A frente de batalha da tuberculose

BERLIM – Esta tem sido uma boa década na luta contra a tuberculose (TB). É provável que alcancemos o Objectivo de Desenvolvimento do Milénio das Nações Unidas de reduzir a prevalência da TB e a mortalidade, para metade, até 2015, com base nos níveis de 1990. Pelo menos uma dúzia de novos candidatos, vacinas e medicamentos, estão em ensaios clínicos e a Organização Mundial de Saúde aprovou um novo teste diagnóstico chamado GeneXpert.

Este progresso é ainda mais importante dada a complacência que levou a uma paralisação completa na investigação e desenvolvimento para novas intervenções na TB, no final do século XX. Os medicamentos para combater a TB, actualmente em uso, foram desenvolvidos entre 1950 e 1970. Na verdade, a vacina BCG (Bacilo Calmette–Guérin) tem quase 100 anos de existência, ao passo que o teste diagnóstico mais amplamente utilizado, a detecção microscópica de bacilos na expectoração, foi desenvolvido há 130 anos.

Não é de admirar que a eficácia destas ferramentas tenha enfraquecido. A actual vacina previne formas graves de TB nas crianças, mas não previne a TB pulmonar que predomina em todos os grupos etários. O exame microscópico fornece falsos resultados em quase metade de todos os casos.

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