Infections with tuberculosis are the seventh leading cause of death worldwide. In 2004, tuberculosis was responsible for 1.5 million deaths or 2.5% of all deaths globally (World Health Organization 2008). The tuberculosis epidemic affects a staggering number of people: at any given time, 13.7 million individuals worldwide suffer from tuberculosis (World Health Organization 2009a). The global incidence of tuberculosis is equally significant, with new infections occurring at an alarming rate. The WHO estimates that 9.27 million new cases of tuberculosis occurred in 2007, compared to 9.24 million new cases in 2006. The disease is predominantly concentrated in developing countries: 55% of global cases occur in Asia and 31% of global cases occur in the African region. In addition, HIV co-infection plays an important role in the epidemiology of tuberculosis. Among the 9.27 million incident cases of tuberculosis that occurred in 2007, approximately 1.37 million (14.8%) were HIV positive. Among the 15 countries with the highest tuberculosis incidence rates, 13 are in Africa, a phenomenon linked to HIV co-infection (World Health Organization 2009a). While tuberculosis can be treated with antimicrobial therapies, the disease has a propensity to recur: on top of the 9.27 million “first episodes” of tuberculosis in 2007, an estimated 1.16 million “subsequent episodes” of tuberculosis occurred in 2007. Such subsequent episodes are defined as episodes occurring in patients who had already experienced at least one previous episode of tuberculosis in the past and who had received at least 1 month of anti-tuberculosis treatment (World Health Organization 2009a). Moreover, tuberculosis pathogens may be either drug susceptible or multidrug resistant; the therapeutic arsenal for both types of pathogens needs improvement. For drug-susceptible tuberculosis, the current four-drug treatment regimen (isoniazid , rifampin , ethambutol , and pyrazinamide ) is effective in most cases, but the treatment takes 6–9 months because the bacteria in the infected host range from rapidly dividing to fully dormant (Webb 2009).
KeywordsSolid Lipid Nanoparticles PLGA Nanoparticles Extrapulmonary Tuberculosis Miliary Tuberculosis Tuberculous Peritonitis
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