World Tuberculosis Day Research Articles

The Berlin Declaration on tuberculosis and its consequences for TB research and control in the WHO-euro region

In his famous presentation ‘Ueber Tuberculose,’ Robert Koch (1843–1910) changed the view on tuberculosis as disease, identified Mycobacterium tuberculosis as the etiologic agent and revolutionized the fight against infectious disease in diagnosis, therapy and prevention. Koch gave this presentation in Berlin on March 24, 1882 [1]. Exactly 100 years later, 1982, the International Union Against Tuberculosis and Lung Disease (IUATLD) proposed the 24th of March as’ World Tuberculosis Day’. Fourteen years later, in 1996, the World Health Organization (WHO) confirmed this day as the official day commemorating the disease and its victims, as well as the global endeavours to fight tuberculosis.

Childhood tuberculosis: a preventable disease not being prevented.

* Abbreviations: LTBI — : latent tuberculosis infection TB — : tuberculosis TST — : tuberculin skin test WHO — : World Health Organization In March 2012, childhood tuberculosis (TB) was the focus of World TB Day. This neglected disease still accounts for at least 1 million annual cases and 100 000 deaths in children. The World Health Organization (WHO) estimates that 9.7 million children have been orphaned by TB.1 The articles in this edition of Pediatrics by Wu et al2 from China and Winston and Menzies3 from the United States remind us of the ongoing scourge of this ancient disease in both high- and low-prevalence countries and highlight many issues that need to be addressed to control it. The study from the Beijing Children’s Hospital reveals the continued high global morbidity and mortality of childhood TB. This study details many unsolved problems in childhood TB globally: huge burden of disease; high propensity for severe forms of extrapulmonary disease; incomplete protection afforded by BCG vaccines; diagnostic delays; high treatment failure rates; and lost opportunities for prevention.4,5 We wonder how many of these cases could have been prevented with routine use of isoniazid preventive therapy, an effective and cost-effective intervention among child household contacts.6 However, in most high-burden settings, use of isoniazid … Address correspondence to Jeffrey R. Starke, MD, 1102 Bates St, Suite 1150, Houston, TX 77030. E-mail: jstarke{at}bcm.edu

High time to tackle childhood tuberculosis

When Robert Koch published his groundbreaking paper on the aetiology of tuberculosis (TB) in 1882, he reported that about a third of the working population died of TB [1]. World TB Day today should remind us not only about the first identification of the tubercle bacillus but also that the main burden of the TB epidemic has shifted from Europe to other regions in the world. The 329,391 reported TB cases in the WHO European Region in 2009 contribute only 5.6% of all newly detected TB cases and relapses in the world, according to the latest report Tuberculosis surveillance in Europe 2009, jointly published by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe [2]. Furthermore a sustained decline in TB can be noted with a mean annual reduction of 3.8% between 2005 and 2009, mainly attributable to the highand intermediate-burden countries in the European Union (EU) and European Economic Area (EAA).

World TB Day 2010: Eradicating tuberculosis in sub-Saharan Africa needs effective and committed north-south partnerships

The World Health Organization (WHO) has designated 24 March of each year as ‘World TB Day’, to mark the anniversary of Robert Koch’s discovery in 1882 of the cause of tuberculosis (TB), Mycobacterium tuberculosis. Regrettably, this is not a day for celebration. Instead, governments, policy makers, scientists and funders must reflect on the paradoxical fact that, although effective and cheap therapy has been available for over 60 years, TB kills nearly 1.8 million people every year, that is, 5 000 people every day! Together with HIV/AIDS and malaria, TB remains one of the most important causes of death from infectious diseases worldwide. World TB Day provides an opportunity to reflect on the poor state of TB control globally, particularly in sub-Saharan African countries (SSA).

World TB Day 2010 - New innovations are required for enhancing the global fight against Tuberculosis: the ‘Captain of all these men of death’

Despite the availability of inexpensive and effective treatment for more than 60 years, tuberculosis (TB) remains a major global health threat (WHO Report 2009a). This is a telling and shameful indictment of the current world order. The pace at which scientific understanding has advanced over the past few decades has been unacceptably slow. Also, researchers have, in general, failed to take into account the complex interaction of factors that sustain the global TB epidemic with the factors that have led to the failure of the global community to get rid of one of the worst scourges that has affected humanity for centuries. Tuberculosis continues to be one of the top three causes of death from infectious diseases, after HIV/AIDS and malaria, causing more than 1.8 million deaths every year (Dye et al. 2008). Over the past decade, the international community has become more aware of the seriousness of the threat of TB to human health. Despair is gradually, although with faltering steps and many setbacks, being replaced by hope (Grange et al. 2009; Zumla et al. 2009). Definite signs of progress in the scaling up of TB diagnostic and treatment services worldwide have been witnessed over the past decade, and almost all countries have adopted the Stop TB strategy of the World Health Organization (WHO), including DOTS (WHO 2009a). Although these achievements are important, the global control of the TB epidemic remains elusive. There is epidemiological evidence that the number of new cases of TB are levelling out in Asia and China, even though the TBdisease burden remains at a very high level (Dye et al. 2009). By contrast, the disease continues to spread relentlessly in high HIV-endemic sub-Saharan African countries. TB also contributes substantially to morbidity and mortality in children under the age of 5 in endemic areas (Marais et al. 2009). It is, however, heartening that it has at last been recognized that children make up a significant proportion of the TB disease burden in sub-Saharan Africa (Donald et al. 2007; WHO Report 2007). The global emergence of multidrug-resistant and extensively drug-resistant (XDR) TB further compromises efforts to control the disease (Gandhi et al. 2006; Schaaf et al. 2009). Without substantially stronger domestic and international commitment to TB control, the number of TB cases will continue to rise, especially in HIV-endemic areas. Creative new strategies and pragmatic new approaches are urgently required if the epidemic is to be brought under control. TB is the most common cause of death among HIVinfected individuals in Africa (Lawn & Churchyard 2009). To reduce this risk, direct strategies to prevent TB such as Isoniazid-preventive therapy (IPT) as well as indirect measures, including antiretroviral therapy (ART) and co-trimoxazole prophylaxis, to improve the immune status of those infected with HIV need to be scaled up urgently (Churchyard et al. 2007; WHO Report 2008). Data from observational studies and a randomized control trial support the early integrated use of ART in patients with TB to reduce mortality. Earlier initiation of ART at higher CD4 counts will greatly reduce the incidence of TB in HIV-infected populations by reducing the risk of overt disease after infection and improving both the effectiveness and durability of IPT. The longstanding call for integration of TB and HIV services should now be heeded by all governments of developing countries (Harries et al. 2009). Such integration will facilitate provider-initiated HIV testing of all TB suspects and patients and their families, thereby allowing prioritization of HIV-infected TB patients for ART initiation and provision of co-trimoxazole. The prevalent misconceptions among both the community and health care workers who maintain the stigma associated with HIV and TB need to be addressed by means of education. A concerted effort is required to empower individuals with TB co-infected with HIV, so that they are able to play a key role in shaping current and future health Tropical Medicine and International Health doi:10.1111/j.1365-3156.2009.02462.x

Tuberculosis in the European Union – ongoing commitment needed to control the disease

World TB day on 24 March commemorates this event and is an opportunity for a critical appraisal of the TB situation, for raising awareness and for joining forces in order to control the disease.

Host versus pathogen: Two sides of the same challenge in the TB world

AbstractHumans have studied tuberculosis for many thousands of years. For most of this time investigations were focused on describing patient symptoms with the hope of ameliorating them and perhaps limiting the spread of disease. At the end of the 19th century, however, the association between the bacterium and disease was demonstrated 1 – a discovery recognized annually on 24 March by World TB Day, a day that also highlights efforts to eliminate the disease. Following the discovery, the study of the disease split in two directions: the nature of the pathogen and the nature of the host response. A key advance to be celebrated this World TB Day 2009 is that we are now in a position to integrate the study of the bacteria with that of the host response and thereby create a more complete understanding of how this pervasive disease develops. With this improved understanding more efficient and targeted intervention will be forthcoming.

Tackling tuberculosis: progress made and challenges remaining for the European Union

World Tuberculosis Day on 24 March commemorates the date in 1882 when Robert Koch presented his findings on the causing agent of tuberculosis (TB) - Mycobacterium tuberculosis. This celebration provides a good opportunity to take stock of the achievements in controlling the disease so far - and the remaining challenges at global, regional, national and local level.

INTERNATIONAL STANDARDS FOR TUBERCULOSIS CARE: RELEVANCE AND IMPLICATIONS FOR LABORATORY PROFESSIONALS

On World Tuberculosis (TB) Day 2006, the International Standards for Tuberculosis Care (ISTC) was officially released and widely endorsed by several agencies and organizations. The ISTC release was the culmination of a year long global effort to develop and set internationally acceptable, evidence-based standards for tuberculosis care. The ISTC describes a widely endorsed level of care that all practitioners, public and private, should seek to achieve in managing individuals who have or are suspected of having, TB and is intended to facilitate the effective engagement of all healthcare providers in delivering high quality care for patients of all ages, including those with smear-positive, smear-negative and extra-pulmonary TB, TB caused by drug-resistant Mycobacterium tuberculosis and TB/HIV coinfection. In this article, we present the ISTC, with a special focus on the diagnostic standards and describe their implications and relevance for laboratory professionals in India and worldwide. Laboratory professionals play a critical role in ensuring that all the standards are actually met by providing high quality laboratory services for smear microscopy, culture and drug susceptibility testing and other services such as testing for HIV infection. In fact, if the ISTC is widely followed, it can be expected that there will be a greater need and demand for quality assured laboratory services and this will have obvious implications for all laboratories in terms of work load, requirement for resources and trained personnel and organization of quality assurance systems.

International standards for tuberculosis care: Relevance and implications for laboratory professionals

On World Tuberculosis (TB) Day 2006, the International Standards for Tuberculosis Care (ISTC) was officially released and widely endorsed by several agencies and organizations. The ISTC release was the culmination of a year long global effort to develop and set internationally acceptable, evidence-based standards for tuberculosis care. The ISTC describes a widely endorsed level of care that all practitioners, public and private, should seek to achieve in managing individuals who have or are suspected of having, TB and is intended to facilitate the effective engagement of all healthcare providers in delivering high quality care for patients of all ages, including those with smear-positive, smear-negative and extra-pulmonary TB, TB caused by drug-resistant Mycobacterium tuberculosis and TB/HIV coinfection. In this article, we present the ISTC, with a special focus on the diagnostic standards and describe their implications and relevance for laboratory professionals in India and worldwide. Laboratory professionals play a critical role in ensuring that all the standards are actually met by providing high quality laboratory services for smear microscopy, culture and drug susceptibility testing and other services such as testing for HIV infection. In fact, if the ISTC is widely followed, it can be expected that there will be a greater need and demand for quality assured laboratory services and this will have obvious implications for all laboratories in terms of work load, requirement for resources and trained personnel and organization of quality assurance systems.

Medics worldwide: news and opportunities from the IFMSA

Actions for life: towards a world free of tuberculosis - The IFMSA's Anti-TB campaign aims to draw attention to the global tuberculosis epidemic. As part of the global Stop TB Partnership, IFMSA will be promoting the World TB Day on 24 March 2006 with the theme “Action for life: towards a world free of tuberculosis.” Visit www.stoptb.org for campaign resources, or contact IFMSA's Anti-TB Campaign initiative coordinator (stoptb@ifmsa.org) for further details on medical students' activities. Opportunity for IFMSA graduates - Have you recently graduated? All IFMSA graduates are eligible for the World Medical …

Medics worldwide: news and opportunities from the IFMSA

Actions for life: towards a world free of tuberculosis - The IFMSA's Anti-TB campaign aims to draw attention to the global tuberculosis epidemic. As part of the global Stop TB Partnership, IFMSA will be promoting the World TB Day on 24 March 2006 with the theme “Action for life: towards a world free of tuberculosis.” Visit www.stoptb.org for campaign resources, or contact IFMSA's Anti-TB Campaign initiative coordinator (stoptb@ifmsa.org) for further details on medical students' activities. Opportunity for IFMSA graduates - Have you recently graduated? All IFMSA graduates are eligible for the World Medical …

Turning the tide against tuberculosis

The history of tuberculosis is one of scientific medical and political failure. Although modern short-course treatment for tuberculosis is among the most effective and inexpensive of treatments for life-threatening diseases tuberculosis remains one of the leading causes of morbidity and mortality worldwide. When WHO declared tuberculosis a global emergency in 1993 the initial response from the international community was slow and inadequate. However the ensuing resurgence of tuberculosis which continues to kill nearly 2 million people each year the emergence of multidrug-resistant tuberculosis and the devastating effect of the HIV epidemic on control programmes in Africa has forced the international community to unite in a more synchronised and effective way. World TB Day is commemorated on March 24 each year and presents an opportunity to review progress in tuberculosis treatment and control the lessons that have been learnt and the challenges remaining in bringing the disease under control. To coincide with World TB Day 2006 we have put together in this issue a series of short essays written by experts from all over the world which analyse areas of global importance and raise awareness of existing research and programmatic developments and needs for the future. (excerpt)

Stop using old weapons to fight the war against TB

This year, World TB Day saw posters in health clinics, on billboards, and in newspapers trumpeting the success of the supervised drug regimen Directly Observed Therapy, Short Course (DOTS) launched 10 years ago. They advertised encouraging statistics, such as that DOTS has a cure rate of 83%.1 But how long will this strategy-which deploys outdated drugs and diagnostic tests-work against the new multi-drug resistant superstrains or those who have both tuberculosis and HIV/AIDS? The same week saw two contradictory press releases. The first, issued by the World Health Organization (WHO), claimed it was “gaining ground” against tuberculosis, and the second, released by the aid agency Medecins …

Tuberculosis in Romania: a devastating revival of a destructive disease

Tuberculosis is a major threat to the health of Romania9s people, with an incidence of more than 10 times that of western European countries. In the lead up to World TB Day 2003 on the 24 March, Alice Scriven describes some aspects of the tuberculosis problem in this changing European country

Websites target tuberculosis' persistent threat

Phthisis, consumption, the Ennglish disease, white plague, decay, tuberculosis. Regardless of its name, the illness caused by Mycobacterium tuberculosis persists, despite earlier seemingly successful efforts to stem its spread, according to Focus on Tuberculosis: Ancient enemy, present threat (http://www.niaid.nih.gov/newsroom/focuson/tb02/tb.html). The website was launched by the US National Institute of Allergy and Infectious Disease (NIAID) on World Tuberculosis Day (March 24). Areas of special interest include “Tuberculosis in history”, which features, among others, an account of German microbiologist Robert Koch's successful effort to get tuberculosis bacteria to grow in the laboratory; “Know thy enemy”, which gives details on how tuberculosis evades the immune system; and, in the section on “Finding and Fighting Infection”, a look at how telemedicine is assisting in tuberculosis research efforts. The NIAID site is one of many that deal with tuberculosis prevalence, prevention, and treatment research. Highlights of other useful and informative sites follow.

World TB Day, March 24, 2000 – Forging new partnerships to stop TB

World TB Day, March 24, 2000 – Forging new partnerships to stop TB

WHO warns of countries failing fight against TB

In the lead-up to World TB day on March 24, Arata Kochi, director of WHO's Global Tuberculosis Programme, warned on March 19 that WHO's target of curing 85% of new infectious TB cases by the year 2000 is not achievable. It is estimated that by 2020, 70 million more people will die from TB if control is not improved. Speaking in London, UK, at the launch of the 1998 WHO global tuberculosis control report, Kochi said that 22 countries now account for 80% of all TB cases. Only three of these countries—Vietnam, Tanzania, and Peru—were making good progress towards control targets.

Making DOTS succeed

Shortly before World Tuberculosis Day, March 24, 1997, WHO announced a “breakthrough in tuberculosis control that will make it possible to save millions of lives”, namely DOTS (Directly Observed Treatment, Short Course). This announcement caused surprise and concern to many tuberculosis workers-surprise because the concept of DOTS is far from new, and concern that this strategy has not been adequately evaluated.1,2