The Challenges Of Fighting Tuberculosis

Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis (MTB) and is a major global concern. In 2019, the WHO reported 1.4 million¹ deaths from TB, making it the leading cause of death globally. 

Dokumeds has been at the forefront of the research against infectious diseases for more than 25 years, seeking treatments for TB through continuous engagements in clinical studies. 

1. TB Manifestation

TB can manifest as a latent infection or an active disease, such as lung cancer. Symptoms attributed to active TB include chest pain, coughing, sweating at night, weight loss, weakness, fever, and chills. Individuals infected with pulmonary (lung) TB can spread the bacterium through sneezing, coughing, or spitting. The TB bacterium manifests into extrapulmonary TB when it attacks other organs like the kidney, lymph nodes, brain, or spleen. 

A rare form of active TB, Miliary TB, manifests when the bacteria invade the bloodstream and spread all over the body. The WHO reports that one-third of the global population has TB but does not exhibit the symptoms. Unfortunately, 10% of this group will likely develop active TB and transmit the disease during their lifetime. 

2. TB Prevalence

Low and middle-income countries are the most affected, reporting more than 90% of the global TB infections. The WHO listed countries most affected by Tuberculosis in 2020, including: India (26%), Indonesia (8.5%), China (8.4%), the Philippines (6%), Pakistan (5.7%), Nigeria (4.4%), Bangladesh (3.6%), and South Africa (3.6%). Only 2.5% of the TB cases were in the WHO European region and 3% in the Americas region, according to the Global tuberculosis report 2020. This region’s high TB prevalence rate is attributed to a lack of comprehensive and appropriate healthcare and inadequate monitoring. 

While the COVID-19-related social distancing measures have led to a decline in TB cases, the WHO acknowledges that such a drop is temporary. Thus, it is necessary to embrace stringent healthcare measures to curb the spread of TB. Studies show a positive correlation between the COVID-19 pandemic and the increase in TB cases. Notably, the pandemic could cause an increase of 6.3million TB cases between 2020 and 2025. 

3. Barriers to Treating TB

To date, there are multiple treatment options for TB patients, and patients who comply with the prescriptions can fully recover from the disease. The various antimicrobial drugs are effective and may take up to 24months to suppress the bacteria. Due to the aggressiveness of TB, patients may begin treatment at the hospital. Unlike active TB, latent TB can be treated by a single antimicrobial drug at a time.  

Non-compliance with the TB therapy program by patients is the major challenge in treating TB. Consequently, the bacteria grow resistant to drugs and become hard to treat. Multi-drug resistant TB (MDR-T) is an example of such a form of TB, which has become a major public health concern globally. China, India, and the Russian Federation are home to about half of the global MDR-TB cases.

Bacillus Calmette-Guérin (BCG), the only licensed human TB vaccine, is effective against Miliary TB, especially among children.

4. Prospects of TB Treatment

Image Source: https://www.insight.mrc.ac.uk/

Stakeholders, such as the US, WHO, and European CDC, are aggressively reducing TB cases by 90% between 2015 and 2035. The “End TB Strategy” is one initiative that seeks to reduce TB prevalence in the high-burden regions by providing access to quality prevention, diagnostic, and treatment services. 

14 TB vaccines are currently in Phase I, II, or III clinical trials, while 22 drugs are available to treat the disease. Researchers continue to work on modern techniques to curb the deadly global disease. 

As a reputable infectious diseases CRO with over 12 years of experience, Dokumeds remains at the forefront in the fight against TB and other infectious diseases. They continue to support research and development of new medicines, including, but not limited to, delamanid, a recently developed anti-TB therapy.

Dokumeds engages in clinical research in Europe and Africa geared towards developing new medicine, including TB therapies, among other drugs. To find out more about Dokumeds’ involvement in the fight against TB, book a call with them here.