An der Tuberkulose-Front

BERLIN – Dies war ein gutes Jahrzehnt im Kampf gegen die Tuberkulose. Wahrscheinlich werden wir das Millenniumziel der Vereinten Nationen erreichen, Prävalenz und Mortalität der Tuberkulose bis 2015 gegenüber ihrem Niveau von 1990 zu halbieren. Mindestens ein Dutzend neuer Impfstoffe und Arzneimittelkandidaten durchlaufen derzeit klinische Tests, und die Weltgesundheitsorganisation hat einen neuen diagnostischen Test namens GeneXpert zugelassen.

Dieser Fortschritt ist umso wichtiger angesichts der Nachlässigkeit, die gegen Ende des 20. Jahrhunderts zu einem vollständigen Stillstand bei der Erforschung und Entwicklung neuer TB-Interventionen geführt hatte. Die derzeit verwendeten TB-Medikamente wurden zwischen 1950 und 1970 entwickelt. Der BCG-Impfstoff (BCG: Bacille Calmette Guérin) ist inzwischen fast 100 Jahre alt, und der am häufigsten eingesetzte diagnostische Test – die mikroskopische Nachweis der Bakterien im Sputum – wurde vor 130 Jahren entwickelt.

Kein Wunder also, dass sich die Wirksamkeit dieser Instrumente abgeschwächt hat. Der aktuelle Impfstoff verhindert schwere TB bei Kleinkindern, aber nicht die in allen Altersgruppen verbreiteteste offenen Lungen-TB. Der mikroskopische Test zeigt in fast der Hälfte aller Fälle ein falsches Ergebnis an.

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