Editing Tuberculosis (section)

== Prevention ==
The main strategies to prevent infection with TB are treatment of both active and latent TB, as well as vaccination of children who are at risk.<ref name="Lawn-2011" />

Although latent TB is not infective, it should be treated in order to prevent its development into active pulmonary TB, which is infective.<ref>{{Cite web |date=2025-02-05 |title=Tuberculosis Vaccine |url=https://www.cdc.gov/tb/vaccines/index.html |access-date=2025-04-21 |website=Centers for Disease Control and Prevention |language=en-us}}</ref> The cascade of person-to-person spread can be circumvented by segregating those with active ("overt") TB and putting them on anti-TB drug regimens. After about two weeks of effective treatment, subjects with [[Antibiotic resistance|nonresistant]] active infections generally do not remain contagious to others; however it is important to complete the full course of treatment which is usually six months.<ref>{{Cite web |date=2025-03-31 |title=Tuberculosis (TB): migrant health guide |url=https://www.gov.uk/guidance/tuberculosis-tb-migrant-health-guide |access-date=2025-04-21 |website=GOV.UK |language=en}}</ref><ref name="Ahmed_2011" />

=== Vaccines ===
{{Main|Tuberculosis vaccines|BCG vaccine}}
The only available [[vaccine]] {{as of|2021|lc=yes}} is [[bacillus Calmette-Guérin]] (BCG).<ref>{{cite journal | vauthors = McShane H | title = Tuberculosis vaccines: beyond bacille Calmette-Guerin | journal = Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences | volume = 366 | issue = 1579 | pages = 2782–89 | date = October 2011 | pmid = 21893541 | pmc = 3146779 |doi-access=free | doi = 10.1098/rstb.2011.0097 }}</ref><ref>{{cite web |title=Vaccines {{!}} Basic TB Facts |url=https://www.cdc.gov/tb/topic/basics/vaccines.htm |date=16 June 2021 |publisher=CDC |access-date=30 December 2021 |archive-date=30 December 2021 |archive-url=https://web.archive.org/web/20211230115301/https://www.cdc.gov/tb/topic/basics/vaccines.htm |url-status=live }}</ref> In areas where tuberculosis is not common, only children at high risk are typically immunized, while suspected cases of tuberculosis are individually tested for and treated.<ref name="WHO_BCG_2018">{{cite journal |vauthors=((World Health Organization)) |date=February 2018 |title=BCG vaccines: WHO position paper – February 2018 |journal=Weekly Epidemiological Record |volume=93 |issue=8 |pages=73–96 |pmid=29474026 |hdl-access=free |hdl=10665/260307}}</ref> In countries where tuberculosis is common, one dose is recommended in healthy babies as soon after birth as possible.<ref name="WHO_BCG_2018" /> A single dose is given by intradermal injection. Administered to children under 5, it decreases the risk of getting the infection by 20% and the risk of infection turning into active disease by nearly 60%.<ref>{{cite journal | vauthors = Roy A, Eisenhut M, Harris RJ, Rodrigues LC, Sridhar S, Habermann S, Snell L, Mangtani P, Adetifa I, Lalvani A, Abubakar I | title = Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis |doi-access=free | journal = BMJ | volume = 349 | page= g4643 | date = August 2014 | issue = aug04 5 | pmid = 25097193 | pmc = 4122754 | doi = 10.1136/bmj.g4643 }}</ref><ref>{{cite journal | vauthors = Dias JV, Varandas L, Gonçalves L, Kagina B | title = Outcomes of childhood TB in countries with a universal BCG vaccination policy | journal = The International Journal of Tuberculosis and Lung Disease | volume = 28 | issue = 6 | pages = 273–277 | date = June 2024 | pmid = 38822485 | doi = 10.5588/ijtld.23.0321 }}</ref> It is not effective if administered to adults.<ref>{{Cite journal |last1=Martinez |first1=Leonardo |last2=Cords |first2=Olivia |last3=Liu |first3=Qiao |last4=Acuna-Villaorduna |first4=Carlos |last5=Bonnet |first5=Maryline |last6=Fox |first6=Greg J. |last7=Carvalho |first7=Anna Cristina C. |last8=Chan |first8=Pei-Chun |last9=Croda |first9=Julio |last10=Hill |first10=Philip C. |last11=Lopez-Varela |first11=Elisa |last12=Donkor |first12=Simon |last13=Fielding |first13=Katherine |last14=Graham |first14=Stephen M. |last15=Espinal |first15=Marcos A. |date=2022-09-01 |title=Infant BCG vaccination and risk of pulmonary and extrapulmonary tuberculosis throughout the life course: a systematic review and individual participant data meta-analysis |journal=The Lancet Global Health |language=English |volume=10 |issue=9 |pages=e1307–e1316 |doi=10.1016/S2214-109X(22)00283-2 |issn=2214-109X |pmid=35961354|pmc=10406427 }}</ref>

=== Public health ===
[[File:Notice Do not spit - National Association for the Prevention of Tuberculosis Dublin Branch.jpg|thumb|A tuberculosis public health campaign in Ireland, 1905]]The first [[International Congress on Tuberculosis]] was held at Berlin in 1899. It was known by this time that tuberculosis was caused by a [[bacillus]], thought to be passed by [[phlegm]] coughed up by a sick person, dried into dust and then inhaled by a healthy person.{{sfn|Maxwell|Pye-Smith|1899|p=5}} Milk was known to be an important means of infection.{{sfn|Maxwell|Pye-Smith|1899|p=5}} Means of prevention included free ventilation of houses and wholesome and abundant food. Milk should be boiled, and meat should be carefully inspected, or else the cattle tested for infection. Cures for the disease included abundant food, particularly of a fatty nature, and life in the open air.{{sfn|Maxwell|Pye-Smith|1899|p=8}}

TB was made a [[notifiable disease]] in Britain; there were campaigns to stop spitting in public places, and the infected poor were pressured to enter sanatoria that resembled prisons.<ref>McCarthy 2001:413-7</ref> In the United States, concern about the spread of tuberculosis played a role in the movement to prohibit public spitting except into [[Spittoon|spittoons]].  

==== Worldwide campaigns ====
[[File:Tuberculosis screening, 1940, Royal Navy Barracks, Chatham (IWM A 2008).jpg|thumb|[[Royal Navy]] sailors being screened for tuberculosis (1940)]]
{{Further information|Elimination of tuberculosis}}

The World Health Organization (WHO) declared TB a "global health emergency" in 1993,<ref name="Lawn-2011" /> and in 2006, the Stop TB Partnership developed a [[Global Plan to Stop Tuberculosis]] that aimed to save 14 million lives between its launch and 2015.<ref>{{cite web|url=http://www.stoptb.org/global/plan/|title=The Global Plan to Stop TB|publisher=[[World Health Organization]] (WHO)|year=2011|access-date=13 June 2011|url-status=live|archive-url=https://web.archive.org/web/20110612030924/http://www.stoptb.org/global/plan/|archive-date=12 June 2011}}</ref> A number of targets they set were not achieved by 2015, mostly due to the increase in HIV-associated tuberculosis and the emergence of multi-drug resistant tuberculosis.<ref name="Lawn-2011" /> 

In 2014, the WHO adopted the "End TB" strategy which aims to reduce TB incidence by 80% and TB deaths by 90% by 2030.<ref>{{Cite web |title=The End TB Strategy |url=https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy |url-status=live |archive-url=https://web.archive.org/web/20210722170507/https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy |archive-date=22 July 2021 |access-date=22 July 2021 |website=who.int}}</ref> The strategy contains a milestone to reduce TB incidence by 20% and TB deaths by 35% by 2020.<ref name="WHO_Global_2020">{{Cite book |url=https://apps.who.int/iris/rest/bitstreams/1312164/retrieve |title=Global tuberculosis report 2020 |publisher=World Health Organization |year=2020 |isbn=978-92-4-001313-1 |access-date=22 July 2021 |archive-url=https://web.archive.org/web/20210722172009/https://apps.who.int/iris/rest/bitstreams/1312164/retrieve |archive-date=22 July 2021 |url-status=live}}</ref> However, by 2020 only a 9% reduction in incidence per population was achieved globally, with the European region achieving 19% and the African region achieving 16% reductions.<ref name="WHO_Global_2020" /> Similarly, the number of deaths only fell by 14%, missing the 2020 milestone of a 35% reduction, with some regions making better progress (31% reduction in Europe and 19% in Africa).<ref name="WHO_Global_2020" /> Correspondingly, also treatment, prevention and funding milestones were missed in 2020, for example only 6.3 million people were started on TB prevention short of the target of 30 million.<ref name="WHO_Global_2020" />

The goal of tuberculosis elimination is being hampered by the lack of rapid testing, short and effective treatment courses, and [[tuberculosis vaccine|completely effective vaccines]].<ref>{{cite journal | vauthors = Uplekar M, Weil D, Lonnroth K, Jaramillo E, Lienhardt C, Dias HM, Falzon D, Floyd K, Gargioni G, Getahun H, Gilpin C, Glaziou P, Grzemska M, Mirzayev F, Nakatani H, Raviglione M | title = WHO's new end TB strategy | journal = Lancet | volume = 385 | issue = 9979 | pages = 1799–1801 | date = May 2015 | pmid = 25814376 | doi = 10.1016/S0140-6736(15)60570-0 | s2cid = 39379915 }}</ref>