Despite the relevant investments and the important results achieved to date, tuberculosis (TB) still remains an important infectious disease and health problem worldwide. The World Health Organization (WHO) estimates that in 2009 there were 9.4 million incident cases, 14 million prevalent cases and 1.68 million deaths (1.3 million and 0.38 million in HIVnegative and HIVpositive patients, respectively).
The fourth edition of the “subseries on TB”, Tuberculosis: The Essentials, is an interesting editorial piece within the series of monographs Lung Biology in Health and Disease. It follows three appreciated editions published in 1993, 2000 and 2006, the first two edited by L.B. Reichman and E.S. Hershfield, and the third edited, like the present one, by M.C. Raviglione, the Director of the Stop TB Department at the WHO in Geneva, Switzerland.
M.C. Raviglione is a wellknown world authority in the field of TB management and control. He has convened 35 top experts from both sides of the Atlantic to update 15 chapters from the previous edition.
Over the course of a few years many changes have occurred in the field of TB. Multidrug resistant (MDR)TB (and the newly described extensively drugresistant (XDR)TB) joined TB/HIV as the key challenges of TB control. The new Stop TB Strategy expanded the classic vision of DOTS, focusing on new priorities such as health system strengthening (which includes, among other activities, human resource development, infection control and the laboratory network), engagement of all healthcare providers, empowering people with TB and communities, and promotion of research.
The chapters on epidemiology have been largely revised to provide an updated and wellreferenced summary of the available information. The chapter on pathogenesis has been rewritten to capture the new insights on TB infection and disease.
The chapters on diagnosis and treatment have been updated with the important body of knowledge developed in recent years. New tests like interferonγ release assays, molecular methods to detect Mycobacterium tuberculosis, are described in detail. Similarly, the challenges posed by MDRTB to develop effective regimens are well described, with a detailed discussion on situations deserving specific precaution. The issue of adherence is also discussed in detail. As previously mentioned, MDR/XDRTB and TB/HIV are clearly tackled both from a clinical and a public health perspective.
The strength of the book is represented by the chapters describing the programmatic approach to TB, MDRTB and TB/HIV, topics that are usually under discussed in favour of clinical issues. Last but not least, the final three chapters describe the stateoftheart development of new diagnostics, drugs and vaccines.
Overall, this book is an essential guide for everybody working in the field of TB, from specialists to nurses and students, both from a clinical and public health perspective.
- ©ERS 2011
