Insights into Recurrent Tuberculosis
Medikoe Wellness Expert
80 feet road indira nagar, Bengaluru Aug 5, 2021
Recurrent TB (tuberculosis) following successful treatment develops a significant challenge to tuberculosis control strategies. Tuberculosis recurrence can be either reactivation of the same bacteria, i.e., relapse, or reinfection with a new kind. Recurrence because of reinfection has become an area of serious study due to its perceived significance in tuberculosis endemic settings with rising rates of HIV (human immunodeficiency virus) coinfection. Recurrent tuberculosis disease is associated with poor treatment results and higher death rates compared to primary tuberculosis infection. Clinical, microbiological or/and epidemiological data cannot be used to distinguish relapse and reinfection. Differentiating between the two mechanisms needs evaluating the homology of the mycobacterium tuberculosis strains isolated during the first and subsequent tuberculosis episode using molecular DNA fingerprinting technology. Prior to the development of DNA fingerprinting technology, primary tuberculosis disease was believed to grant some measure of immunity, and subsequent tuberculosis infection was the consequence of reactivation of the strain from the original occurrence of infection.
What is Recurrent TB disease?
Recurrent tuberculosis disease is defined as the diagnosis of a succeeding episode of tuberculosis following the cure or treatment completion at the end of your most recent course of treatment. Recurrent tuberculosis disease occurs after the initial tuberculosis disease episode has been listed as clinically cured. As per the WHO guidelines, the cure is described as a smear and culture-negative sputum samples from the last month of treatment and on at least one past event.
What is TB Relapse?
The relapsed disease is defined as a subsequent episode of tuberculosis disease due to the reactivation/reemergence of the original infecting strain of mycobacterium tuberculosis, determined by genotypic homogeneity assessment of initial and recurrent Mycobacterium tuberculosis strains. Given that mycobacterium tuberculosis strains are highly homogenous by nature, combined with high transmission rates, the classification of relapse infection is testing.
What is TB reinfection?
Reinfection is described as a subsequent episode of tuberculosis disease because of the exogenous infection with a Mycobacterium tuberculosis strain distinct from the organism that led to the initial infection. An objection regarding detection of reinfection is that in high TB-endemic settings, patients might be exposed to be reinfected with a very similar strain that caused the primary infection, making differentiation between relapse disease and reinfection challenging.
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