3. Tuberculosis control
Jim Yong Kim, Aaron Shakow, Arachu Castro, Chris Vande, Paul Farmer
The burden of tuberculosis: Individual health burden (1)
- Once infected, people may never develop active disease, develop it at a later point, or progress quickly to active disease
- 'Active' disease is most commonly manifest as pulmonary disease: coughing, chest pain, hemoptysis, shortness of breath, and constitutional symptoms such as malaise, weakness and fever
Once a patient is infected with the TB bacillus, most never develop active disease. Some patients, particularly the immunosuppressed, can progress quickly to active disease. Others do not develop active disease immediately-reservoirs of viable TB bacteria are held in check by the cell-mediated immune system. This state is referred to as 'TB infection'. Patients at this stage are not infectious and can be treated prophylactically with antibiotic drug regimens that are less intense than those required for active disease. 'Active TB' disease occurs either with direct airborne infection of the lungs leading to illness or when patients with TB infection progress to being actively sick with the disease. Though capable of infecting virtually every organ system of the human body, TB most commonly manifests itself as pulmonary disease, where symptoms include coughing, chest pain, hemoptysis, shortness of breath, and constitutional symptoms such as malaise, weakness and fever.