Photo for illustration. (Photo: iStock)
Through the ages it used to have several names: phthisis, scrofulathe white plague and digestion (or just digestion).
In of novels such as Leo Tolstoy’s Anna Karenina in Victor Hugo Wretched all Verdi is operated, The Traviataand Edvard Munch’s oil painting, The Sick Childyou will find references to the dreaded disease, which we know today as tuberculosis (TB).
After so many centuries, it is still one of the most infectious diseases, causing more than 1.6 million deaths per year. TB is caused by the bacteria, Mycobacterium tuberculosis, mainly causes and affects the lungs, but can also affect the kidneys, spine and brain. It is 12th after the disease that causes the most deaths worldwide.
Historically, TB has not only been responsible for millions of deaths, but has shaped societies and had a remarkable influence on the development of medical science.
The origin of tuberculosis
Evidence of TB has been discovered, among other things, in the remains of ancient Egyptian mummies dating back to 2400 BC The ancient Greeks were also familiar with the disease, with Hippocrates describing it as phthisisa term that would be used for tuberculosis for centuries.
According to the American Microbiology Association however, the earliest physical signs of it can be traced back much further (almost 9,000 years!) to the remains of a mother and child in the ancient Neolithic city of Atlet Yam, which is now under the Mediterranean Sea.
During the Middle Ages it was called the “white plague” or “king’s evil” (King’s Evil) known, because it was believed that royal touch could cure the disease. The spread of TB was exacerbated by overcrowding and poor living conditions in urban areas.
In the 18th and 19th centuries TB was increasingly associated with the Romantic movement in literature and art. TB sufferers were often portrayed as delicate, sensitive individuals destined for an early grave. It was during this period that doctors began to recognize the contagious nature of TB and recommended isolation as a means of preventing transmission.
The development of sanatoriums was an important milestone in the fight against TB. Sanatoriums were specialized facilities where TB patients received a prescription for fresh air, a healthy diet and rest. The first sanatorium opened in Germany in 1854, and this concept quickly spread throughout Europe and North America.
Turning point in the fight against TB
The 20th century was a turning point in the fight against tuberculosis, with significant advances in understanding the disease and the development of effective treatments.
On March 24, 1882, the German scientist Robert Koch die Mycobacterium tuberculosis-bacterium identified as the cause of TB, a breakthrough date that we today as World Tuberculosis Day commemorating Koch’s discovery laid the groundwork for future research and helped dispel misconceptions about the disease. He was awarded the Nobel Prize for Medicine in 1905.
Cook it too pioneering work done in identifying bacteria that cause anthrax, septicemia and cholera, among others. He is often referred to as the father of the study of bacteria, a title he shares (often) with the famous French pharmacist and microbiologist, Louis PasteurShare.
Die BCG-entstof, developed in 1921 by French scientists Albert Calmette and Camille Guérin (hence the name Bacille Calmette-Guérin or BCG), and still in use more than 100 years later, was a critical breakthrough in TB prevention. It was initially met with great skepticism, but eventually became widely used, significantly reducing the incidence of TB in many countries.
The introduction of antibiotics in the mid-20th century was another important step in the fight against TB. streptomies, discovered in the 1940s, was the first effective drug against TB. The subsequent development of other drugs, such as isoniazid and rifampicin, made it possible to cure the majority of TB cases, leading to a drastic decrease in TB-related deaths.
Enemy not defeated for a long time
Despite significant progress in the treatment of TB, the disease remains a preventable and mostly curable global health crisis. However, the emergence of drug-resistant forms of TB, such as multidrug-resistant (MDR-TB) and extremely drug-resistant tuberculosis (XDR-TB), poses a significant threat.
In addition, HIV/AIDS and the Covid-19 pandemic have contributed to a resurgence of TB in some regions, as individuals with weakened immune systems are more susceptible to infection. Alcohol use and smoking are two other factors that increase the risk of TB.
Although more than 70 million lives between 2000 and 2020 are estimated according to the World Health Organization (WHO) saved by TB diagnosis and treatment, 10.6 million people contracted TB worldwide in 2021. Of these, around 6 million were men, 3.4 million were women and 1.2 million were children.
South Africa is on the WHO’s list of countries responsible for more than 90% of the world’s TB cases. In fact, South Africa is one of a handful of countries that, according to the World Tuberculosis Report 2022 appear on three “red” lists of countries with a high TB burden: for ordinary TB cases, as well as for HIV-related and multidrug-resistant TB.
According to the Stellenbosch University South Africa has a very high TB burden with an estimated 328,000 people developing TB in 2020. Of these, 30,000 children were under the age of 15, but only 16,500 children were diagnosed. Almost one out of every two children with TB in South Africa has therefore not been diagnosed, treated or reported.
maroela media last year reported on South Africa’s pioneering work to develop a shorter, more effective treatment protocol for drug-resistant tuberculosis. Based on research by, among others, the University of the Witwatersrand, the WHO has changed its guidelines for the treatment of this potentially fatal disease. Treatment time was shortened from 18 to 6 months and the number of pills was reduced from 23 per day to 23 per week.
It is estimated that $13 billion (about R240 billion) is needed annually for the prevention, diagnosis, and treatment of TB, but only a little more than $5 billion (about R92 billion) was spent on this in 2021, according to the WHO’s figures.
