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McGill TB Research Group Madhukar Pai, MD, PhD Associate Professor

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Presentation on theme: "McGill TB Research Group Madhukar Pai, MD, PhD Associate Professor"— Presentation transcript:

1 McGill TB Research Group Madhukar Pai, MD, PhD Associate Professor

2 What is TB? Tuberculosis is an infectious disease – Patient is sick, contagious – We call this ‘TB’ Mycobacterium tuberculosis is name for the bacteria that causes TB Most infected people do not develop the disease – These people are not contagious – We call this ‘latent infection’

3 Clinical manifestations of TB General – Fever, weight loss, weakness – “Consumption”, “Phthisis” Organ specific – Lungs: cough, spitting up blood – Others: Scrofula: swollen lymph nodes Spine: ‘hump-back’ Etc.

4 Chest x-ray in pulmonary TB Cavity represents collection of millions of bacteria that are transmitted by cough TB is reason why X-rays are done with immigration

5 TB disease and infection: Natural History Infection Infection without disease – 90% Person with active TB

6 TB disease and infection: Natural History Infection Progression to active TB disease - 10% Infection without disease – 90% Person with active TB Preventive treatment: Isoniazid

7 Global epidemiology Tuberculosis disease – ~9 million new cases per year – 1.5 million deaths per year Every 15 seconds Latent infection – 2 billion persons infected One person infected each second – If 10% progress, 200 million future cases

8 No estimate 300 or more Estimated new TB cases (all forms) per population TB incidence per 100,000 people Source: WHO

9 – No estimate or more Estimated number of new cases (all forms) TB cases Source: WHO

10 TB in Canada has declined to low levels, but it remains an important concern in immigrants and Aboriginals April 2011

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12 Globally, incidence rates falling after peak in 2004, but only at <1%/year Peak in 2004 Incidence (all forms, incl. PLHIV) TB Notifications Incidence TB in PLHIV shaded area = uncertainty band Notification gap Courtesy: WHO Stop TB Department

13 TB elimination is impossible with current tools

14 Diagnostic tools that Robert Koch used… Microscopy CultureTuberculin test 14

15 are still in use today! Active TB – Sputum microscopy [1882] – Mycobacterial culture [1882] – Chest X-rays [1896] Latent TB (LTBI) – Tuberculin skin test [1890] 15

16 We desperately need new TB vaccines and drugs BCG: 1920s Rifampin: 1950s

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18 Host genetics and strain variations

19 New TB diagnostics

20 New TB drug regimens

21 Global health and TB

22 Modeling and cost-effectiveness

23 Social determinants

24 Statistical methods and approaches

25 Knowledge translation and policy

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28 Sources of funding

29 Thank you!


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