March 24 is World Tuberculosis (TB) Day, an annual event to recognize the day in 1882 when Dr. Robert Koch discovered Mycobacterium tuberculosis, the organism that causes tuberculosis (TB). TB primarily affects the lungs, although it can also infect other parts of the body, and it spreads from person to person through the air. Those with active TB in the lungs may experience a persistent cough, constant fatigue, fever, weight loss and night sweats. If not treated, TB can lead to death. At the turn of the 20th century, TB was the leading cause of death in the U.S., but because of advances in prevention, treatment and research through the efforts of organizations like the American Lung Association, the disease is now largely controlled in the U.S. However, it is still a leading cause of death worldwide.
Below are five things to understand about the global TB epidemic:
1. 60 percent of the TB cases worldwide occur in six countries
According to the World Health Organization (WHO)'s global TB report, 10.4 million people fell ill and 1.8 million died from TB in 2015. Sixty percent of those cases come from just six countries: China, India, Indonesia, Nigeria, Pakistan and South Africa. About one-third of the world's population lives with latent TB, which means they have the tuberculosis germs in their bodies, but their immune systems prevent them from becoming sick. Those with latent TB aren't contagious, but can become contagious if their TB becomes active. People with latent TB need treatment to prevent TB disease from becoming active and spreading the disease.
2. TB requires extensive treatment
While deadly, TB is a treatable and curable disease and the WHO estimates that 49 million lives were saved between 2000 and 2015 because of proper medication. Active TB is treated with a combination of several drugs over a six- to 12-month period. Some patients must take their medications in consultation with a healthcare worker or trained volunteer, as without proper supervision it can be more difficult for a patient to complete treatment. For those specifically living outside of the U.S. in rural areas, the length of treatment and the amount of support required can make it harder to treat the disease properly.
3. Multidrug-resistant and extensively-drug resistant TB
When the disease is not correctly treated, TB germs can become resistant to medications and develop into multidrug-resistant tuberculosis (MDR TB). This form of TB is more serious because the medications we currently use don't kill these particular germs and it is harder to treat. Even more dangerous is extensively drug-resistant TB (XDR TB) because it is also resistant to the drugs used to treat MDR TB. Treatment for XDR TB is more difficult, expensive and extensive. All TB patients are at risk of developing drug-resistant TB if they do not take their medications regularly or for the recommended amount of time, develop TB again after being treated for TB previously or come from an area where drug-resistant TB is more common. To avoid drug-resistant TB, it's imperative that patients take their medication as directed. According to the WHO, only 52 percent of MDR TB patients worldwide and 28 percent of XDR TB are treated successfully.
4. TB and HIV Worldwide
People with compromised immune systems, such as people with malnutrition or diabetes or those that smoke, are at a higher risk of getting TB. This is specifically true for people who are living with human immunodeficiency virus (HIV). According to the WHO, those who are HIV positive are 20 to 30 times more likely to develop active TB. At least one third of the HIV population worldwide was infected with TB in 2015. Internationally, TB is the leading killer of people who are HIV-positive.
5. What we are doing about TB in the U.S.
Founded in 1904 to combine the energies of physicians and the general public in fighting disease, the American Lung Association has played a critical role in developing and funding increasingly effective weapons to prevent, detect and treat TB. The American Lung Association continues to fund research related to TB that will help us better understand and treat this disease worldwide. In 2016, our funded projects include:
- Research to identify genes that contribute to TB
- The impact of text messages on treatment adherence
- Understanding missed diagnoses and treatment delays in children with TB,
- Investigating glycolipids in developing new treatments for TB
- Potential targets for new TB drugs
In 2015, 9,577 TB cases were reported in the U.S., according to the Centers for Disease Control and Prevention. Eradicating TB was a founding principle of the American Lung Association and we are still committed to that goal. Learn more about tuberculous and the research being done through the American Lung Association at Lung.org/research.
