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Editorial Analysis 20 May

20th May, 2024

Daily Editorial Analysis

Editorial Analysis based on “The challenge of extra-pulmonary TB which was published in The Hindu.

Introduction:

  • Just as we have an undercount of the people infected with TB, the public health challenge of extra-pulmonary TB (EPTB) may be larger than our current estimates.
  • As per The World Health Organization (WHO) reports over 10 million new cases of TB is reported every year and India alone accounts for 27% of the global TB burden.
  • Despite being a preventable and curable disease, 5 million people die from TB each year – making it the world’s top infectious killer.
  • Most of the people who fall ill with TB live in low- and middle-income countries, but TB is present all over the world. About half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa.
  • While the most common form of tuberculosis (TB), which is pulmonary TB, infects the lungs, some 20% of TB infections develop in the lymph nodes, brain, gut, eyes, or other organs.
  • Some of these organs have immune privileges in the body. This means that extra-pulmonary infections can persist even after the TB infection in the lungs is resolved.

Tuberculosis:

  • TB is a bacterial infection that mainly affects the lungs and can also affect any part of the body.
  • Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis.
  • The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain.
  • Only 10% of infected individuals develop active tuberculosis disease, while the rest successfully contain the infection in a latent state.
  • Tuberculosis (TB) - Symptoms, Types, Causes, Risk factors & Prevention.

Types of tuberculosis disease

Tuberculosis can be classified into different clinic-pathological types depending on various factors based on:

  • The sequence of events following the first exposure
  • Location

Three types of tuberculosis arise when the disease is classified according to the sequence of events following the first exposure, such as:

  • Primary tuberculosis - Occurs in persons exposed to Mycobacterium tuberculosis for the first time.
  • Progressive primary tuberculosis - Arises when there is impaired immunity. It is most commonly seen in infants, adolescents and the elderly.
  • Post-primary tuberculosis - Generally seen in adults due to endogenous reactivation or exogenous reinfection in a previously sensitised (infected and treated) patient who has retained some degree of acquired immunity.

Based on the location of the infection, two types of tuberculosis are seen, such as:

  • Pulmonary tuberculosis - tuberculosis is seen in the lungs
  • Extrapulmonary tuberculosis - Occurs in organ systems other than the lungs. The most common sites are lymph nodes, pleura, bone and joints, urogenital tract, and meninges.

Types of drug-resistant TB

  • Mono-resistance: resistance to one first-line anti-TB drug only
  • Poly-resistance: resistance to more than one first-line anti-TB drug, other than both isoniazid and rifampicin
  • Multidrug resistance (MDR): resistance to at least both isoniazid and rifampicin
  • Extensive drug resistance (XDR): resistance to any fluoroquinolone, and at least one of three second-line injectable drugs (capreomycin, kanamycin and amikacin), in addition to multidrug resistance
  • Rifampicin resistance (RR): resistance to rifampicin detected using phenotypic or genotypic methods, with or without resistance to other anti-TB drugs. It includes any resistance to rifampicin, in the form of mono-resistance, poly-resistance, MDR or XDR.

Read about INDIA TB REPORT 2024

https://www.iasgyan.in/daily-current-affairs/india-tb-report-2024

Status of TB in India and Initiatives taken by India:

https://www.iasgyan.in/daily-current-affairs/tuberculosis