TB Flashcards
cases and deaths 2022
10.6 mil, 1.3 mil
big areas of TB burden
south/SE Asia
SS Africa
latent TB storage
in granulomas in the lungs
innate immune cells important
macrophages as first line of defence
dendritic cells to bring in the adaptive immune response
neutrophils maybe
adaptive immune responses
CD4+, IFNgamma is important
potentially CD8+ and B cells?
TB diagnosis
tuberculin skin test- bit old
IGRA- IFNgamma release assay, more specific and can be blood- or cell-based
also rogue stuff like PCR, lateral flow urine tests sometimes but those seem to be the main 2
TB treatment
currently a fairly complex ABX course for 6 months, used to not be much pre-ABX so was like sanitoria etc
issues w drug treatment
poor adherence, long and complex treatment makes it hard, expensive, treatment gaps are an issue, resistance (made worse by poor adherence)
DOTS (directly observed therapy) can be useful here
M vaccae vaccine
another mycobacterium, non-pathogenic so used to try and generate cross-immunity
Maybe useful? but patchy results
old prophylactic vaccines
using bovine TB, very early on- kinda just gave people TB
BCG vax- basics
attenuated vaccine, 1921, also from cow but weaker
BCG efficacy
up to 80% in some places (UK), but can have basically 0 effectiveness in some endemic regions
example of a new vax
MTBVAC- subunit vaccine involving a viral vector, not great efficacy
M72- 50%ish efficacy
