DR.Ahmed Hany: Tuberculosis is back

Professor of Allergy, Chest and Environmental Medicine

Tuberculosis is one of oldest diseases in history that is highly related to environmental conditions.

After it was controlled in the nineties it fired back fiercely and the prevalence and incidence started to rise again.

Unfortunately it stroke with a virulent variant that is resistant to Rifampicin the drug that helped much to control the disease.

Air pollution affected the lungs and decreased its immunity and at the same time it caused mutation in the Mycobacterium kanisii to be more virulent in Europe.

Air pollution and malnutrition played a major role in the development of the disease.

The over-crowdedness in poor countries and in poor districts of the rich countries facilitate the transmission of the disease from the patients to healthy individuals.

It is the virulence of the disease versus the personal immunity that determine whether the person would develop the disease or not.

The world could control the disease by drugs, BCG vaccine, controlling malnutrition and giving social support to the poor families.

Vaccination gives about 60% immunity only.

Efforts to discover new cases helped much to control the disease by treating patients before infecting many people who live in the poor environmental conditions.

Coal and silicon miners and other polluting jobs gave the disease the opportunity to infect the affected lungs by the different pollutants.

At the same time cows that were infected transmitted the disease through milk.

AIDS that is widely spread in Africa and South Asia destroys the immunity system and now there is an association between the two diseases.

While the main causes of having tuberculosis in rich countries are diabetes and other diseases that affect the immunological system, the picture is different in poor countries.

Malnutrition, famines, air pollution, living in refugees camps due to catastrophes or armed conflicts that prevent health authorities from providing the services, and the spread of infectious diseases that add to the weakness of the immunity are the main causes in poor countries and in poor districts and shanty towns in rich countries.

The causes of the development of the Rifampicin resistant variant are many. Most of them are environmental like pollution, malnutrition and incomplete treatment courses due to shortage of drug supplies either due to financial problems or armed conflicts.

Malnutrition and endemic diseases make the disease sever and lethal.

Monkey-pox and polio were eradicated and surprisingly the scientists discovered new cases that started to spread.

Will the world witness more infectious diseases due to pollution and climate changes?

The answer is most probably yes and the health authorities have to follow up the diseases maps and be ready for them

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