Current Status and Future Prospects for Tuberculosis

Tuberculosis is declared to be an infectious disease of global emergency by WHO. Approximately one-third of the world's population is infected with the tuberculosis. The lengthy and laborious current treatment of 6-9 months is associated with problems like patient noncompliance, multiple drug resistance and persistence of mycobacterium and significant toxicity of drugs. The increasing emergence of drug resistance of mycobacterium highlights an urgent need to develop novel therapeutic targets and agents that are not only effective against drug resistant bacteria but can also herald the persistent form of bacteria and thereby shorten the length of TB treatment. However, an approach towards understanding the physiological characteristics of the mycobacterium and designing of such novel therapeutic agents that are effective against drug resistance & persistent bacteria can bring about a revolution in the TB chemotherapy in near future. INTRODUCTION: Tuberculosis (TB) is a systemic chronic granulomatous disease caused by Mycobacterium tuberculosis 1. With the advent of HIV, TB has become a serious health hazard worldwide & hence is declared as global emergency by W H O in 1993. 2 There are an estimated eight million new TB cases diagnosed each year and about two million deaths worldwide. Approximately one-third of the world's population is infected with the tuberculosis. 3. India is classified amongst those countries with a high burden of TB including the MDR and XDR cases and the least prospects of a favourable time trend of the disease as of now (Group IV countries). The average prevalence of all forms of tuberculosis in India is estimated to be 5.05 per thousand, prevalence of smear-positive cases 2.27 per thousand and average annual incidence of smear-positive cases at 84 per 1,00,000 annually.