Abstract
Tuberculosis (TB) presents new challenges as a global public health problem, especially at a time of increasing threats to some particular patients due to Human Immunodeficiency Virus (HIV) infection and multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis. The World Health Assembly strives to reduce TB deaths by 95% and to decrease TB incidence by 95% by 2035. However, new approaches are necessary in order to attain these objectives. Such approaches include active ascertainment of cases in high risk populations, increasing the availability of accurate point-of-care testing, rapid detection of drug resistance, novel vaccines, and new prophylaxis and treatment regimens (particularly for MDR and XDR TB). The ultimate objective of those programs is to develop highly effective drug regimens that can achieve high cure rates regardless of strains’ resistance patterns.
Highlights
Global Burden of Tuberculosis Mycobacterium Tuberculosis is an ancient and highly harmful successful human pathogen
The 2015 update of the World Health Organization (WHO) Global Tuberculosis Report [2] estimated that there were still approximately 10.4 million (5.9 million men, 3.5 million women, and 1 million children) incident cases worldwide and TB was considered the underlying cause of 1.8 million deaths, 400,000 of whom were among Human Immunodeficiency Virus (HIV)-positive individuals [4]
Bedaquiline is the first new anti-TB drug approved by the Food and Drug Administration (FDA) in 50 years to be used as part of combination treatment with multidrug resistant tuberculosis (MDR-TB) for adults when other alternatives are not available [38]
Summary
Global Burden of Tuberculosis Mycobacterium Tuberculosis is an ancient and highly harmful successful human pathogen. GenXpert Mycobacterium Tuberculosis/RIFAMPICIN (GENXpert MTB/RIF), is a nucleic acid amplification assay conducted in sputum that simultaneously tests for presence of Mycobacterium Tuberculosis DNA and RIF resistance This is a simple and reproducible test with a 90% sensitivity (reaching 98% in patients with positive bacilloscopy but dropping to 70% in smear negative disease) and 99% specificity. Bedaquiline is the first new anti-TB drug approved by the Food and Drug Administration (FDA) in 50 years to be used as part of combination treatment with MDR-TB for adults when other alternatives are not available [38] It targets both active and dormant bacilli [39, 40], and has the profile required of a core drug. Group A: Fluoroquinolones B: Second line injectable drugs C: Other core second-line drugs
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