Prevention is a Neglected Aspect in the Eradication Policies Against Tuberculosis

Abstract

Tuberculosis remains unapparent in about 80% of the infected cases. It turns symptomatic in cases of stress, undernourishment, i.e., weakening of the immune defenses, hygiene deficits, or massive exposure of fragile and/or stressed populations, including overworked health agents, to the pathogen. It is, thus, mostly a disease of the stressed, the poor, and the indigents. Prevention demands a detection of unapparent infections at risk of turning symptomatic. Diagnostic tests based on the detection of the antigen in sputum and occasionally in other organs have their use but need to be completed with the detection of asymptomatic cases. It is possible by the monitoring of immunoglobulin G (IgG) antibodies during the early process of infection, before the bacillus has reached a mass able to vigorously suppress the immune capacities of the patient. Some drugs are immune depressive and impair the recovery of successfully treated patients. At consultation, the patient is often already fully immune depressed; a monitoring of his IgG-specific antibodies shows that the level of antibodies is very low and will rise if the treatment is successful. The monitoring of the immune status of the patients and the application of immunostimulating products to those patients who show a need therefore will complete the chemotherapy. Nothing of this is currently applied and the serodiagnostic, so useful in rural areas, has been banned, to be replaced by an expensive and inaccurate antigen-test. In addition, the continuing use of an iatrogenic vaccine defeats the purpose.