This month, the AMSA editorial board makes its first publication, which is themed based on the world tuberculosis day, which is celebrated on the 24th of March every year and is centralized on creating the right awareness about the pathologic condition referred to as tuberculosis.
About 1.7 billion people worldwide suffers from T.B and there 1.7million recorded deaths per year. After HIV, Tuberculosis is the leading infection cause of death in the world. In 2016, seven countries had high tuberculosis mortality rate with India leading, followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. In 2016, an estimated 1milion children became ill and 250,000 children died from TB.
The causative organism which is Mycobacterium tuberculosis flourishes where there is poverty, crowding and chronic debilitating illness. Certain disease states increase the risk of tuberculosis such as diabetes mellitus, Hodgkin’s lymphoma, chronic lung disease (particularly silicosis), alcoholism, chronic renal failure and immunosuppression.
Tuberculosis is a disease that affects the lungs majorly, but in up to one-third of cases other organs are involved. If properly treated, TB is curable in all cases and if untreated, the disease may be fatal within 5 years. The causative agent, which is a bacteria have a cell wall, which prevents the fusion of the phagosome with a lysosome. It also evade macrophage-killing by neutralizing reactive oxygen & nitrogen intermediates. By these the bacteria multiply unchecked within the macrophages.
Tuberculosis can be transmitted via airborne means and can spread in the body by various routes through the lymphatic system, blood, natural passages (e.g. lung into the pleural, transbronchial spread into adjacent lung, TB Salphingitis into the peritoneal cavity), swallowing infected sputum, coughing up infected sputum into the larynx.
TB is the leading killer of HIV positive people and in 2016, 40% of HIV deaths was as a result of TB. About one-quarter of the world’s population is infected with tuberculosis (i.e. latent tuberculosis), which means people have been infected with the disease and are not yet ill with the disease and cannot transmit the disease. However, when a person develops active tuberculosis disease, the symptoms which includes cough, fever, night sweats or weight loss may be mild for many months; which could lead to delay in seeking care and transmission to others.
In Nigeria, tuberculosis is diagnosed with Sputum or smear culture – conventionally, the lowensen Jensen medium, and the liquid media medium. The WHO, has three strategic pillars that need to be put in place to effectively end the epidemic:
- Pillar 1: integrated patient-centred care
- Pillar 2: bold policies and supportive system
- Pillar 3: intensified research and innovation
The success of the strategy will depend on countries respecting the following 4 keys principles as they implement the interventions outlined in each pillars:
- Government stewardship and accountability, with monitoring and evaluation
- Strong coalition with civil society organizations and communities
- Protection and promotion of human rights, ethics and equity
- Adaptation of the strategy and targets at country level, with global collaboration.
Thus, I implore all readers in the spirit and recognition of the world tuberculosis day to show care and concern for all those living with tuberculosis and implore all health workers to work together to put an end to the devastating illness called tuberculosis.
IDOWU MARY
EDITOR-IN-CHIEF
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