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Tuberculosis Prevention Capstone Project

¶ … Tuberculosis vaccine has been around for decades. However, tuberculosis is still one of the most significant reasons for death globally. Furthermore amidst the still developing nations, tuberculosis has not decreased, with cases on the rise annually. Measures to prevent tuberculosis must be taken. Recent studies and articles relaying information on better medications, and increased efforts towards prevention has led to potential decline in tuberculosis cases. Within the next decade, hopes are for Africa, where tuberculosis diagnosis remains high, to also see a decline. Notwithstanding these developments, full scale-up of tuberculosis and HIV cooperative undertakings remains perplexing and evolving drug-resistant tuberculosis is slowly becoming a key threat. Morbidity and Mortality Statistics

This article review will focus on existing information on tuberculosis cases to better understand the spread of tuberculosis globally. It will contain articles that examine the failure of national programs to address treatment and diagnosis of tuberculosis which adds to the annual death rates of TB. Along with an evolving drug-resistant strain of tuberculosis, the latest research focuses on new vaccines and treatments to counteract the evolving disease. There needs to be a visible improvement in diagnostics when it comes to TB therefore some articles will...

"In 2008, an estimated 440,000 cases of MDR tuberculosis emerged globally. India and China carry the greatest estimated burden of MDR tuberculosis, together accounting for almost 50% of the world's total cases" (Nathanson et al., 2010, pp. 1050-1058).
Literature Review

In an article by Zumla (2013) author discusses new and original drugs and treatments for all forms of TB such as Bedaquiline. Bedaquiline is approved by the FDA, however is not recommended for all TB patients as it does have serious adverse reactions. While on the medication, they may experience headache, chest pain, and nausea. Ever since the 1960's there hasn't been much change in way of treatments and vaccinations. However this article highlights emerging ones. Such programs that involve testing TB medications and getting them FDA approved are likely to employ both repurposed drugs and new biological mechanism. More than a few of these treatments are now succeeding through clinical trials. Zumla covers present ideas and modern developments in TB drug innovation and growth, including an update of continual TB regimen trials, newer clinical trial proposals, TB biomarkers and aide-de-camp host-directed therapies (Zumla, 2013, pp. 388).

Not only does the article highlight recent advances, it also targets…

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In order for the nations with the highest cases to meet the budgetary concerns, they must integrate the groundwork for determined budgets for the deterrence and control of MDR tuberculosis. "These plans must be consistent with policies on health care financing, including social-protection schemes (the delivery of commodities to reduce the social vulnerability of poor populations), and with broader planning and financing frameworks"(Nathanson et al., 2010, pp. 1050-1058).The best part about this article concerns how to establish the budget needed for these protocols. It urges the middle-income countries amongst the 27 nations to assemble their national assets. With proper gathering of resources, these nations can then afford an effective means of combating MDR TB.

Effective vaccines for TB are also in development. In an article by Checkley and Mcshane, they discuss how new vaccines are being manufactured through sustained global investment. "An effective tuberculosis (TB) vaccine could have a significant impact on the current TB pandemic. The past decade has seen sustained global investment into reaching this goal; currently there are several promising vaccines in clinical trials" (Checkley & Mcshane, 2011, p. 601).Existing methods comprise of the expansion of an enriched bacilli Calmette-Guerin (BCG) vaccine to be administered at birth as well as a booster vaccine to be given after the BCG vaccine. The combination of the vaccine and booster shots given directly after birth will prevent many children from facing risk of developing TB from late administration of vaccine. The authors help the reader better understand present vaccination strategies and the weaknesses inherent in the traditional methods by describing current strategies and looking over the primary concerns in new TB vaccine development. Although they present new findings in relation to vaccination approaches they do not truly sell the idea of new vaccines or their efficacy. "The main challenge in early trials is the lack of a defined correlate of vaccine-induced immune protection. Following this, large efficacy trials are undertaken, which face the daunting challenges of cost, logistics and trial site capacity" (Checkley & Mcshane, 2011, p. 601).

In an article by Kawkridge & Mahomed, the authors explore some of the problems surrounding the progress of new vaccines against TB and provide detailed information on the principal contenders. As previously discussed in the Checkley & Mcshane article, a redone BCG vaccine is supposed to be a new and effective means of combating TB. This article highlights evidence suggesting just how ineffective the normal BCG vaccine is. "Tuberculosis in infants and young children remains an all too common cause of morbidity and mortality
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