Predictors of Re-Emerging Tuberculosis: A Review

Abstract

Tuberculosis (TB) is a deadly disease that still remains a global burden despite of worldwide measures to curb the disease. As of 2015, the goals of the WHO STOP TB Strategy (2006-2015) have been met and the new WHO End TB Strategy (2015-2030) has been implemented with aim of eradicating the disease. Following that, further studies have demonstrated that TB is a disease that cannot be controlled purely by anti-tuberculous medication alone. It is widely understood that various factors such as rising income inequality, overcrowding populations, compliance to healthcare and resistance pose great barriers to the eradication of disease. In many developing countries including Malaysia, TB is showing or re-emerging trend in both reported cases and resistance. Various predictors for poor disease outcome have been mentioned in the literature such as demographic factors, socioeconomic instability and severe comorbidities amongst the population. Therefore, a prompt review and understanding of the factors at play in the sequestration of TB cases in high risk groups may better inform preventative measures in the future.

Paucisymptomatic pulmonary and right ear tuberculosis in young woman suffering from anorexia and bulimia nervosa

“…These conditions are the cause of malnutrition that in many cases is severe and increases the risk of tuberculosis, even being a risk factor for the reemerging of the disease, especially in patients with BMI < 18.5, in our case the patient had a BMI of 12 in the moment of admission [10], [11]. Severe malnutrition, especially protein-energy malnutrition, causes immunity impairment especially cell-mediated immunity especially the delayed type hypersensitivity, that is the main defense mechanism of the host toward tuberculosis.…”

Investigating the risk factors for contraction and diagnosis of human tuberculosis in Indonesia using data from the fifth wave of RAND’s Indonesian Family Life Survey (IFLS-5)

“…Although this disease is curable, multi-drug resistance caused by improper treatment regimens or incompliance with regimens has made TB difficult to treat effectively. Also, TB was thought to be receding in the past decade, but there is evidence that it has been re-emerging in recent years (Shajahan et al, 2016).…”

Ambient Air Pollution and Pulmonary Tuberculosis in Malaysia

“…In 2016, Malaysia had a total of 25,739 new cases, an annual TB incidence rate of 92 cases per 100,000 population, and an attributed mortality rate of 5.1 cases per 100,000 population [1]. Notably, the increasing trend of TB cases was observed in populous states, urban areas and industrialized cities [6] [14]. Previous studies in Malaysia have reported multiple factors associated with the risk in TB incidence [6] [15].…”

“…Previous studies in Malaysia have reported multiple factors associated with the risk in TB incidence [6] [15]. One major contributory factor has been the influx of immigrants to Malaysia [6] [14]. Urban populations, especially those in crowded dwellings and slum areas, have been identified among the most susceptible population to TB infection [6].…”

“…Numerous TB factors associated with PTB infection that includes people from the Sabahan and Sarawakian who mostly live in the Borneo Island. Differences in TB susceptibility may be associated with factors such as co-morbidities, crowding, poverty, housing structure, and lifestyle; for example, heavy alcohol and tobacco consumption might aggravate TB infection among some ethnic populations[14].…”