Tubercolosis: a neglected disease strikes back

摘要: l 'n recent years tuberculosis has been considered a minor, and .decreasing, problem in industrialized countries despite the fact that it remained severe for numerous developing countries. Now this neglect is striking back: on increase all over world, not only but also Here we report World Congress Tuberculosis held Bethesda, MD, USA, November 1992. Worldwide, 60 million people suffer from active tuberculosis; annually, 10 new cases arise 3 die. Thus, responsible more than 6% of deaths 25% preventable deaths, short, die infection with Mycobac ter ium any other single infectious agent. There no question primarily countries, which 95% occur. Yet, steadily declining incidence many reversed during past two years. In 1992 about 26 000 were reported represents an 18% since 1988. Similar increases are being observed European countries: compared to lowest recorded incidences between 1985 1988, numbers 1990-1991 have increased by 33% Switzerland, 30% Denmark, 20% Norway, Ireland, 17% Austria, 9% The Netherlands, 5% Sweden 4% UK (C.L. Hu, Health Organization, Geneva, Switzerland). transmitted aerogenicaUy individuals normal immune status do general develop disease symptoms. Rather, bacteria establish stable stimulates host system. Infection T cell activation can be demonstrated positive delayed-type hypersensitivity reactions tuberculin. Frequently, labile balance develops defence mechanisms survival M. such later lead full-blown disease, typically following or specific depression response. According Organization estimates, 1.7 billion (one third total world population) infected hence at risk reactivating tuberculosis. Two factors contribute distribution tuberctflosis: (1) number who may future its spread, (2) contagious. Rapid case detection initiation therapy prime importance individual control transmission. Obviously, global HIV/ AIDS endemic had major impact current situation, particularly During 1984-1991, doubled Zambia tripled Malawi. It estimated worldwide 4.4 co-infected HIV tuberculosis, half (by year 2000