TUBERCULOSIS CURRENT ISSUES IN DIAGNOSIS AND MANAGEMENT Edited by Bassam H. Mahboub Mayank G. Vats TUBERCULOSIS CURRENT ISSUES IN DIAGNOSIS AND MANAGEMENT Edited by Bassam H. Mahboub and Mayank G. Vats Tuberculosis: Current Issues in Diagnosis and Management Edited by Bassam H. Mahboub and Mayank G. Vats Contributors Raquel Lima De Figueiredo Teixeira, Marcia Lopes, Philip Suffys, Adalberto Santos, Luciene Scherer, Mochammad Hatta, Andi Rofian Sultan, Gunes Senol, Héctor Javier Sánchez-Pérez, Attapon Cheepsattayakorn, Zakaria Hmama, Beatrice Saviola, Isamu Sugawara, Qin Zhang, Wolfgang Frank, Said Hamed Abbadi, Claude Kirimuhuzya, Magana- Arachchi, Antonio De Miranda, Marcos Catanho, Handzel, Matthias Stehr, Armando Acosta, Hum Nath Jnawali, Sungweon Ryoo, Simona Alexandra Iacob, Diana-Gabriela Iacob, Raquel Teixeira, Rafael Pinto, Lizania Spinasse, Fernanda Mello, Jose Roberto Lapa E Silva, Wellman Ribón Copyright © 2016 Second Edition All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. 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First published March, 2013 second - 2016 ISBN-10: 953-51-1049-7 ISBN-13: 978-953-51-1049-1 Contents Preface IX Section 1 Pathophysiology and Immunogenesis of Tuberculosis 1 Chapter 1 Mycobacterium tuberculosis Adaptation to Survival in a Human Host 3 Beatrice Saviola Chapter 2 The Immune Response to Mycobacterium tuberculosis Infection in Humans 19 Zeev Theodor Handzel Chapter 3 Lipid Inclusions in Mycobacterial Infections 31 Matthias Stehr, Ayssar A. Elamin and Mahavir Singh Chapter 4 The Role of Antibodies in the Defense Against Tuberculosis 57 Armando Acosta, Yamile Lopez, Norazmi Mohd Nor, Rogelio Hernández Pando, Nadine Alvarez, Maria Elena Sarmiento and Aharona Glatman-Freedman Chapter 5 Influence of the Interferon–Gamma (IFN–γ) and Tumor Necrosis Factor Alpha (TNF–α) Gene Polymorphisms in TB Occurrence and Clinical Spectrum 79 Márcia Quinhones Pires Lopes, Raquel Lima de Figueiredo Teixeira, Antonio Basilio de Miranda, Rafael Santos Pinto, Lizânia Borges Spinassé, Fernanda Carvalho Queiroz Mello, José Roberto Lapa e Silva, Philip Noel Suffys and Adalberto Rezende Santos Chapter 6 Tuberculosis Pharmacogenetics: State of The Art 105 Raquel Lima de Figueiredo Teixeira, Márcia Quinhones Pires Lopes, Philip Noel Suffys and Adalberto Rezende Santos VI Contents Chapter 7 Pathophysiology of Tuberculosis 127 Ruiru Shi and Isamu Sugawara Section 2 Diagnosis and Management of Tuberculosis 141 Chapter 8 Laboratory Diagnosis of Tuberculosis - Latest Diagnostic Tools 143 Gunes Senol Chapter 9 Diagnostic Evaluation of Tuberculosis 153 Mochammad Hatta and A. R. Sultan Chapter 10 First– and Second–Line Drugs and Drug Resistance 163 Hum Nath Jnawali and Sungweon Ryoo Section 3 Multi-Drug Resistant Tuberculosis 181 Chapter 11 Epidemiology of Multidrug Resistant Tuberculosis (MDR-TB) 183 Dhammika Nayoma Magana-Arachchi Chapter 12 Drug Resistance in M. Tuberculosis 203 Said Hamed Abbadi Chapter 13 Management of Drug-Resistant TB 225 Zakaria Hmama Chapter 14 Drug-Resistant Tuberculosis – Diagnosis, Treatment, Management and Control: The Experience in Thailand 261 Attapon Cheepsattayakorn Section 4 Extra Pulmonary Tuberculosis 287 Chapter 15 Tuberculous Pleural Effusion 289 Wolfgang Frank Chapter 16 Neurotuberculosis and HIV Infection 315 Simona Alexandra Iacob and Diana Gabriela Iacob Contents VII Section 5 Miscellaneous 351 Chapter 17 Research and Development of New Drugs Against Tuberculosis 353 Juan D. Guzman, Ximena Montes-Rincón and Wellman Ribón Chapter 18 Web Resources on TB: Information, Research, and Data Analysis 381 Marcos Catanho and Antonio Basílio de Miranda Chapter 19 Peadiatric Tuberculosis: Is the World Doing Enough? 393 Claude Kirimuhuzya Chapter 20 Economic Evaluation of Diagnosis Tuberculosis in Hospital Setting 451 Luciene C. Scherer Chapter 21 Pulmonary Tuberculosis in Latin America: Patchwork Studies Reveal Inequalities in Its Control – The Cases of Chiapas (Mexico), Chine (Ecuador) and Lima (Peru) 465 Héctor Javier Sánchez-Pérez, Olivia Horna–Campos, Natalia Romero-Sandoval, Ezequiel Consiglio and Miguel Martín Mateo Preface One famous saying by Robert Louis Stevenson “It is not a hard thing to know what to write; the hard thing is to know what to leave out" holds very true for us while writing the preface of this book. Tuberculosis (TB) is as old as mankind and continues to haunt the mankind despite several spectacular advances in the diagnosis and management of TB. TB is the commonest single infectious cause of death and accountable for over 25% of avoidable deaths worldwide but can still be labeled as “Captain of all these men of death”. In the initial sections of the book chapters covering the basic pathophysiology and the im‐ portant factors contributing to the same viz. epidemiology of TB, iron metabolism, unusual properties of M. Tuberculosis, lipid inclusion, role of small regulatory RNA and adaptation to survival in human host, which makes it “tough bug” to treat, has been included in details. Our understanding of the host pathogen interaction at the molecular level, especially immu‐ nopathogenesis of TB has improved enormously and has been extensively covered in the book. Chapters have been included to cover several new drug and potential vaccines for TB. New development such as the interferon-gamma release assays [IGRAs] for latent TB infec‐ tion, use of liquid culture and molecular method of diagnosis are ushering in a new era in TB diagnostics. Comprehensive knowledge of latest modes of diagnosis has been also incor‐ porated in the book. Furthermore, issues concerning quality assurance in antituberculosis drug susceptibility testing are getting established. Data are rapidly accumulating from all over the world regarding the efficacy of standar‐ dized treatment regimens for drug-sensitive, drug-resistant TB and latent TB infection. While we are facing the menace of multi drug-resistant TB [MDR-TB], extensively drug-re‐ sistant tuberculosis [XDR¬ TB] has emerged threatening to undermine global efforts at TB control. Hence we have included chapters to cover all aspects of the diagnosis and manage‐ ment of MDR TB. This book will cover all these developments in great detail. With the widespread availability of internet globally various standard web resources availa‐ ble on TB have also been included so that the readers may get the comprehensive and up‐ dated guidelines from these resources. The changing clinical presentation of TB, advances in laboratory, imaging diagnostic modalities, therapeutic measures and emergence of MDR TB all suggest a pressing need to have a updated book on TB. Furthermore, while all physicians encounter the TB disease in their clinical practice, there have been a lot of controversies and misconceptions over various issues for the diagnosis and management of TB. Paucity of a well referenced, updated, standard book of TB has prompted us to undertake this venture sharing the clinical experience of global experts of TB. X Preface Our book contains chapters on epidemiology, immune-pathology, diagnosis, treatment and latest advances for TB, highlighting the global perspective of tuberculosis. World-wide re‐ surgence of MDR TB indicates that the battle against this foe of mankind will continue in the coming years. TB still remains to be a research priority of paramount importance from medical, social and financial aspects and we have attempted to highlight all the aspects for the treatment of TB. We believe that this book will serve as a practical guide for the diagnosis and management of TB for practicing physicians (especially pulmonologists and internists) and all those who are involved in the management of TB. This book has several contributors, all of them leading authorities from various parts of the world. All the chapters have been thoroughly re-written and updated with preservation of the views of the contributors in a uniform format. This effort would not have been possible without the kind cooperation of our contributors who patiently went through revisions and updating of their chapters. We convey our heartfelt thanks to all contributors and to InTech Publisher, Croatia for their encouragement and excellent technical assistance as and when required. Lastly we would like to thank the almighty god, our parents, wives and children, without their untiring support and encouragement this book would not have seen the light of the day. Editor: Dr. Bassam H. Mahboub Director, Department of Pulmonary Medicine and Allergy, Rashid Hospital & Dubai Hospital, Dubai; Assistant Professor, Dept of Medicine & Respiratory Disease & Allergy, University of Sharjah, UAE Co-editor: Dr. Mayank G. Vats Senior Specialist, Pulmonologist, Intensivist & Sleep Physician, Rashid Hospital, Dubai Health Authority, Dubai, UAE