2009
Tuberculosis case reports and rates by age group and sex, UK, 2009
Introduction to tuberculosis
A major issue in the medical world which biologists attempt to solve is Tuberculosis, an infectious disease that kills millions of males and females every year. It iscaused
by Mycobacterium tuberculosis and Mycobacterium bovis. The bacteria may stay in the lymph system for years before becoming active, then likely will infect the lungs and possibly other organs in the body and damage them, if the lung mucus and immune system fails to defend in the first place. [1] ...view middle of the document...

A possible solution to the problem could be preventing the spread of the mycobacteria tuberculosis. Active tuberculosis sufferers infect on average 10-15 other people a year. By improving hygiene, number of new tuberculosis cases could be radically decreased. But improving hygiene would not cure those who suffer from tuberculosis infection. Tuberculosis victims will require antibacterial chemotherapy. This type of treatment kills the mycobacteria and prevents them from growing. Standard therapy for pulmonary tuberculosis (lungs infected only) consists of a six-month regimen;
* two antibiotics: isoniazid and rifampicin (every day for six months), plus
* two additional antibiotics: pyrazinamide and ethambutol (for the first two months).
Extrapulmonary tuberculosis (infection spread from lungs to other body parts) requires the same course for treatment but may take 12 months rather than six months to complete.
A nationwide study in the UK involving tuberculosis patients being treated with chemotherapy has been carried out to look at how chemotherapy reduces mortality rate. The results are in the table below. [fig 1]

[Figure 1] Tuberculosis treatment outcomes at 12 months, UK, 2008

“Of the 8,152 cases reported in 2008, for whom information on treatment outcome was received, 6,618 (81%) completed treatment within 12 months. The most common reasons for not completing treatment were death (6%) still on treatment (4.9%) and lost to follow up (4.6%) [4]

Another study described as “Retrospective cohort study of patients with TB in the Dominican Republic, Hong Kong Special Administrative Region (People's Republic of China), Italy, Ivanovo Oblast (Russian Federation), the Republic of Korea, and Peru” investigated the mortality of tuberculosis patients after chemotherapy. Of the 5526 new tuberculosis cases, 4585 (83%) was treated successfully and 138 (2%) died, and “and 151 (3%) experienced short-course chemotherapy failure.” [4.5]

Figure 2
Figure 2
This type of antibiotic chemotherapy using a combination of isoniazid, rifampicin, ethambutol and pyrazinamide is effective against tuberculosis and it should not be taken as a single drug as this can cause mycobacteria to become resistant to the drug. The combination effectively disables and kills most if not all mycobacteria tuberculosis in the infected patient’s body. [fig 2] shows a diagram of the drugs and the function they are involved in. All the four drugs are required for the mycobacteria to be successfully killed.

* Isoniazid prevents the mycobacteria from synthesising new cell walls.
* Ethambutol inhibits synthesis of a different part of the cell.
* Pyrazinamide does not allow the mycobacteria to respire so it will have no energy to develop.
* Rifampin inhibits RNA transcription so the mycobacteria will not be able to divide through mitosis.
If the treatment is carried out with an improper combination of these drugs, the mycobacteria might develop...

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