Tuberculosis, Epidemiology of
Tuberculosis is a disease caused by bacilli belonging to the Mycobacterium tuberculosis complex, which includes the species Mycobacterium tuberculosis (most frequently detected in human beings), Mycobacterium africanum, and Mycobacterium bovis. It is primarily an airborne disease. Mycobacteria enter into the human airways through the inhalation of droplet nuclei, i.e., particles containing mycobacteria aerosolized by coughing, sneezing, talking, or singing. Other rare, recognized ways of transmission are the ingestion of cow milk contaminated by Mycobacterium bovis (frequent route of transmission in the past), cutaneous inoculation in laboratory workers and pathologists, and sexual intercourse .
KeywordsTuberculosis Patient Tuberculosis Case Certolizumab Pegol Latent Tuberculosis Infection Antituberculosis Drug
- Acquired immunodeficiency syndrome (AIDS)
Clinical syndrome caused by the Human Immunodeficiency Virus (HIV). Its pathogenesis is related to a qualitative and quantitative impairment of the immune system, particularly a reduction of the CD4+cell count (surrogate marker of the disease). After an average of 10 years if untreated, HIV + individuals can develop opportunistic diseases (i.e., infections and neoplasias rarely detected in immunocompetent subjects). The natural history of the disease can be dramatically modified with administration of combination therapy composed of at least three antiretroviral (ARV) drugs.
- Human immunodeficiency virus (HIV)
Virus that causes Acquired Immunodeficiency Syndrome (AIDS). It belongs to Retroviridae family and was discovered in 1983 by Luc Montagnier and Robert Gallo. It is transmitted mainly through sexual intercourse, exchange of contaminated syringes among intravenous drug users, and contaminated blood transfusion. HIV-1 is the type most frequently detected worldwide.
Rate describing the number of new cases of disease occurring within a unit of time in a defined cohort at risk of disease (expressed in cases per 100,000 population per year).
- Latent tuberculosis infection (LTBI)
Infection caused by Mycobacterium tuberculosis transmitted mainly through the air. Clinical and/or radiological signs of latent tuberculosis infection cannot be detected in the majority of the cases. The infection can be presumptively diagnosed by a positive tuberculin skin testing and/or a positive interferon-γ release assay (IGRA), being able to identify a persistent adaptive immunological reactivity against mycobacterial antigens. In most individuals mycobacteria can be eliminated through chemoprophylaxis. It is estimated that one third of the human population is infected by Mycobacterium tuberculosis worldwide.
Rate describing the number of deaths from a disease occurring within a unit of time in a defined cohort at risk of death (expressed in deaths per 100,000 population per year).
- Mycobacterium tuberculosis
Bacterium that causes tuberculosis, discovered by Robert Koch in 1882. It is genetically closely related to other mycobacteria with which it forms a complex (Mycobacterium africanum, frequently detected in Western Africa, and Mycobacterium bovis, frequently detected in the past in cows and transmitted to human beings through unpasteurized milk).
Number of cases of disease in a defined population at a specific point in time; it is mainly presented as a relative frequency (i.e., proportion usually expressed per 100,000 population).
Infectious disease caused by Mycobacterium tuberculosis. It usually involves the lungs (pulmonary tuberculosis) but can also affect other organs (i.e., kidneys, central nervous system, lymph nodes, bones, etc.: extrapulmonary tuberculosis). Pulmonary tuberculosis, which is the most frequent clinical form, can be classified as smear-positive or smear-negative according to the result of the sputum bacteriological examination. The former is a major public health problem being highly contagious. Only a few individuals develop tuberculosis after a mycobacterial infection, and most of them soon after infection: it is estimated that the lifetime risk is 5–10% in HIV-negatives and 5–15% yearly in HIV-positives.
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