Tuberculosis—the Face of Struggles, the Struggles We Face, and the Dreams That Lie Within (2024)

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Tuberculosis—the Face of Struggles, the Struggles We Face, and the Dreams That Lie Within (1)

Emerging Infectious Diseases

Patrick K. MoonanTuberculosis—the Face of Struggles, the Struggles We Face, and the Dreams That Lie Within (2)

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Tuberculosis disease, or phthisis (ϕθίσις, the Greek word for consumption), was named by the father of allopathic medicine, Hippocrates (c. 460–370 BCE), because the disease appeared to consume the affected person through substantial weight loss and wasting (1). Hippocrates warned his students against treating persons in late stages of tuberculosis, because nearly all of their patients would die, which would likely tarnish their reputations as healers (2).

Today, >10 million persons become ill with tuberculosis, and 2 million die from the disease each year (3). India accounts for the largest number of persons with tuberculosis and tuberculosis-related deaths in the world. In 2016, 1.9 million tuberculosis cases were reported to the Revised National Tuberculosis Programme of India (3). An additional 1.2–5.3 million patients were estimated to have received treatment for the disease in the private sector of India but remained unrecognized by the global surveillance system (4). Many millions of future case-patients will emerge from the huge reservoir of an estimated 354 million persons currently infected with tuberculosis in India (5).

India has a large burden of poverty and malnutrition among both adults and children. Malnutrition has wide-ranging effects on health, including increased susceptibility to infectious diseases such as tuberculosis (6). In 2016, malnutrition was the leading risk factor for 14.6% of the total disability-adjusted life-years for all-cause illness and death in India (7). More than half of all cases of active tuberculosis among women (55%, 95% CI 27%–76%) and men (54%, 95% CI 26%–75%) in India are attributable to susceptibility caused by malnutrition (8).

Having been inspired by the faces behind tuberculosis, the artist Stefan Prakash Eicher (http://www.stefaneicher.com/), born in Maharashtra, India, captures the essence of the term “consumption” through his portrait of an emaciated and wasting man rescued from the streets of New Delhi. In What Dreams Lie Within (Figure), dark tones represent muscle atrophy recessed against a bony torso and sunken cheeks to highlight the debilitating cost of advanced stages of tuberculosis, partly due to catabolic losses by a cachetin-induced mechanism (a macrophage-secreted cytokine) (9) and malnutrition (10). Billowing clouds and a blue sky of hope within his eyes subtly support the struggle of survival found within the intensity of his furrowed brow.

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Figure

What Dreams Lie Within by Stefan Prakash Eicher. Oil on canvas, 2009.

Each year on March 24, we commemorate World TB Day (https://wwwnc.cdc.gov/EID/page/world-tb-day) in honor of the day Robert Koch announced at the University of Berlin Institute of Hygiene that he discovered the cause of consumption, the tuberculosis bacillus. World TB Day is a time to remember the millions of faces of persons who suffer from tuberculosis, to reflect on struggles we face as public health practitioners to end the epidemic, and to find hope in the eyes of the patients we treat and in the dreams that lie within our surviving patients searching for a better tomorrow.

Biography

Dr. Moonan is a senior epidemiologist in the Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, and has provided technical support to the Revised National Tuberculosis Programme of India for nearly a decade. His public health interests include tuberculosis transmission, operational research, and strengthening national tuberculosis programs to better manage drug-resistant forms of tuberculosis.

Footnotes

Suggested citation for this article: Moonan P. Tuberculosis—the face of struggles, the struggles we face, and the dreams that lie within. Emerg Infect Dis. 2018 Mar [date cited]. http://dx.doi.org/10.3201/eid2403.170128

References

1. Daniel TM, Iversen PA. Hippocrates and tuberculosis.Int J Tuberc Lung Dis. 2015;19:373–4. 10.5588/ijtld.14.0736 [PubMed] [CrossRef] [Google Scholar]

2. Finer KR. Tuberculosis. New York: Chelsea House for Infobase Publishing; 2003. [Google Scholar]

3. World Health Organization. Global tuberculosis report, 2017. Geneva: The Organization 2017 [cited 2017 Dec 1]. http://www.who.int/tb/publications/global_report/en/

4. Arinaminpathy N, Batra D, Khaparde S, Vualnam T, Maheshwari N, Sharma L, et al. The number of privately treated tuberculosis cases in India: an estimation from drug sales data.Lancet Infect Dis. 2016;16:1255–60. 10.1016/S1473-3099(16)30259-6 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

5. Houben RM, Dodd PJ. The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling.PLoS Med. 2016;13:e1002152. 10.1371/journal.pmed.1002152 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

6. Schaible UE, Kaufmann SH. Malnutrition and infection: complex mechanisms and global impacts.PLoS Med. 2007;4:e115. 10.1371/journal.pmed.0040115 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

7. Dandona L, Dandona R, Kumar GA, Shukla DK, Paul VK, Balakrishnan K, et al.; India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study.Lancet. 2017;390:2437–60. 10.1016/S0140-6736(17)32804-0 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

8. Bhargava A, Benedetti A, Oxlade O, Pai M, Menzies D. Undernutrition and the incidence of tuberculosis in India: national and subnational estimates of the population-attributable fraction related to undernutrition.Natl Med J India. 2014;27:128–33. [PubMed] [Google Scholar]

9. Friedland JS. Cytokines, phagocytosis, and Mycobacterium tuberculosis.Lymphokine Cytokine Res. 1993;12:127–33. [PubMed] [Google Scholar]

10. Cegielski JP, McMurray DN. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals.Int J Tuberc Lung Dis. 2004;8:286–98. [PubMed] [Google Scholar]

Articles from Emerging Infectious Diseases are provided here courtesy of Centers for Disease Control and Prevention

Tuberculosis—the Face of Struggles, the Struggles We Face, and the Dreams That Lie Within (2024)

FAQs

Why was tuberculosis called phthisis? ›

Tuberculosis disease, or phthisis (ϕθίσις, the Greek word for consumption), was named by the father of allopathic medicine, Hippocrates (c. 460–370 BCE), because the disease appeared to consume the affected person through substantial weight loss and wasting (1).

What are the long term effects of tuberculosis? ›

“But they suffer from considerable long-term consequences, medically and socially.” Tuberculosis can leave scars in the lungs, which lead to restricted lung volume and increase the risk of respiratory problems. Post-tuberculosis can also manifest as a persistent cough, phlegm, and shortness of breath.

How many people have died from tuberculosis? ›

A total of 1.3 million people died from TB in 2022 (including 167 000 people with HIV). Worldwide, TB is the second leading infectious killer after COVID-19 (above HIV and AIDS).

Is tuberculosis still around? ›

Today, TB remains the 13th leading cause of death worldwide. There are options for treating latent TB infection to prevent getting TB disease later as well as treatment regimens for active TB disease that take several months. A healthcare provider will decide the appropriate treatment option.

What is phthisis called today? ›

Tuberculosis (TB) was called “phthisis” in ancient Greece, “tabes” in ancient Rome, and “schachepheth” in ancient Hebrew. In the 1700s, TB was called “the white plague” due to the paleness of the patients. TB was commonly called “consumption” in the 1800s even after Schonlein named it tuberculosis.

Is TB mentioned in the Bible? ›

Tuberculosis is additionally mentioned within the Bible, Leviticus 26:16, where God warns the people of Israel, saying, "I will do that also to you: I will be able to send you fear, dry disease, and fever, which can corrupt your eyes and make your soul mourn." Sickness was considered a punishment from God, sent to ...

Does tuberculosis stay with you forever? ›

The infected person's immune system walls off the TB organisms. And the TB stays inactive throughout life in most people who are infected. This person would have a positive skin or blood test for TB but a normal chest X-ray or one that only shows past scarring from the disease.

Can you fully recover from tuberculosis? ›

Active, drug-sensitive TB disease is treated with a standard 6-month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer. The vast majority of TB cases can be cured when medicines are provided and taken properly.

Does tuberculosis affect life span? ›

What is the life expectancy of a person with TB? An older 2014 study investigated the longevity loss among people who were cured of TB. The authors found that people who received full treatment had an average life expectancy that was 3.6 years shorter than that of people who did not contract TB.

What gender is most affected by tuberculosis? ›

Globally men are significantly more at risk of contracting and dying from TB than women.

Has anyone ever survived tuberculosis? ›

We found 12 studies with TB-specific mortality data. Ten-year survival was 69% in North America (95% CI 54–81) and 36% in Europe (95% CI 10–71).

Is tuberculosis still a death sentence? ›

Once deemed as an incurable disease, tuberculosis, or TB, is a mostly curable health condition today.

What is the deadliest disease in the world? ›

1. Ischemic Heart Disease (Coronary Artery Disease)

What is the deadliest contagious disease? ›

Each year, tuberculosis (TB) kills about 1.3 million people worldwide—that's more deaths than HIV/AIDS and malaria combined. TB is the world's deadliest infectious disease (though briefly eclipsed by COVID-19), killing someone every 20 seconds.

Is tuberculosis fatal? ›

Remember, even though tuberculosis can be treated, it can also be fatal if it's not treated. Tuberculosis is an infection that is spread through the air. Even though it can be treated, it's still responsible for many deaths around the world.

What is the meaning of phthisis? ›

plural phthises ˈt(h)ī-ˌsēz ˈt(h)is-ˌēz. : a progressively wasting or consumptive condition. especially : pulmonary tuberculosis.

How did tuberculosis get its name? ›

Any of the infectious diseases of humans or other animals caused by bacteria of the genus Mycobacterium. From the Latin tuberculum, "small swelling," the diminutive form of tuber, "lump." Tuberculosis has existed in humans since antiquity; it is believed to have originated with the first domestication of cattle.

What is the old common name for the disease TB? ›

Throughout history, the disease tuberculosis has been variously known as consumption, phthisis, and the White Plague.

What animal did tuberculosis come from? ›

The name Tuberculosis comes from the nodules, called 'tubercles', which form in the lymph nodes and other affected tissues of affected animals. Cattle are considered to be the major reservoir M. bovis, and are the main source of infection for humans.

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