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Free Content The biosocial dynamics of tuberculosis

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Abstract:

Summary The declaration by the WHO of tuberculosis as a ‘global emergency’ illustrates the paradox of tuberculosis. The treatment of this disease is a good example of ‘evidence-based medicine’, having been fine-tuned by numerous clinical trials. Modern short-course anti-tuberculosis therapy is among the most effective and cost-effective ways of saving and prolonging human life; yet, this disease is more prevalent today than in the days before the advent of effective therapy and is currently the cause of one in seven deaths and one in four deaths among young adults. It would seem that something has gone seriously wrong and, to shed light on the cause, it is necessary to take a very broad historical look at the changing trends in the behaviour of the disease in communities worldwide and the attitudes of the various communities to the disease in their midst, not just to understand past mistakes, but to make sure we do not make the same mistakes now and in the future.

French
La déclaration de la tuberculose comme une «urgence mondiale» par l’OMS illustre le paradoxe de la maladie. Le traitement de cette maladie est un bon exemple de «médecine fondée sur des preuves», après avoir été affiné par de nombreux essais cliniques. La thérapie moderne de courte durée contre la tuberculose est parmi les moyens les plus efficaces et rentables de sauver et de prolonger la vie humaine. Pourtant cette maladie est plus répandue aujourd’hui qu’avant l’avènement de la thérapie efficace et est actuellement la cause d’un mort sur sept et d’un décès évitables sur quatre chez les jeunes adultes. Il semblerait que quelque chose s’est très mal passé et dans le but de faire la lumière sur la cause, il est nécessaire de prêter une attention très large à l’historique de l’évolution des tendances dans le comportement de la maladie dans les communautés du monde entier et les attitudes des différentes communautés face à la maladie dans leur milieu, non seulement pour comprendre les erreurs du passé, mais aussi pour nous assurer que nous n’allons pas refaire les mêmes erreurs aujourd’hui et dans l’avenir.

Keywords: Resistencia a medicamentos; control; contrôle; drug-resistance; economic; económica; epidemia; epidemic; histoire; historia; history; résistance aux médicaments; social; sociale; tuberculose; tuberculosis; économique; épidémie

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2008.02205.x

Affiliations: 1:  Centre for Infectious Diseases and International Health, University College London, London, UK 2:  National TB Program, Ministry of Health, Lusaka, Zambia 3:  University Teaching Hospital and UNZA-UCLMS Project, Lusaka, Zambia

Publication date: February 1, 2009

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