How effective is tuberculosis (TB) treatment in less economically developed countries?

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How affective is tuberculosis (TB) treatment in less economically developed countries

How effective is tuberculosis (TB) treatment in less economically developed countries

1.1 Introduction

Tuberculosis (TB) is an infectious disease that is caused by several bacteria called ‘Tubercle bacillus’. The bacterium were discovered and named as a cause of TB in 1882 by the German Biologist Robert Koch. Tubercle bacillus is a small and extremely dangerous bacterium; it has a long life span and can survive for months in dryness and resist mild disinfectants (Stefan, 2000).

TB is a contagious disease which spreads in similar way to common cold and flu viruses; the bacteria are transferred from host to host in small droplets. There are numerous types of TB, of which Pulmonary TB is one. It can be transferred when an infected person sneezes, coughs or spits and an uninfected person comes into contact with the droplets, for example in saliva (Stefan, 2000).


The symptoms of this disease are severe coughing including bloody mucus, chest pains, shortness in breathe, fever, weight loss and sweating. The secondary infection affects the immune system, bones and gut. The most common scenario when infected with TB is when a person contacts it following another disease or infection which has weakened the immune system. For example when a person has the human immunodeficiency virus (HIV) their immune system is weakened; people with HIV therefore show an increased rate of TB infections. Only when you show symptoms of TB can you infect others (Ottenhoff and Kaufmann, 2012).

Organ infected by tuberculosis

TB is an extremely harmful disease cause by microorganisms called ‘Tubercle bacillus’. It harms many organs in the human body. It mainly affects the lung (as shown in figure 1) and that is called ‘pulmonary tuberculosis’ the initial symptom last up to 6/7 months. During this long time period the immune system fights of the disease and bacterium. After that period and the immune system resisting the disease some particles of the bacteria escapes into the bloodstream, this is then carried around the body. Usually the immune system cannot stop the bacteria and leads to being untreated. If left untreated for a long period of time then the environment in the body is perfect for the bacteria to multiple, this is extremely dangerous as the tissues of the organ for example; the tissue of the lung may become infected. When the lung is infected it results in destruction in the respiratory system. It is important this is not left unattended as it will cause permanent scarring to the tissues of organs.  


The main method of diagnosing TB is a harmless skin test. This is performed by injecting a small amount of fluid under the skin around the forearm; this is a special fluid containing a protein copied from the microorganism Tubercle bacillus. After a few days the area where the fluid was injected is visually scanned. To determine whether you have the infection the scientist will measure the diameter and hardness of skin where the injection was placed. If the area if hard and the skin appears to be raised it will mean you have a bacterial protein present in your body. The redness in the area injection is not taken in to account.  With this test it is possible to get false positive, for example a negative test does not mean you do not have TB.  If the test is positive a chest x-ray will be taken to assess whether the TB infection is active (see figure 1).

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Areas affected by tuberculosis

TB was a main cause of death in the late 19th century and early 20th century. TB still occurs in humans worldwide but more concentrated in many developing countries and kills 4 out of 10 people who are infected.

Figure 2 shows that over 15 years (1990 to 2005) the estimated TB incidence rate global has not changed much, with incidence in Europe slowly increasing whilst staying below the global average.  In Africa however the estimated incidence has remained above the global average. Figure 2 also demonstrates that having human immunodeficiency virus (HIV) is a risk ...

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