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Tuberculosis Once Again Top Killer Among World's Infectious Diseases

Tuberculosis is again the leading cause of deaths from infectious disease after COVID-19 displaced it briefly during the pandemic. Photo by Adobe Stock/HealthDay News

In the highest tally ever recorded for tuberculosis cases, the World Health Organization reported Tuesday that over 8 million people worldwide were diagnosed with the lung disease last year.

Of that number, 1.25 million people died of TB, the new report found, meaning that it is once again the leading cause of deaths from infectious disease after COVID-19 displaced it briefly during the pandemic.

"The fact that TB still kills and sickens so many people is an outrage, when we have the tools to prevent it, detect it and treat it," WHO Director-General Dr. Tedros Adhanom Ghebreyesus said in an agency news release. "WHO urges all countries to make good on the concrete commitments they have made to expand the use of those tools, and to end TB."

Some countries are hit harder by the disease than others: It continues to mostly affect people in Southeast Asia, Africa and the Western Pacific. India, Indonesia, China, the Philippines and Pakistan account for more than half of the world's cases, the WHO noted.

Who is most vulnerable?

According to the report, 55% of people who developed TB were men, while 33% were women and 12% were children and young adolescents.

Many of new TB cases were driven by five major risk factors: undernutrition, HIV infection, alcohol use disorders, smoking (especially among men) and diabetes.

Tackling these issues, along with other social determinants such as poverty, requires a coordinated approach, the WHO added.

"We are confronted with a multitude of formidable challenges: funding shortfalls and catastrophic financial burden on those affected, climate change, conflict, migration and displacement, pandemics and drug-resistant tuberculosis, a significant driver of antimicrobial resistance," Dr. Tereza Kasaeva, director of WHO's Global Tuberculosis Programme, said in the agency news release. "It is imperative that we unite across all sectors and stakeholders, to confront these pressing issues and ramp up our efforts."

There was a silver lining in the report.

TB deaths continue to fall globally, and the number of people being newly infected is starting to stabilize.

"However, multidrug-resistant TB remains a public health crisis," the WHO noted. "Treatment success rates for multidrug-resistant or rifampicin-resistant TB [MDR/RR-TB] have now reached 68%. But, of the 400 000 people estimated to have developed MDR/RR-TB, only 44% were diagnosed and treated in 2023."

Tuberculosis is caused by airborne bacteria that mostly attacks the lungs. Roughly a quarter of the global population is estimated to have TB, but only about 5% to 10% of those develop symptoms, the WHO said.

People with TB infection often don't feel sick and aren't contagious. Only a small proportion of people who are infected with TB will experience symptoms, with babies and children at higher risk.

TB symptoms may be mild for many months, so it is easy to spread the disease to others without knowing it, the WHO noted.

Common TB symptoms are:

prolonged cough (sometimes with blood)

chest pain

weakness

fatigue

weight loss

fever

night sweats

The symptoms people get depend on which part of the body is affected by TB. While it typically strikes the lungs, it can also damage the kidneys, brain, spine and skin, the WHO added.

More information

The CDC has more on TB.

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Novel Plant-Derived Compound May Be Game-Changer For Drug-Resistant Tuberculosis

A bloodroot flower – CC 4.0. BY-SA Erutuon.

A plant-derived compound was shown in a recent study to kill strains of tuberculosis that were resistant to existing therapies.

The compound was found in a plant native to North America, and was not only able to suppress dormant TB bacteria from resurfacing but also didn't damage the gut microbiome.

Tuberculosis is the second-leading killer of humans from an infectious disease worldwide, and has been developing resistance to many of the antibiotics previously used to treat it.

Caused by a species of bacteria that invades the respiratory system called Mycobacterium tuberculosis, it can also affect the heart, brain, and spinal column.

A new study published in the journal Anti-inflammatory Nutraceuticals and Chronic Diseases, found that sanguinarine, a derivative of bloodroot, a wildflower found in North America, could combat multidrug-resistant tuberculosis (MRTB) after being genetically modified to reduce its natural toxicity.

TB is treated with multiple medications over a 6-month period, exposing the human organism to substantial weakening. By contrast, the sanguinarine selectively targeted the bacteria responsible for MRTB, leaving harmless and beneficial bacteria intact.

However, in its natural form, sanguinarine is toxic to human cells, so Dr. Jim Sun, senior author and assistant professor at the University of British Columbia's Department of Microbiology and Immunology, led a team to genetically reduce the toxicity of the phytochemical while increasing its potency as a tuberculosis killer.

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This resulted in the creation of 35 new derivatives, two of which—BPD9 and BPD6—showed over 90% inhibition of 8 different forms of Mycobacterium tuberculosis, 3 that were particularly virulent, and 5 that were resistant to existing drugs.

"TB treatment takes six months because the bacteria can 'hibernate' in your lungs until reactivated. Most antibiotics work best against actively growing bacteria, but BPD9 seems to be able to stop dormant bacteria from coming back to life," explained Dr. Sun.

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It took just 8 days to significantly reduce the quantity of MRTB and other TB strains in mice treated with BPD9, delighting the research team, who nonetheless say that more work needs to be done to lower the compounds' toxicity and conducting additional tests on drug-resistant strains of TB-causing bacteria.

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