Tuberculosis: current issues on diagnosis and management

Abstract

In 1993, the World Health Organisation (WHO) declared tuberculosis (TB) a global emergency and in 1996, South America declared TB as a priority disease. The most effective means of controlling TB is through rapid diagnosis by direct sputum microscopy for acid fast bacilli (AFB), or culture for Mycobacterium tuberculosis (MTB) and prompt initiation of the correct therapy by means of the Directly Observed Treatment, Short course (DOTS) strategy. In 1997, it was estimated that 10 million of the 30 million people infected with the human immuno-deficiency virus (HIV) worldwide were co-infected with TB. This review article focuses on TB diagnosis, including newer laboratory tests, treatment:, and chemoprophylaxis. Special issues such as extra pulmonary TB, childhood TB, BCG immunisation, and the deadly alliance between TB and HIV/AIDS are also considered. Tuberculosis is a treatable disease and the aim of any family practitioner should be to treat smear positive patients as soon as possible, and cure them at the first attempt (SA Pam Pract 2003;45(2):38-43).