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Tuberculosis: The Essentials

2009 Edition, November 18, 2009

Complete Document

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Active, Most Current

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ISBN: 978-1-4200-9023-9
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Product Details:

  • Revision: 2009 Edition, November 18, 2009
  • Published Date: November 18, 2009
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 408
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


The third edition of Tuberculosis—A Comprehensive International Approach was published just three years ago with the aim to provide health workers, students, scientists, and all interested in the field with a textbook featuring the "state-of-the-art" knowledge in tuberculosis control and research. Judging from the success of the book, we succeeded in disseminating the most up-to-date understandings in the field, thanks to the over 100 scientific authorities and colleagues who contributed their expertise and knowledge.

However, the field of tuberculosis is moving faster and faster, with information becoming available very rapidly in all aspects of the disease. For instance, by the time of publication of the third edition, the international health community became acutely aware of the existence of extensively drug-resistant tuberculosis (XDR-TB)—a form of multidrug-resistant tuberculosis (MDR-TB) resistant to the most powerful first- and second-line antituberculosis drugs. This recognition has caused great concern internationally, not only because XDR-TB has been found in most places where second-line drugs have been used, but also because XDR-TB has started affecting people living with HIV/AIDS, resulting in extremely high case fatality. The fear generated by XDR-TB is without precedents in the tuberculosis world, as the specter of an incurable disease, like in the preantibiotic era, has reappeared. Almost simultaneously with the recognition of XDR-TB, theWorld Health Organization has announced that global tuberculosis rates per capita might have reached a peak in 2004. This is also unprecedented, as rates had been increasing annually for decades, at least globally. This is largely the result of a changing direction of the HIV/AIDS incidence curve in Africa. In this region, the HIV/AIDS factor had determined the dramatic increases of tuberculosis rates starting in the 1980s until very recently. Peaking of the HIV epidemic has meant finally also a decrease of tuberculosis in many countries. At the same time, the interaction between tuberculosis and HIV has been recognized also outside of the tuberculosis community, and combined approaches between national HIV/AIDS and tuberculosis programs have started to produce results.

In the field of tuberculosis research, the recent demonstration that molecular diagnostics, such as the line-probe assays, may reduce dramatically the time of detection of multidrug-resistant tuberculosis and be applicable also to resource-limited settings has spurred a sense of hope that was not felt for decades. At last, the first products of the recent investments in tuberculosis research and development after many years of neglect have become available. This is unprecedented too. Similarly, advances are evident in various research fields, with new drugs in the pipeline and a dozen vaccine candidates getting ready for large clinical trials.

These new developments prompted the decision to update the third edition of our book very rapidly. While the first (1993) and second (2000) editions, edited by L. B. Reichman and E. S. Hershfield, were separated by seven years and the second and third (2006) editions by six years, this time, the publishers have decided to pursue a rapid update to keep the pace of the new discoveries and observations in the field of tuberculosis. However, not all chapters of the 2006 third edition are in need of an update. Thus, we have decided to focus only on those topics that are constantly and frequently changing. Hence, we have selected fifteen essential areas, which were updated to provide the reader with the best information available today. To begin, tuberculosis epidemiology, both descriptive and general, is changing constantly, as is the complex field of pathogenesis. We have therefore asked prominent scientists in these fields to present the latest information. The clinical chapters of diagnosis and treatment of the various forms of tuberculosis, including those associated with HIV and those due to drug-resistant organisms, are fundamental for the clinician and in need of regular update. This has been achieved by asking expert authorities to take a new look at the case management of tuberculosis, including its variants of HIV-associated tuberculosis and MDR-TB. Control-related issues of paramount importance include the status of drug resistance in the world, on which new important information has become available in 2008; the programmatic approach to drug-resistant tuberculosis, which has required quick strategic adjustments during 2008 to cope with the emerging threat of XDR-TB; and the approach against HIV-associated tuberculosis with the clearer recognition of the interventions necessary from both the HIV/AIDS and tuberculosis programs. All these are also part of the comprehensive StopTBStrategy launched in 2006, which in itself needs some refining after the first years of implementation. For this reason, we are presenting in this edition the latest updates of the strategy that, today, covers comprehensively all major thematic areas of control and research. In addition, the issue of case detection has become very prominent since we have witnessed a slowing down in the growth of cases detected by programs world-wide: this requires a specific chapter assessing what can be done to increase and accelerate detection of cases while maintaining high treatment success rates. Finally, the field of research is ever evolving and new information needs to be disseminated rapidly for a better knowledge of the area. Thus, the three chapters devoted to development of new diagnostics, drugs, and vaccines present the latest information available from some of the key scientists involved in research toward new tools.

These topics constitute our fifteen essential chapters that form this fourth edition. We have entitled it Tuberculosis, Fourth Edition: The Essentials. In our intention, most chapters are the updated versions of those in the third edition, while the remaining ones in that edition remain valid and constitute a source of additional knowledge for those who will approach the complex and fascinating field of tuberculosis starting with the "Essentials."