Word: tb
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Thousands of years after tuberculosis ravaged ancient cultures stretching from Greece to Egypt, more than a century after the bacillus responsible for the disease was first identified and decades after the first antibiotic treatments, TB continues to survive, even thrive, in ever more aggressive forms. In 2006, 9.2 million more people were diagnosed with the disease, almost exclusively in the developing world, and 1.7 million people died from it. More alarming is a growing subset of TB cases, estimated at half a million, that are resistant to more than one of the handful of anti-TB drugs. While they still...
...doesn't have to be this way. TB is an entirely preventable and treatable disease. And the drug-resistant strains beginning to emerge in Africa, Russia, China and India, say experts, are epidemics of our own making. Unlike H.I.V., the tubercle bacillus succumbs to powerful medications. But the drugs are not where they need to be, and when they are, spotty monitoring and poor health infrastructure make it hard to ensure that patients take the daily pills or frequent injections they must receive for six months to eradicate the infection. Stopping treatment too early allows the small population of drug...
...biggest threat, XDR TB, is currently resistant to the most potent classes of first- and second-line anti-TB drugs available - and there is no third line of pharmaceutical defense. While some promising candidates are being tested, even if they prove effective, they will not be available for at least five more years. There is also no easy way to detect drug-resistant strains of TB; current sputum-based screens can take anywhere from two weeks to two months, during which time doctors protectively place infected patients on first-line drugs too weak to battle the aggressive strain effectively rather...
...response, the World Health Organization (WHO) in June recommended widespread use of a new, faster test that can screen for drug-resistant TB in the blood in one or two days. But it requires sophisticated lab facilities for amplifying genes that are beyond the limited resources of most developing nations. "It will be very difficult to bring expensive technologies, machines and trained technicians on a wider scale," predicts Dr. Arvinder Pal Gill, district TB officer in Moga, in India's Punjab region. In addition, the test can detect only MDR TB, not the emerging XDR strains. But both...
...document the ongoing TB epidemic, TIME's James Nachtwey traveled to seven countries over the last five months, photographing the diverse and changing face of the disease. As his images show, controlling the epidemic requires investing not just in new technologies but also in expanding existing programs to control and detect TB before it even becomes resistant. And dots (Directly Observed Treatment, Short Course) is a critical part of that strategy. Developed in the 1990s, the program requires health officials to be present to watch their patients take their complete course of medications, even if it means visiting them...