Tuberculosis: Current status and recent developments in diagnostics, drugs and vaccines

Tuberculosis is today the leading cause of death from a single infectious pathogen. Although antibiotics with potent activity against Mycobacterium tuberculosis are available, long-term multi-drug treatment regimens are complex and compliance with therapy is poor. The number of tuberculosis sufferers in the major industrialised nations has been increasing over the past decade. The HIV pandemic, increased occurrence of multi-drug resistant bacteria and socio-economic factors - poverty, homelessness, poor access to healthcare - have contributed to this increase. Preventative vaccination with Bacille Calmette-Guerin (BCG) is controversial as the protection afforded is incomplete. Following a quarter century when little research into tuberculosis was carried out, progress is now being made in our understanding of this complex disease - new tools are available to aid diagnosis, several promising new antimycobacterial agents are being evaluated and novel targets for chemotherapeutic intervention are being defined. Clarification of the mechanism of host immunity to M. tuberculosis infection may lead to new and effective vaccines.