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In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan.

2024 Dec 22.

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Tuberculosis Overview

Ellis H. Tobin et al.

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Tuberculosis (TB) encompasses a huge topic regarding a common disease that is challenging to diagnose, treat, and prevent. Throughout recorded history, TB has been responsible for more human lives lost than any other infectious disease., [Global tuberculosis report 2024. Geneva: World Health Organization]. TB, caused by Mycobacterium tuberculosis (Mtb), is a preventable disease. The World Health Organization has ambitiously established a goal of a 90% reduction in incidence between 2015 and 2035. Before the SARS-CoV-2 pandemic, TB was the world's most prevalent human disease. Unlike SARS-CoV-2, M tuberculosis has been a human pathogen for millennia. Robert Koch reported his discovery of the Mtb bacterium in 1882, and its complete genome sequence was mapped over 100 years later.

The diagnostic Mantoux skin test, developed in 1909, remains in use today with minor modifications in reagents and interpretive criteria. Interferon-gamma release assay (IGRA), developed in 2014, offers another approach to TB diagnosis. Both tests possess diagnostic and predictive limitations that require a sophisticated understanding of interpretive criteria. The bacterium is slow-growing, frequently sparse, and often difficult to identify in sputum and tissue samples. The recent introduction of molecular nucleic acid amplification tests (NAATs) has mitigated these challenges in confirmatory TB diagnostics. However, NAATs are not readily available in many parts of the world where TB is most prevalent. When and how to best implement these tests in practice remains a work in progress. New tests to enhance diagnostic accuracy are gradually emerging.

The regimens required to treat TB are challenging to administer. The most commonly used anti-TB antibiotics were developed in the mid-20th century and remain the mainstay of therapy. For the first time in over 40 years, 2 new anti-TB antibiotics have recently been approved for treatment. Anti-TB regimens vary depending on the stage and anatomic location of the infection, the immune status and age of the host, the presence of comorbidities, the development of toxicities, drug-drug interactions, and resistance patterns of the bacterium. Resistance of tuberculosis to antibiotics is increasing, and treatment often requires the administration of novel antibiotic combinations that have undergone limited testing in clinical trials. The prolonged duration of therapy needed to eradicate the organism represents an additional challenge. Recently, shorter treatment regimens for latent TB infection have been developed to minimize adverse effects and maximize patient compliance.

TB prevention remains a worldwide challenge as the disease is easily transmitted, and conditions that favor poverty, overcrowding, and lack of public health infrastructure contribute to the communicability. Nonspecific symptoms such as persistent cough often go unnoticed, resulting in high transmission rates. In the case of active TB, the multiple antibiotics required to eliminate the disease and their prolonged course of administration represent a challenge even in regions with robust public health infrastructure. Indeed, those parts of the world with the highest TB prevalence often lack adequate public health resources. In resource-rich parts of the world where TB is relatively uncommon, many clinicians rarely encounter the disease, are unfamiliar with the clinical manifestations, and lack experience in approaches to diagnosis and management.

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Conflict of interest statement

Disclosure: Ellis Tobin declares no relevant financial relationships with ineligible companies.

Disclosure: Debbie Tristram declares no relevant financial relationships with ineligible companies.

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References

    1. Cole ST. Learning from the genome sequence of Mycobacterium tuberculosis H37Rv. FEBS Lett. 1999 Jun 04;452(1-2):7-10. -PubMed
    1. Cole ST, Brosch R, Parkhill J, Garnier T, Churcher C, Harris D, Gordon SV, Eiglmeier K, Gas S, Barry CE, Tekaia F, Badcock K, Basham D, Brown D, Chillingworth T, Connor R, Davies R, Devlin K, Feltwell T, Gentles S, Hamlin N, Holroyd S, Hornsby T, Jagels K, Krogh A, McLean J, Moule S, Murphy L, Oliver K, Osborne J, Quail MA, Rajandream MA, Rogers J, Rutter S, Seeger K, Skelton J, Squares R, Squares S, Sulston JE, Taylor K, Whitehead S, Barrell BG. Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature. 1998 Jun 11;393(6685):537-44. -PubMed
    1. Lalvani A, Whitworth HS. Progress in interferon-gamma release assay development and applications: an unfolding story of translational research. Ann Transl Med. 2019 Jul;7(Suppl 3):S128. -PMC -PubMed
    1. MacLean E, Kohli M, Weber SF, Suresh A, Schumacher SG, Denkinger CM, Pai M. Advances in Molecular Diagnosis of Tuberculosis. J Clin Microbiol. 2020 Sep 22;58(10) -PMC -PubMed
    1. WHO consolidated guidelines on tuberculosis: Module 3: Diagnosis – Tests for tuberculosis infection. World Health Organization; Geneva: 2022.

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