TB Quick Facts and Frustrations

Tuberculosis is a complicated disease, and when you throw it in with HIV, pregnancy, or different populations (peds vs adult) it transforms into an even more complex entity. This week was the first time that I experienced that feeling you get when you realize you are starting to become comfortable with a subject you are studying. The vocabulary is familiar, the explanations in each article or book start to follow a certain pattern, and what has or has not been studied starts to become apparent.

Some interesting facts about TB...(I am going to keep this basic since some of you have mentioned that the medical stuff on the blog has been a bit confusing/boring...sorry!)

1) 1 out of 3 people are infected with TB globally!! Infection does not mean that a person has active disease, but they have been exposed and now the bacteria is hanging out waiting for a good moment to make the person sick (active disease).

2) Approximately 1 out of 10 of these infected people will develop active disease in his/her lifetime.

3) In the HIV+ population, approximately 1 out of 10 infected people will develop active disease PER YEAR.


Young children with HIV are particularly at risk to develop severe active TB disease. Luckily, there is a drug (isoniazid) that can be given to an HIV+ child who has been exposed to TB for a period of time that significantly decreases the development of active disease AND mortality. For one child, it costs approximately 15 USD for the entire treatment duration.

You're probably thinking, "well that's great!"

This is where my frustration comes in...

Unfortunately, in many low-resource settings, implementation of isoniazid preventive therapy delivery has not occurred! The reasons range from politics to lack of education. However, the bottom line is that the literature demonstrates the positive impact this preventive measure could have on communities burdened with TB (particularly HIV+ children), and yet implementation is crawling. This makes me CRAZY, and it reinforces the need for individuals in medicine and public health to shift their focus to implementation/operations research in order to close the gap between the scientific literature and healthcare delivery!