Chapter 4 : Epidemiology of Tuberculosis

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Study of the epidemiology of tuberculosis has been greatly assisted by the availability of a test for infection, the tuberculin test, that enables one to distinguish those who are infected but without disease from those who are uninfected. The principal risk for acquiring infection with is breathing. The concept that microbes may exist in sufficient concentration in the air to cause airborne infection and disease was controversial until the middle of this century. Tuberculosis due to reactivation of latent bacilli is presumed to result from a failure in immune surveillance. Until relatively recently, rates of tuberculosis in developed countries had shown large and consistent declines for many decades. The epidemic of HIV infection has radically changed the epidemiology of tuberculosis. Recent outbreaks of multiple-drug-resistant (MDR) tuberculosis in AIDS units and other congregate settings suggest an increased risk of primary infection with . The demonstration of exogenous reinfection raises the issue of the effect of HIV on primary transmission of in developed countries. HIV has profoundly changed the epidemiology of tuberculosis, disrupting the balance between tuberculosis infection and control in both developing and developed countries.

Citation: Smith P, Moss A. 1994. Epidemiology of Tuberculosis, p 47-59. In Bloom B (ed), Tuberculosis. ASM Press, Washington, DC. doi: 10.1128/9781555818357.ch4
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Figure 1

Diagrammatic representation of the natural history of tuberculosis within individuals as they age.

Citation: Smith P, Moss A. 1994. Epidemiology of Tuberculosis, p 47-59. In Bloom B (ed), Tuberculosis. ASM Press, Washington, DC. doi: 10.1128/9781555818357.ch4
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Table 1

Risk of clinical tuberculosis in HIV-infected persons in six prospective studies

Citation: Smith P, Moss A. 1994. Epidemiology of Tuberculosis, p 47-59. In Bloom B (ed), Tuberculosis. ASM Press, Washington, DC. doi: 10.1128/9781555818357.ch4

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