McGill International TB Centre, McGill University, 1020 Pine Avenue West, Montréal, Québec, Québec H3A 1A2, Canada.
Manipal McGill Center for Infectious Diseases, Manipal University, Manipal, India.
Nat Rev Dis Primers. 2016 Oct 27;2:16076. doi: 10.1038/nrdp.2016.76.
Tuberculosis (TB) is an airborne infectious disease caused by organisms of the Mycobacterium tuberculosis complex. Although primarily a pulmonary pathogen, M. tuberculosis can cause disease in almost any part of the body. Infection with M. tuberculosis can evolve from containment in the host, in which the bacteria are isolated within granulomas (latent TB infection), to a contagious state, in which the patient will show symptoms that can include cough, fever, night sweats and weight loss. Only active pulmonary TB is contagious. In many low-income and middle-income countries, TB continues to be a major cause of morbidity and mortality, and drug-resistant TB is a major concern in many settings. Although several new TB diagnostics have been developed, including rapid molecular tests, there is a need for simpler point-of-care tests. Treatment usually requires a prolonged course of multiple antimicrobials, stimulating efforts to develop shorter drug regimens. Although the Bacillus Calmette-Guérin (BCG) vaccine is used worldwide, mainly to prevent life-threatening TB in infants and young children, it has been ineffective in controlling the global TB epidemic. Thus, efforts are underway to develop newer vaccines with improved efficacy. New tools as well as improved programme implementation and financing are necessary to end the global TB epidemic by 2035.
结核病(TB)是一种由结核分枝杆菌复合体引起的空气传播传染病。尽管主要是肺部病原体,但结核分枝杆菌几乎可以在身体的任何部位引起疾病。结核分枝杆菌的感染可以从宿主的隔离状态发展而来,在这种状态下,细菌被隔离在肉芽肿中(潜伏性结核感染),到传染性状态,此时患者会出现咳嗽、发热、盗汗和体重减轻等症状。只有活动性肺结核才具有传染性。在许多低收入和中等收入国家,结核病仍然是发病率和死亡率的主要原因,而且在许多情况下,耐药性结核病是一个主要关注点。尽管已经开发了几种新的结核病诊断方法,包括快速分子检测,但仍需要更简单的即时检测方法。治疗通常需要长期使用多种抗生素,这促使人们努力开发更短的药物治疗方案。虽然卡介苗(BCG)疫苗在全球范围内使用,主要用于预防婴儿和幼儿的致命性结核病,但它在控制全球结核病流行方面效果不佳。因此,正在努力开发更有效率的新型疫苗。为了在 2035 年终结全球结核病流行,需要新的工具以及改进的方案实施和筹资。