tuberculosis test tubes BSIP | getty images

Den Kampf gegen TB gewinnen

SEATTLE – Die Menschheit kämpft seit der Steinzeit gegen Tuberkulose, aber erst seit dem vergangenen Jahrhundert konnten Fortschritte in diesem Kampf erzielt werden. Ein Impfstoff, der 1921 erstmals Menschen verabreicht wurde, ist noch heute in Gebrauch. Und eine Reihe von Antibiotika, beginnend mit Streptomyzin in den 1940er Jahren, hat sich bei der Behandlung von TB-Infektionen bewährt.

Seit 1990 konnte die jährliche Zahl der Todesopfer durch TB fast um die Hälfte gesenkt werden. Zwischen 2000 und 2014 haben Diagnose- und Behandlungsverbesserungen 43 Millionen Menschenleben gerettet. Aber insgesamt hat sich der Fortschritt doch beträchtlich verlangsamt, woraus wir schließen müssen, dass der Kampf noch lange nicht gewonnen ist. Die jährliche Rückgangsrate betrug im vergangenen Jahrzehnt nur 1,65 Prozent, 2014 tötete TB 1,5 Millionen Menschen.

Gleichzeitig entwickeln bestimmte Stämme der Krankheit Resistenzen gegen die Behandlung. Missbrauch und Missmanagement von Antibiotika hat zu einer multiresistenten Tuberkulose geführt. Diese Stämme müssen mit Second-Line-Medikamenten behandelt werden, die teurer sind und oft schwerwiegendere Nebenwirkungen haben. Es sind außerdem bereits Stämme aufgetaucht, die auch gegen Second-Line-Medikamente resistent sind, die so genannten extrem arzneimittelresistente TB (XDR-TB).

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