Talk:Tuberculosis/Archive 3

Archive 1

Archive 2

Archive 3

Archive 4

precaution

which precaution should be take by patient after cure?Bhavinkundaliya (talk) 17:46, 28 March 2012 (UTC)

Fix

That such an important article has fallen into disarray is unfortunate. Will see if I can fix it.--Doc James (talk · contribs · email) 12:23, 29 December 2011 (UTC)

We have a great 2011 Lancet review here

• Lawn, SD (2011 Jul 2). "Tuberculosis". Lancet. 378 (9785): 57–72. PMID 21420161. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Escalante, P (2009 Jun 2). "In the clinic. Tuberculosis". Annals of internal medicine. 150 (11): ITC61-614, quiz ITV616. PMID 19487708. {{cite journal}}: Check date values in: |date= (help)Doc James (talk · contribs · email) 04:53, 5 January 2012 (UTC)

2011 US data

[1] Doc James (talk · contribs · email) 16:40, 23 March 2012 (UTC)

Seminar

The Lancet have a seminar in print (doi:10.1016/S0140-6736(10)62173-3) that might be useful for updating the article.JFW | T@lk 07:31, 27 June 2011 (UTC)

And here is the 2011 WHO report [2]--Doc James (talk · contribs · email) 22:16, 31 March 2012 (UTC)

1. Lienhardt, C (2011 Nov). "What research is needed to stop TB? Introducing the TB Research Movement". PLoS medicine. 8 (11): e1001135. PMID 22140369. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
2. Marais, BJ (2011). "What do we know about how to treat tuberculosis?". Advances in experimental medicine and biology. 719: 171–84. PMID 22125044.
3. Lessells, RJ (2011 Nov 15). "Evaluation of tuberculosis diagnostics: establishing an evidence base around the public health impact". The Journal of infectious diseases. 204 Suppl 4: S1187-95. PMID 21996701. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
4. McShane, H (2011 Oct 12). "Tuberculosis vaccines: beyond bacille Calmette-Guerin". Philosophical transactions of the Royal Society of London. Series B, Biological sciences. 366 (1579): 2782–9. PMID 21893541. {{cite journal}}: Check date values in: |date= (help)-Doc James (talk · contribs · email) 11:15, 1 April 2012 (UTC)

GA Review

This review is transcluded from Talk:Tuberculosis/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Axl (talk · contribs) 20:30, 20 April 2012 (UTC)

Okay, I'll review it. Axl ¤ [Talk] 20:30, 20 April 2012 (UTC)

Thanks --Doc James (talk · contribs · email) 03:42, 21 April 2012 (UTC)

From the lead section, paragraph 2: "Diagnosis relies on ... blood tests." Diagnosis does not rely on blood tests. Axl ¤ [Talk] 20:31, 20 April 2012 (UTC)

The ref says "Tuberculin skin test has been the only screen avliable for the diagnosis of latent infection with TB. Its major failing is its inability to reliably distinguish individuals infects from individuals immunized with BCG. IGRAs were developed whereby interferon-gama titres were measured after in vitro stimulation of peripheral blood mononuclear cells... These have now become the gold standard for identifying individuals whose immune system has previously encountered MTB" It is a blood test. 90% of the population has been immunized with BCG.

IGRAs can be used as rule out but not rule in tests for diagnosis of active tuberculosis.Page 64 of the Lancet.--Doc James (talk · contribs · email) 04:07, 21 April 2012 (UTC)

Okay thanks the Mantoux and IGRA are for latent TB not for active TB will fix/clarify Doc James (talk · contribs · email) 04:14, 21 April 2012 (UTC)

On a related note, from "Diagnosis", subsection "Active tuberculosis", paragraph 1: "a tuberculin skin test (Mantoux test) or a interferon gamma release assay are typically part of the initial evaluation." An IGRA is not typically part of the initial evaluation. Axl ¤ [Talk] 20:37, 20 April 2012 (UTC)

Yes sorry that section was originally about both latent and active TB before I split them into separate sections. Thanks for picking it up.Doc James (talk · contribs · email) 04:26, 21 April 2012 (UTC)

From the lead section, paragraph 2: "Antibiotic resistance is a growing problem in (extensively) multiple drug-resistant tuberculosis." I don't think that "extensively" needs to included in parentheses here in the lead section. XDR is mentioned in the "Management" section. Axl ¤ [Talk] 20:49, 20 April 2012 (UTC)

Agree Doc James (talk · contribs · email) 04:26, 21 April 2012 (UTC)

From "Signs and symptoms": "General symptoms such as: fever, chills, night sweats, appetite loss, weight loss, fatigue, and finger clubbing may also occur." Finger clubbing is not a symptom. (Fever and weight loss may be both signs and symptoms.) Axl ¤ [Talk] 20:59, 20 April 2012 (UTC)

fixed Doc James (talk · contribs · email) 04:37, 21 April 2012 (UTC)

From "Signs and symptoms", subsection "Pulmonary": "Spitting up stones known as lithoptysis has been described due to bronchial lymph nodes communicated with the airways." I wasn't aware of that symptom. A PubMed search for "lithoptysis" revealed only 23 results. Most of these describe broncholithiasis, often in association with bronchiectasis. Admittedly TB can cause bronchiectasis and broncholithiasis. However I believe that this symptom is exceedingly rare, in my opinion not worth mentioning in this article. Axl ¤ [Talk] 21:25, 20 April 2012 (UTC)

It is mentioned in "Dolin, [edited by] Gerald L. Mandell, John E. Bennett, Raphael (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier. pp. Chapter 250" But yes I assume it is very uncommon. Doc James (talk · contribs · email) 05:50, 21 April 2012 (UTC)

Okay, it is mentioned as a complication of calcified nodes. (It should be "coughing", not "spitting".) I'm still not convinced that it should be in Wikipedia's article. Axl ¤ [Talk] 12:01, 23 April 2012 (UTC)

Sure removed :-) Doc James (talk · contribs · email) 12:16, 23 April 2012 (UTC)

Thanks. Axl ¤ [Talk] 12:55, 23 April 2012 (UTC)

From "Signs and symptoms", subsection "Extrapulmonary": "In the other 25% of active cases, the infection moves from the lungs." The first 75% haven't been explicitly noted. Axl ¤ [Talk] 21:30, 20 April 2012 (UTC)

Done --Doc James (talk · contribs · email) 23:46, 3 May 2012 (UTC)

From "Causes", subsection "Mycobacteria", paragraph 1: "The main cause of TB is Mycobacterium tuberculosis, a small, aerobic nonmotile bacillus or less commonly, the closely related Mycobacterium bovis." The third paragraph goes on to discuss MTB complex, including M. bovis. Perhaps remove the mention of M. bovis from the first paragraph? Axl ¤ [Talk] 09:56, 21 April 2012 (UTC)

Done --Doc James (talk · contribs · email) 23:48, 3 May 2012 (UTC)

From "Causes", subsection "Mycobacteria", paragraph 1: "Mycobacteria have an outer membrane lipid bilayer, yet microbiology textbooks continue to classify them as a Gram-positive bacteria." This sentence implies that the reader should know that the presence of an outer membrane lipid bilayer precludes the label of Gram-positive bacteria. The sentence needs to be refactored, in conjunction with the subsequent sentence. Axl ¤ [Talk] 10:03, 21 April 2012 (UTC)

Probably best in within a subpage.--Doc James (talk · contribs · email) 23:52, 3 May 2012 (UTC)

From "Causes", subsection "Mycobacteria", paragraph 2: "The most common acid-fast staining technique, the Ziehl-Neelsen stain, dyes AFBs a bright red that stands out clearly against a blue background. Other ways to visualize AFBs include an auramine-rhodamine stain and fluorescent microscopy." These sentences do not have a reference. In the UK, I believe that auramine-rhodamine is more commonly used, although I have been unable to find a reference. Interestingly, Mandell, Douglas & Bennett states: "Fluorescent stains [such as auramine-rhodamine] are more sensitive for the detection of mycobacteria, particularly in direct specimens, because the organisms stain brightly and can be clearly distinguished from background material." Axl ¤ [Talk] 18:02, 23 April 2012 (UTC)

Okay found a couple of refs that state these two are the most commonly used.--Doc James (talk · contribs · email) 00:11, 4 May 2012 (UTC)

The latter sentence: "Other ways to visualize AFBs include an auramine-rhodamine stain and fluorescent microscopy." seems to imply that auramine-rhodamine is a distinct technique separate from fluorescence microscopy. Axl ¤ [Talk] 18:05, 23 April 2012 (UTC)

Fixed--Doc James (talk · contribs · email) 00:11, 4 May 2012 (UTC)

From "Causes", subsection "Risk factors": "Worldwide, the most important of these is HIV, with coinfection present in about 13% of cases." Can this sentence be simplified to make it easier for lay readers to understand? Actually, I think that the "Risk factors" subsection should be in "Epidemiology", not "Causes". Axl ¤ [Talk] 18:34, 23 April 2012 (UTC)

I usually put my comments on risk factors in the section on causes rather than epidemiology. I think it usually fits better their. In epidemiology I than discuss how common the condition is in which parts of the world and how the rate is changing over time. Doc James (talk · contribs · email) 12:48, 24 April 2012 (UTC)

Simplified the wording.--Doc James (talk · contribs · email) 00:19, 4 May 2012 (UTC)

I meant simplification of "coinfection". What is coinfection? 13% of people with HIV have TB, or 13% of people with TB have HIV? Axl ¤ [Talk] 10:26, 4 May 2012 (UTC)

How about "The most important risk factor globally is HIV; 13% of all TB cases are also infected with HIV."? Axl ¤ [Talk] 17:47, 4 May 2012 (UTC)

Sure Doc James (talk · contribs · email) 20:02, 4 May 2012 (UTC)

From "Mechanism", subsection "Transmission", paragraph 2: "Others at risk include people in areas where TB is common, people who inject illicit drugs, inhabitants and employees of locales where vulnerable people gather (eg. prisons, homeless shelters), medically underprivileged and resource-poor populations, high-risk racial or ethnic minorities, children in close contact with high-risk category patients, those who are immunocompromised by conditions such as HIV infection, people who take immunosuppressant drugs, and health care providers serving these clients." This list should be in the "Epidemiology" section, along with the other risk factors. Axl ¤ [Talk] 11:00, 24 April 2012 (UTC)

Combined into section on risk factors.--Doc James (talk · contribs · email) 00:19, 4 May 2012 (UTC)

From "Mechanism", subsection "Transmission", paragraph 3: "The cascade of person-to-person spread can be circumvented by effective segregation of those with active (overt) TB, and putting them on recommended anti-TB drug regimens." Is the word "recommended" required here? Axl ¤ [Talk] 09:55, 26 April 2012 (UTC)

Good point and will remove.Doc James (talk · contribs · email) 10:12, 26 April 2012 (UTC)

From "Pathogenesis", paragraph 1: "About 90% of those infected with M. tuberculosis have asymptomatic, latent TB infections (sometimes called LTBI), with only a 10% lifetime chance that a latent infection will progress to TB disease." This is referenced to Robbins Basic Pathology. I found the following text in Robbins Basic Pathology: "About 5% of those newly infected develop significant disease [primary tuberculosis].... In approximately 95% of cases, development of cell-mediated immunity controls the infection." Regarding the development of secondary TB (i.e. reactivation of LTBI), Robbins states: "Whatever the source of the organism, only a few individuals (less than 5%) with primary disease subsequently develop secondary tuberculosis." Axl ¤ [Talk] 09:52, 27 April 2012 (UTC)

The WHO reference states: "People infected with TB bacteria have a lifetime risk of falling ill with TB of 10%." However primary TB isn't distinguished from LTBI reactivation in this figure. Axl ¤ [Talk] 18:04, 27 April 2012 (UTC)

Do you not think the WHO ref supports this? Never the less I have found a better ref which I think does.--Doc James (talk · contribs · email) 00:53, 4 May 2012 (UTC)

The new reference only supports the second half of the sentence. Axl ¤ [Talk] 18:17, 4 May 2012 (UTC)

Added a second ref. Doc James (talk · contribs · email) 21:53, 8 May 2012 (UTC)

I am not able to view that reference, but I'll assume good faith. Axl ¤ [Talk] 10:08, 9 May 2012 (UTC)

From "Signs and symptoms", subsection "Pulmonary": "The upper lungs are believed to be more frequently affected due to their poor lymph supply rather than more air flow." This is referenced to Mandell, Douglas & Bennett. The reference supports the statement. However Robbins Basic Pathology states: "Secondary pulmonary tuberculosis is classically localized to the apex of one or both upper lobes. The reason is obscure but may relate to high oxygen tension in the apices." Axl ¤ [Talk] 09:56, 27 April 2012 (UTC)

I do not have access to a Robbins Basic Pathology. Will balance.--Doc James (talk · contribs · email) 00:53, 4 May 2012 (UTC)

I have adjusted the text. Axl ¤ [Talk] 18:22, 4 May 2012 (UTC)

From "Mechanism", subsection "Pathogenesis", paragraph 1: "However, if effective treatment is not rendered, the death rate for active TB cases is more than 50%." The reference (WHO) states: "Without proper treatment up to two thirds of people ill with TB will die." Axl ¤ [Talk] 19:47, 30 April 2012 (UTC)

I think I see the problem. This text was written based on a 2004 WHO statement which has subsequently been updated. Fixed --Doc James (talk · contribs · email) 01:04, 4 May 2012 (UTC)

I have changed "rendered" to "given". Axl ¤ [Talk] 18:35, 4 May 2012 (UTC)

"Mechanism", subsection "Pathogenesis", paragraph 2 has duplicate text describing Simon foci. Axl ¤ [Talk] 20:00, 30 April 2012 (UTC)

Done --Doc James (talk · contribs · email) 01:16, 4 May 2012 (UTC)

I have adjusted the text. Axl ¤ [Talk] 18:37, 4 May 2012 (UTC)

From "Mechanism", subsection "Pathogenesis", paragraph 3: "Tuberculosis is classified as one of the granulomatous inflammatory conditions." How about "diseases" instead of "conditions"? Axl ¤ [Talk] 20:07, 30 April 2012 (UTC)

Done --Doc James (talk · contribs · email) 01:16, 4 May 2012 (UTC)

From "Mechanism", subsection "Pathogenesis", paragraph 3: "Another feature of the granulomas of human tuberculosis is the development of abnormal cell death (necrosis) in the center of tubercles." Why is this called out as "human tuberculosis"? Is this specific to humans? The reference states: "The caseous necrosis is the basic process of tuberculosis disease in humans." Axl ¤ [Talk] 20:14, 30 April 2012 (UTC)

Agree and removed human. --Doc James (talk · contribs · email) 01:20, 4 May 2012 (UTC)

From "Mechanism", subsection "Pathogenesis", paragraph 4: "This severe form of TB disease, most common in infants and the elderly, is called miliary tuberculosis." I am surprised that HIV/AIDS isn't mentioned. This reference states: "In North America, miliary TB is most common in elderly people and in HIV-infected patients." Axl ¤ [Talk] 20:44, 30 April 2012 (UTC)

Yes and fixed --Doc James (talk · contribs · email) 01:39, 4 May 2012 (UTC)

Given that the new reference is Textbook of Pediatric HIV care, I'm not convinced that it supports the statement indicating high incidence: "This severe form of TB disease, most common in young children and those with HIV, is called miliary tuberculosis." Axl ¤ [Talk] 19:18, 4 May 2012 (UTC)

The ref is/was [3] --Doc James (talk · contribs · email) 20:01, 4 May 2012 (UTC)

You have missed my point. The textbook is about paediatric HIV disease. We cannot infer that miliary TB is common in young children, or even that it is more common than in adults. Axl ¤ [Talk] 21:37, 4 May 2012 (UTC)

Hum. Okay added a couple of different refs and than there is this one http://books.google.ca/books?id=8dfhwKaCSxkC&pg=PA75 --Doc James (talk · contribs · email) 22:11, 4 May 2012 (UTC)

The new reference, "A practical guide to pediatric emergency medicine : caring for children in the emergency department", has the same problem. It is implicitly about the paediatric group. "TB/HIV: A Clinical Manual" is a better reference. Axl ¤ [Talk] 12:44, 6 May 2012 (UTC)

Done Doc James (talk · contribs · email) 20:23, 6 May 2012 (UTC)

From "Mechanism", subsection "Pathogenesis", paragraph 4: "People with this disseminated TB have a fatality rate near 100% if left untreated. However, if treated early, the fatality rate is reduced to about 10%." The reference is Kim, "Miliary tuberculosis and acute respiratory distress syndrome". I don't have access to the paper. However it looks like a primary source. The paper seems to be about miliary TB with ARDS, not miliary TB alone. What exactly does the source say about mortality rate? I am struggling to find a source that gives mortality rates for miliary TB, untreated & treated. Axl ¤ [Talk] 17:36, 1 May 2012 (UTC)

reworded --Doc James (talk · contribs · email) 01:40, 4 May 2012 (UTC)

I have adjusted the text. Axl ¤ [Talk] 12:56, 6 May 2012 (UTC)

From "Diagnosis", subsection "Active tuberculosis", paragraph 2: "However, the difficult culture process for this slow-growing organism can take four to 12 weeks for blood or sputum culture." The reference is the NICE guideline. Culture really shouldn't take more than six weeks – and even that is usually in cases where mycobacteria are not actually TB. In any case, I can't find the statement in the reference. The reference has 307 pages and it is unhelpful to quote the whole document as the source for a single statement. The main purpose of referencing is for verifiability. Axl ¤ [Talk] 18:13, 1 May 2012 (UTC)

Ref was just for the very last sentence. Have corrected the statement in question and provided a ref.Doc James (talk · contribs · email) 09:18, 4 May 2012 (UTC)

From "Diagnosis", subsection "Latent tuberculosis": "These are not affected by immunization or environmental mycobacteria, so they generate fewer false-positive results." There are some mycobacteria that create false positives: notably M. szulgai, M. marinum and M. kansasii. "Clinical evaluation of the QuantiFERON-TB Gold test in patients with non-tuberculous mycobacterial disease". Axl ¤ [Talk] 19:02, 1 May 2012 (UTC)

Yes and added. Doc James (talk · contribs · email) 09:28, 4 May 2012 (UTC)

From "Diagnosis", subsection "Latent tuberculosis": "There is also evidence IGRAs are more sensitive than the skin test." This is referenced to Lalvani. This looks like a letter, not a secondary source. Also, Lalvani is the guy who invented T-SPOT.TB. Axl ¤ [Talk] 10:40, 3 May 2012 (UTC)

Thanks for picking that up. Replaced with review. Doc James (talk · contribs · email) 01:50, 4 May 2012 (UTC)

From "Causes", subsection "Risk factors": "Chronic lung disease is another significant risk factor - smoking more than 20 cigarettes a day seems to increase the risk of TB by two to four times." Smoking isn't a chronic lung disease. Axl ¤ [Talk] 18:04, 4 May 2012 (UTC)

Yes and separated.Doc James (talk · contribs · email) 19:04, 4 May 2012 (UTC)

In "Causes", subsection "Risk factors", can I recommend this 2010 review article from the European Respiratory Journal over the existing 2006 article from Transactions of the Royal Society of Tropical Medicine and Hygiene? Axl ¤ [Talk] 19:38, 6 May 2012 (UTC)

Updated. Doc James (talk · contribs · email) 19:53, 6 May 2012 (UTC)

From "Prognosis", paragraph 1: "These dormant bacilli can produce tuberculosis in 2% to 23% of these latent cases, often many years after infection." It's odd that this range is quoted; earlier in the article, 10% lifetime risk of re-activation of LTBI is quoted. Axl ¤ [Talk] 19:51, 6 May 2012 (UTC)

Updated with newer ref. Doc James (talk · contribs · email) 22:44, 6 May 2012 (UTC)

From "Epidemiology", paragraph 1: "However, not all infections with M. tuberculosis cause TB disease, and many infections are asymptomatic." 90–95% are asymptomatic at the time of infection. Axl ¤ [Talk] 09:18, 7 May 2012 (UTC)

Added with ref. Doc James (talk · contribs · email) 22:02, 8 May 2012 (UTC)

I have adjusted the text. Axl ¤ [Talk] 10:15, 9 May 2012 (UTC)

From "Epidemiology", paragraph 2: "China has achieved particularly dramatic progress, with an approximate 80% decline in its TB mortality rate." Over what period of time? Axl ¤ [Talk] 10:05, 7 May 2012 (UTC)

Fixed Doc James (talk · contribs · email) 22:06, 8 May 2012 (UTC)

From "Epidemiology", paragraph 2: "Hopes of totally controlling the disease have been dramatically dampened because of a number of factors, including the difficulty of developing an effective vaccine, the expensive and time-consuming diagnostic process, the necessity of many months of treatment, and the emergence of drug-resistant cases in the 1980s." What about HIV? Axl ¤ [Talk] 21:32, 8 May 2012 (UTC)

You are correct. I missed that one and have now added. --Doc James (talk · contribs · email) 22:12, 8 May 2012 (UTC)

From "Epidemiology", paragraph 3: "These rates contrast with 98 per 100,000 in China and 48 per 100,000 in Brazil." Why are China and Brazil singled out for comparison with Western Europe? Axl ¤ [Talk] 10:32, 9 May 2012 (UTC)

Both are very large countries. I guess I could add India aswell... --Doc James (talk · contribs · email) 00:43, 12 May 2012 (UTC)

Okay removed most country specific data and replaced it with region specific data. --Doc James (talk · contribs · email) 00:57, 12 May 2012 (UTC)

I think that the region-specific information would be better displayed as a table. Also, I'm not sure why the Canadian aboriginal peoples are singled out. [Conflict of interest perhaps? ;-) ] Axl ¤ [Talk] 10:55, 12 May 2012 (UTC)

Okay will do and see what it looks like. Will look for content regarding aboriginal populations in general. Only a little COI... --Doc James (talk · contribs · email) 21:41, 12 May 2012 (UTC)

In "Epidemiology", I wonder if the last paragraph should be in the "History" section? Axl ¤ [Talk] 10:39, 9 May 2012 (UTC)

Agree --Doc James (talk · contribs · email) 00:37, 12 May 2012 (UTC)

From "History", paragraph 1: "A genomic approach comparing M. tuberculosis complex (MTBC) in humans to MTBC in animals suggests that humans did not acquire MTBC from animals during animal domestication, as was previously believed." For the benefit of lay readers, what is a "genomic approach"? Axl ¤ [Talk] 10:53, 9 May 2012 (UTC)

Good point and simplified. --Doc James (talk · contribs · email) 01:23, 12 May 2012 (UTC)

From "History", paragraph 1: ""Phthisis" is a Greek term for consumption." Again, for the benefit of lay readers, what is "consumption" in this context? Axl ¤ [Talk] 11:04, 9 May 2012 (UTC)

Clarified what it means --Doc James (talk · contribs · email) 01:33, 12 May 2012 (UTC)

From "History", last paragraph: "This technique [artificial pneumothorax] was of little or no benefit and was largely abandoned by the 1950s." Was it really of little/no benefit? I can only view the abstract of the reference. The full article is in German so I won't understand it anyway. Axl ¤ [Talk] 18:11, 9 May 2012 (UTC)

Found a better ref --Doc James (talk · contribs · email) 01:47, 12 May 2012 (UTC)

Break

From "Society and culture": "One molecular diagnostics test which gives results in 100 minutes is currently being offered to 116 low- and middle-income countries at a discount with support from the World Health Organization and the Bill and Melinda Gates Foundation." The merits of the test are being emphasized rather than the cultural impact and charitable work. The position of this test in a formal screening or diagnostic protocol is still being evaluated. The reference is Reuters, which shouldn't be used to describe the merits of the test itself when peer-reviewed medical sources are available. Axl ¤ [Talk] 18:34, 9 May 2012 (UTC)

Have added a second ref supporting the science part of it.--Doc James (talk · contribs · email) 02:01, 12 May 2012 (UTC)

The problem here is that the section is "Society and culture". Currently, the text emphasizes the significance of the test, not the societal impact of the WHO and Bill & Melinda Gates Foundation. The short time to a result is not relevant in this section. The text needs to be re-factored to make the societal impact more prominent. Something like: "The World Health Organization and the Bill and Melinda Gates Foundation are subsidizing a new fast-acting diagnostic test for use in low- and middle-income countries." Axl ¤ [Talk] 10:43, 13 May 2012 (UTC)

Okay that would be good. Must catch another plane. Doc James (talk · contribs · email) 23:35, 13 May 2012 (UTC)

I have changed the text. Axl ¤ [Talk] 10:35, 14 May 2012 (UTC)

From "Society and culture", paragraph 1: "It is useful for diagnosis MDR-TB or HIV-associated TB." Again, this isn't really relevant in "Society and culture". Axl ¤ [Talk] 10:56, 13 May 2012 (UTC)

I have deleted the sentence. Axl ¤ [Talk] 10:36, 14 May 2012 (UTC)

From "Society and culture": "Implementation is pending for programs similar to the Revised National Tuberculosis Control Program that has helped reduce TB levels amongst people receiving public health care." This statement implies that RNTCP is now defunct. Is that correct? The reference is from "Hypothesis" Journal. This journal doesn't appear to be listed on PubMed. Although there does seem to be a degree of peer review, they state: "We aim to establish an interdisciplinary journal that swiftly publishes new, provocative, and sometimes currently untestable ideas". I am not convinced that this journal is a suitable secondary source for referencing Wikipedia's articles. Axl ¤ [Talk] 18:49, 9 May 2012 (UTC)

Added ref and adjusted wording. I usually give a little more leyway with respect to refs in the "society and culture" section Doc James (talk · contribs · email) 02:03, 12 May 2012 (UTC)

Regarding the x-ray in the Infobox, it would be helpful if the caption stated the significance of the arrows. Axl ¤ [Talk] 20:13, 11 May 2012 (UTC)

Add info. Doc James (talk · contribs · email) 02:03, 12 May 2012 (UTC)

I have adjusted the caption. Axl ¤ [Talk] 11:02, 13 May 2012 (UTC)

Summary

I am just waiting on Doc James to address a few more points above. Otherwise, the article looks very good.

1. The article is well-written.
2. It is accurate and appropriately referenced.
3. The article covers the whole topic without undue detail.
4. It is neutral in tone.
5. The content is stable, without any edit warring.
6. The pictures are all freely available from Wikimedia Commons. They help to illustrate the article.

Axl ¤ [Talk] 20:21, 11 May 2012 (UTC)

Okay, the article meets the GA criteria. I am awarding GA status. My thanks and congratulations to Doc James (Jmh649).

There are some areas that can be improved:-

• From "Epidemiology", paragraph 3, the regional incidence values could be better displayed as a table.

Not really room for a table.Doc James (talk · contribs · email) 22:04, 25 May 2012 (UTC)

• From "Epidemiology", paragraph 3, the information about Canadian aboriginals seems to give undue weight to that population and should be removed.

Added balancing details. Doc James (talk · contribs · email) 22:04, 25 May 2012 (UTC)

• The "History" section should include information about thoracoplasty and plombage as well as artificial pneumothorax.

Will consider putting in the sub article of history. Doc James (talk · contribs · email) 22:04, 25 May 2012 (UTC)

• The references need to be standardized to a single format. Some journal names use abbreviations while others do not; some use capital letters, while others don't.

Do you know if there is a bot that can do this? Doc James (talk · contribs · email) 07:04, 18 May 2012 (UTC)

• Reference 59 (NICE) has several formats, of different length and with different text. The full document is 307 pages long, while the abbreviated document is 63 pages long. In the interest of verifiability, the reference should specify which format is being used, and which page.

Axl ¤ [Talk] 10:53, 14 May 2012 (UTC)

To add

• http://www.ncbi.nlm.nih.gov/pubmed/17943789

--Doc James (talk · contribs · email) 21:52, 12 May 2012 (UTC)

Done --Doc James (talk · contribs · email) 22:26, 25 May 2012 (UTC)

The White Death

I've heard that TB was called 'The White Death' at some point in the past. I can find no mention of the term in the article. Isn't it worthy of a mention? Perhaps in the history section? VenomousConcept (talk) 10:39, 16 May 2012 (UTC)

It is mentioned in "History of tuberculosis". Axl ¤ [Talk] 21:04, 16 May 2012 (UTC)

Post-GA improvement

" Not really room for a table [of regional incidence values]. "

— Doc James

What do you mean "Not really room"? Space is not an issue in Wikipedia articles. Adding a table isn't going to make the article impractically large.

While we have two images in that section on epidemiology right now. Adding a table will make formatting worse.Doc James (talk · contribs · email) 23:05, 26 May 2012 (UTC)

" Added balancing details [about aboriginals]. "

— Doc James

I'm still not convinced that this focus on aboriginal peoples is appropriate for this general article. Anyway, I am prepared to ignore it for the time being. The FAC reviewers will consider it when the time comes and we can get a consensus.

" Will consider putting [thoracoplasty and plombage] in the sub article of history. "

— Doc James

These used to be important and common treatments for TB. This article should at least mention them in the "History" section. I could add this.

" Do you know if there is a bot that can do this [standardize references]? "

— Doc James

I don't know. I can go through the reference list and fix these issues.

Axl ¤ [Talk] 10:24, 26 May 2012 (UTC)

The bacteria in granulomas are not dormant. The granuloma is helpful to the host, but dow not prevent dissemination of the disease. See articles by L. Ramakrishnan at U. Washington in the journal,Cell. — Preceding unsigned comment added by Chemtr (talk • contribs) 09:05, 14 October 2012 (UTC)

2013 review in the NEJM

Zumla, A (2013 Feb 21). "Tuberculosis". The New England journal of medicine. 368 (8): 745–55. PMID 23425167. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:57, 28 February 2013 (UTC)

Pending needed edit.

The very second citation does not support the assertion that TB spreads through"saliva". How do you know it does not spread through mucous, or free baccilli suspended in air. This is wrong, and needs to be changed promptly: It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit their saliva through the air.[2]Go scan the citation - it has nothing whatsoever to do with the issue of transmission, it is an article about diagnostics. I can't perform this edit from this account and won't, from my primary account, due to WP-policy compliant reasons of my own.Agent128 (talk) 01:02, 7 March 2013 (UTC)

Yes "The infection is transmitted by respirable droplets generated during forceful expiratory manoeuvres such as coughing." Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:04, 7 March 2013 (UTC)

But we know that is not a comprehensive description in that the infection can in some cases be transmitted by events other than "expiratory manoeuvres". In any case I am glad you supported my edit as it is not "saliva" but rather the baccilli which transmit, via pulmonary and perhaps other material originating in the sinuses, the oral mucosa. I don't know that the baccillus has been isolated from saliva, or from sinoidal fluid, or from mucous, but I imagine that a late stage patient does indeed have swarms of MTD everywhere. Agent128 (talk) 01:45, 7 March 2013 (UTC)

Vaccine

I was just going to add that the vaccine is "no longer" used routinely in the UK, because it was up until like 2006. I think i may have been in the last year to get it. Just saying it's not routinely given suggests that it never was, when there a good couple of generations of people with the scars to prove otherwise! — Preceding unsigned comment added by 129.215.149.97 (talk) 22:13, 8 April 2013 (UTC)

Yes good point. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:09, 19 May 2013 (UTC)

Reduction of cost for test to detect drug-resistant strain(s)

Public-Private Partnership Announces Immediate 40 Percent Cost Reduction for Rapid TB Test, press release reprinted by WHO, Aug. 6, 2012.

"PEPFAR, USAID, UNITAID and Bill & Melinda Gates Foundation have finalized an agreement to expand access to GeneXpert®, a molecular diagnostic system that provides a two-hour rapid diagnosis of TB, TB/HIV co-infection and drug-resistant TB. . . "

" . . . can detect TB disease in patients co-infected with HIV and resistance to the antibiotic rifampicin – a widely accepted indicator of the presence of multi-drug resistant TB . . . "

The Stop TB Partnership, which operates through a secretariat hosted by the World Health Organization (WHO) in Geneva, Switzerland, with WHO also as a leading partner. Published evidence and commentary on the Xpert MTB/RIF assay, a PDF file containing 11 pages of published studies and commentary, updated April 5, 2013.

I added these two references to our Diagnosis . . . Active tuberculosis subsection. I AM NOT A DOCTOR. However, I am interested in issues of public health, and am willing to do the work (time permitting of course) of getting good references. Cool Nerd (talk) 22:27, 17 May 2013 (UTC)

Have moved to were this discussion already was in the society and culture section. Refs need further formatting. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:45, 18 May 2013 (UTC)

Hi Doc James, good to here from you!  :>) In the Extrapulmonary subsection our article states "In those with HIV, this occurs in more than 50% of cases." And I'm assuming that's why microscopic examination of morning sputum is less helpful . . . but I'd still ask if the patient co-infected with HIV might tend to have extrapulmonary in addition to pulmonary? Now, on the question of drug resistance, I'm surprised there's not the best bet approach used, say like what a seasoned poker player might do. I mean, if a certain type of resistance is present in 30% of TB strains in a region, why don't doctors treat all cases in that region as if such resistance is present? I know WHO has gone from DOTS to DOTSPlus and I think two further levels as well. And I know there's been a debate, with some people saying, Hey, DOTS has saved a whole bunch of lives over the years, and other people saying, Yes, and we can do better.

On the issue of formatting the references, I'm against it! I mean, just straight up. Please remember, I'm one of the people who think we pay dearly for the (over-) formality of wikipedia, often at the expense of the accuracy of the information itself, and certainly at the expense of breadth of coverage. To me, the formatted reference is more complicated to do and more complicated to correct and improve. For example, we might loss the part from above "a PDF file containing 11 pages of published studies and commentary," which is what it is and is useful information to share with our readers. Cool Nerd (talk) 18:16, 18 May 2013 (UTC)

"In those with HIV, this occurs in more than 50% of cases" simply refers to extrapulmonary Tb and yes they likely also have pulmonary Tb. With respect to "I mean, if a certain type of resistance is present in 30% of TB strains in a region, why don't doctors treat all cases in that region as if such resistance is present?". They might be I am not sure. Every other ref in this article is formatted in a certain fashion. I have formatted these two. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:53, 18 May 2013 (UTC)

Familial disseminated atypical mycobacterial infection

Or Mendelian Susceptibility to Mycobacterial Disease can expand on this? Jpogi (talk) 07:23, 16 May 2013 (UTC)

Evidence

• Weiand, D (2012 Sep). "Assessing and improving adherence with multidrug therapy". Leprosy review. 83 (3): 282–91. PMID 23356029. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Sumpter, C (2013 Jan). "Systematic review and meta-analysis of the associations between indoor air pollution and tuberculosis". Tropical medicine & international health : TM & IH. 18 (1): 101–8. PMID 23130953. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:45, 18 May 2013 (UTC)

History, first sanatorium

In the article, it is written

Hermann Brehmer opened the first TB sanatorium in 1859 in Sokołowsko, Poland.[104]

I read from this sentence, that the sanatorium was opened in Poland. This is not true. In 1859, this town was called Görbersdorf and it was part of the Lower Silecian Province in Prussia. — Preceding unsigned comment added by 139.20.118.102 (talk) 08:09, 21 May 2013 (UTC)

Inaccurate information

From the article,"One third of the world's population is thought to have been infected with M. tuberculosis,[3] with new infections occurring at a rate of about one per second." I went to the source http://www.who.int/mediacentre/factsheets/fs104/en/index.html and found that "At least one-third of the 34 million people living with HIV worldwide are infected with TB bacteria, although not yet ill with active TB. " was the only mention of the 1/3 statistics and this clearly represents a skewed class in which the people infected with HIV is non-representative of the global population. Secondly, through their information of ~9 million people falling ill per year--> this leads to only 0.3 per sec not 1 per second. I request either removable or change unless someone can find sources on this sentence. Andy Jiang (talk) 00:44, 22 May 2013 (UTC)

What do you think about this line "About one-third of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with disease and cannot transmit the disease."[4] Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:04, 22 May 2013 (UTC)

As far as I can tell, the original source does not indicate that the one-third of the world's population has TB but rather one-third of the HIV population "About one-third of the world's HIV population has latent TB." would be more appropriate. Also, the second half of the one case per second is false.Andy Jiang (talk) 05:07, 22 May 2013 (UTC)

That however is not what the WHO site states. Have you tried writing to the WHO to ask them to correct / clarify this? There site very clearly states "one-third of the world's population" Do you have a counter ref saying this is incorrect? Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:43, 22 May 2013 (UTC)

And if WHO is wrong so are dozens of review articles such as this one [5] and [6] plus many textbooks. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:47, 22 May 2013 (UTC)

I agree with James. Flyer22 (talk) 08:29, 22 May 2013 (UTC)

Can you point to me which line in the WHO site has that information of 1/3 of the world? Also that would imply ~2.3 billion people which is much more than 10 times of 8.7 million. I simply wish to see an estimate of the total that is approximately 1/3 of the world's population.Andy Jiang (talk) 14:17, 22 May 2013 (UTC)

Linked above twice and two additional links provided. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:45, 22 May 2013 (UTC)

I apologize,I just found it in the article. It should be kept. It just seemed a little out of proportions. The one per second statistics I assume is also based on the total cases--latent and active? I think it should be made more clear that this is the case.Andy Jiang (talk) 00:46, 23 May 2013 (UTC)

They are in the same sentence so I felt that would be enough. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:52, 23 May 2013 (UTC)

The WHO article now reads: "About one-quarter of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease." So at the very least I would think the Wikipedia page should be updated to read "one-quarter" instead of "one-third" (and perhaps it should specify that these are latent TB cases).--Fivehundredmillionsprings (talk) 23:01, 27 November 2017 (UTC)

specter of TDR in India

Now, this is independent media (I think) or in any case, a source I'm not familiar with. All the same, the author does include a lot of references.

Tuberculosis – Still A Scourge, News Laundry, posted by Anand Ranganathan, May 24, 2013.

' . . . The government, however, refused to believe Dr Udwadia. They said it wasn’t TDR but rather XXDR. In a Madam Speakeresque fashion they asked everyone to “calm down, calm down”, traumatised as they were by that one word: Totally. . . '

' . . . “We have thrown every possible salvage drug in a desperate attempt to treat each patient”, says Udwadia. “We have come a full circle, back to the sanatoria days, and are operating on large numbers, too. The new drugs, Bedaquiline and Delamanid offer hope. One of our TDR patients was the first Indian patient to start on Bedaquiline and I was delighted he sputum-converted [i.e. responded to treatment]. But a single new drug is doomed to failure and we need new regimens, which are a decade away.” . . . '

posted by Cool Nerd (talk) 16:15, 17 June 2013 (UTC)

---

Killer TB theory 'premature': Govt, The Times of India, Jan 19, 2012.

' . . . The seven were subjected to the basic TB test called sputum microscopy in various municipal labs in the city. And the medicines that appear to be working for them are special drugs that are outside the defined purview of TB treatment. "These patients are under salvage treatment using drugs that are meant for other conditions," said Dr R K Jindal, one of the experts in the central team. Some of these salvage drugs are usually used to treat conditions such as leprosy or staph infections. . . '

Prevention

I was told by a biology teacher some 50 years ago that TB could not live in oxygen, and that by filling your lungs once a day would ensure you're not being affected. 1. Is this true? 2. If it is (or any variation on it) is that information not worthwhile in a prominent position? My logic is that in places were it is a major threat people can take simple action to ward off infection. PeterM88 (talk) 07:26, 23 August 2013 (UTC)

Does O2 prevent TB? Not that I am aware of. Would need ref. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:41, 23 August 2013 (UTC)

No, it is not true. Indeed one suggested reason for TB's predilection for the upper lobes is due to a higher V/Q ratio, leading to a higher oxygen content there than in other parts of the lung. Axl ¤ [Talk] 09:23, 23 August 2013 (UTC)

Lungs?

Is there any reason we can't say lungs in place of respiratory organs in "the infection spreads outside the respiratory organs"? Thanks. Biosthmors (talk) 09:23, 9 September 2013 (UTC)

No good reason. I have changed the text. Axl ¤ [Talk] 21:49, 9 September 2013 (UTC)

Semi-protected edit request on 13 February 2014

Hi -- I request correction of a grammatical error: "After determining the disease was contagious in the 1880s, TB was put on a notifiable disease list..."

Obviously, TB didn't determine that the disease was contagious. Please change, to something like "After TB was determined to be contagious in the 1880s, it was put on a notifiable disease list..."

thanks, Richard Sedlock 71.215.179.54 (talk) 05:31, 13 February 2014 (UTC)

 Done - Thanks for pointing that out - Arjayay (talk) 10:47, 13 February 2014 (UTC)

Semi-protected edit request on 5 March 2014

Under the transmission section it is stated: Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10 bacteria may cause an infection).[41] However in the reference, that specific journal article cites additional sources for the infectious dose being only 1 M. tuberculosis organism. It explicitly states that the reader is directed for discussion of the inferred infectious dose; specifically 3 articles, Wells (1955), Ratcliffe (1952), and Nyka (1962). The article does not itself address the number of bacteria needed to establish infection, but discusses the bacterial vehicle for transmission. Mainly the respiratory droplets and their change in size during a cough or sneeze of typical healthy patients from 4 previous studies. The Poisson equation for risk depends on whether infection can be established with just one organism and can significantly change if not just 1. Request that the infectious dose and reference to it should be further clarified. Coveted Intelligence (talk) 01:25, 5 March 2014 (UTC)

What do you want it changed to? Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:31, 5 March 2014 (UTC)

Not done: it's not clear what changes you want made. Please mention the specific changes in a "change X to Y" format. — {{U|Technical 13}} ^{(t • e • c)} 11:59, 5 March 2014 (UTC)

TUBERCULOMA

Hi, I noticed that in ALL the project the voice Tuberculoma MISSING! I wrote it but I can not put it because of the blockade. Here there are other sources http://it.wikipedia.org/wiki/Tubercoloma Seeing her SERIOUSLY LACK hope you can write it AS SOON AS POSSIBLE!

The 'tuberculoma' is a clinical manifestation of the tuberculosis which happens to conglomerate tubercles and radiologically simulating a cancer. Since these are evolutions of primary complex, the tuberculomas may contain within caseum or calcifications. With the passage of time, in fact, for degeneration, Mycobacterium tuberculosis (also called Bacillus Koch) is transformed into crystals of calcium. Can affect every organ such as the brain or intestine.

Sure lets work on adding something. First of all can you just use secondary sources from the last 5 years as references. These include review articles. I will than help you with the text and add the content. Also WP:MEDHOW gives an overview of a better way to reference. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:34, 8 March 2014 (UTC)

I don't see the "edit" link ... How can I add it? — Preceding unsigned comment added by 79.41.26.4 (talk) 22:22, 10 March 2014 (UTC)

References

Masquerading as Tuberculosis

A science magazine had a medical diagnostician story about patient who died after initially dismissing Tuberculosis but found to have "mycobacterium avium paratuberculosis". Exposure can be inhaled and sourced by dust from dried pigeon droppings. Shjacks45 (talk) 09:47, 13 March 2014 (UTC)

Yes MAC. Not that uncommon. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:54, 13 March 2014 (UTC)

Lack Of Clarity, & Some Ludicrous "Facts"

This wiki article makes absolutely no clarification in whether or not the treatments of TB cure people with TB if it's not antibiotic-resistant, or whether it just prolongs their lives, or makes it go back to dormancy. All it does is discuss treatments, and not at all how much it does, or does not help. (And, if it does cure it, doesn't it mean that one can overcome it naturally?) There's also almost nothing in here about ordinary TB versus antibiotic-resistant TB, or about the latter originally coming... If I recall, from Russian prisons. And, someone has the article saying a third of the world has TB. I call BS on that. That would mean dormant TB is widely spread all over the planet, even here in the United States, where almost no one has so much as dormant TB, let alone active. It would also be so huge everyone would hear/read a lot of news regarding it, which isn't the case. A very huge portion of the global population lives in countries that do not have TB problems, or where their TB problems are only in places like prisons. And, TB clearly isn't a giant problem in many third world countries either, with malaria, and AIDS being much bigger issues. So, how could a third of the world possibly be infected with TB? I mean, by that claim, I'd be likely to have it, at least dormantly, by now; or, else, some-to-many third world countries would have to all be infected (and, I mean as in just about every single citizen). So, this 1/3 of the world has TB claim is ridiculous. It gets better. That paragraph goes onto say more outragious, and unbelievable statistics, as well as it's alleged factual statistics being quite old while pretended like they're recent enough to represent current statistics, despite the same paragraph says TB is going down in it's prevalence. The entire paragraph is just weird, and inaccurate. I'm sorry, I just don't believe that I could possibly have TB, or catch it courtesy of my diabetes in my lifetime without going to a country with a TB problem. I also can't believe that the rest of you would be likely to have it, or to catch it in your lifetimes if not having it already. (Yes, it implies likewise of you guys, not just me. Though, I probably have lower immunities than the rest of you from Type 1 Diabetes.)--97.117.177.103 (talk) 12:53, 21 May 2014 (UTC)

Read the references would be a good start. The 1/3 statement is from WHO. You could write to them. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:51, 21 May 2014 (UTC)

1. Perhaps it would be better to write that 1/3 of the population has at one point in their lives been infected. That's enough to get a positive reaction in tests, but it does NOT mean you'll develop the illness. I know that my parents and both sets of grandparents had a positive test result (obligatory, because they were all teachers), most probably from drinking infected milk in their childhood, but their immune systems eliminated the bacillus.

2. Multiresistent TB obviously developed in hospitals, not in Russian prisons.

3. I think you underestimate the dangers of TB and you clearly have no idea about the condition of the health care system for the poorer part of the US-American citizens. Some third-world-countries have higher standards!--79.194.228.29 (talk) 22:44, 14 July 2014 (UTC)

Quantiferon Gold test

This article is missing the Dx test of Quantiferon Gold! 129.180.159.8 (talk) 12:52, 8 June 2014 (UTC)

Here's a link QuantiFERON 129.180.159.8 (talk) 12:52, 8 June 2014 (UTC)

IGRAs are mentioned in the article. The main article "Tuberculosis diagnosis" gives more details. Axl ¤ [Talk] 13:16, 8 June 2014 (UTC)

Semi-protected edit request on 9 June 2014

PLEASE Jman23424 (talk) 19:17, 9 June 2014 (UTC)

Er, are you requesting an edit? Axl ¤ [Talk] 20:07, 9 June 2014 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. — {{U|Technical 13}} ^{(e • t • c)} 22:26, 9 June 2014 (UTC)

Semi-protected edit request on July 14th, 2014

History, first sanatorium

In the article, it is written

Hermann Brehmer opened the first TB sanatorium in 1859 in Sokołowsko, Poland.[104]

I read from this sentence, that the sanatorium was opened in Poland. This is not true. In 1859, this town was called Görbersdorf and it was part of the Lower Silesian Province in Prussia. — Preceding unsigned comment added by 139.20.118.102 (talk) 08:09, 21 May 2013 (UTC)

Done. I've clarified the location. —Mr. Granger (talk · contribs) 23:52, 14 July 2014 (UTC)

Merge notice

Gilded Snail (talk) 02:28, 1 August 2014 (UTC)

DOTS & STOP TB & Tuberculosis in relation to HIV

• This article needs some mention of DOTS and STOP TB - WHO's treatment guidelines. I suggest some merging of content from Tuberculosis management

• There should be some mention of the article Tuberculosis in relation to HIV

-- CFCF 🍌 (email) 07:50, 4 August 2014 (UTC)

Decreas or increase?

It seems to me that the text and the graph of new cases disagree (unless the text is referring per capita incidence, in which case MAYBE the two can be reconciled). Am I missing some=thing, or is this an error: "decrease" vs. rising dots on graph.Kdammers (talk) 06:13, 22 August 2014 (UTC)

This is the offending graph:-

Annual number of new reported TB cases

References

I have deleted the graph from the article and moved it here. (The formatting used in the article's editing page made it difficult to find.) The reference provided is unhelpful for verifiability.

This document by the WHO indicates falling incidence, prevalence & mortality (page 15, or page 28 of the pdf). The only way that I could resolve this is to assume a disconnect between estimated incidence and "reported" cases, but that is pure speculation on my part. In the meantime, the graph should not be in the article. Axl ¤ [Talk] 10:10, 22 August 2014 (UTC)

Popular press

I have trimmed some popular press that was added. It is based on a recent primary source [7] We need to wait for proper secondary sources per WP:MEDRS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:43, 23 August 2014 (UTC)

What about the original article by the study team in "Nature"? Isn't this an RS?Parkwells (talk) 15:51, 23 August 2014 (UTC)

It is a primary source. We should be using secondary sources generally per WP:MEDRS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:13, 23 August 2014 (UTC)

Semi-protected edit request on 11 November 2014

add 'vinegar kill mycobacteria' to somewhere in https://wiki.riteme.site/wiki/Tuberculosis#Mycobacteria Arnon81 (talk) 20:07, 11 November 2014 (UTC)

Not done: No WP:MEDRS. Cannolis (talk) 20:50, 11 November 2014 (UTC)

Semi-protected edit request on 14 February 2015

The description of the cause of hemoptysis (coughing up blood) is incorrect. Coughing up bloody sputum is mostly caused by destruction of alveolar lung tissue and creation of cavities. This is my expert opinion, and may be omitted. Erosion into a pulmonary artery is a rare cause. This is described as the main (only) cause of massive (>500 ml in a 24 hr period) hemoptysis. The main cause of massive hemoptysis in tb, and the reason that it is remembered vividly as a cultural memory (most doctors can think of only this single cause of massive hemoptysis) is BRONCHIAL artery rupture. This is a feature of the disease process bronchiectasis which is a near ubiquitous part of active pulmonary tuberculosis. Here is a reference as to successful treatment of a majority of cases of massive hemoptysis due to tb: http://www.ncbi.nlm.nih.gov/pubmed/8756916 71.229.159.242 (talk) 06:01, 14 February 2015 (UTC)

Just to be clear, are you suggesting that the reference to Rasmussen's aneurysm be removed and replaced with something about bronchial artery rupture? If so, I think there may be something to this - the only source on the article for Rasmussen's aneurysm is this, which states "However, the hemoptysis resolved only after subsequent embolization of the bronchial artery." However, I am far from an expert and will leave this to one of the expert editors Cannolis (talk) 08:24, 14 February 2015 (UTC)

Yes agree just one cause. We have a review here which states "Because of bronchial artery or a branch of pulmonary artery erosion due to cavitary infiltration, bronchiectasis, fungus ball, broncholithiasis or destroyed lung, the bleeding can some" Will adjust Doc James (talk · contribs · email) 12:34, 14 February 2015 (UTC)

Notable people who died from TB

There doesn't seem to be any refererence or link to the 884 wiki-notable people who have died from TB, as listed at Category:Deaths from tuberculosis. Perhaps the link could go in a 'See also' section, along with Tuberculosis in relation to HIV and Tuberculosis in India, which don't appear to be linked in the text. >MinorProphet (talk) 20:09, 27 February 2015 (UTC)

There is no see also section. There is already [8] but it needs refs and is linked in the navbox Doc James (talk · contribs · email) 01:57, 28 February 2015 (UTC)

Semi-protected edit request on 3 March 2015

27.49.64.138 (talk) 15:34, 3 March 2015 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. — {{U|Technical 13}} (e • t • c) 16:13, 3 March 2015 (UTC)

Semi-protected edit request on 7 October 2015

Please delete or put into context the use of the term "high-risk ethnic minorities" as written in the Wikipedia entry on Tuberculosis. This term has no meaning without relevant context. e.g. Africans are not an ethnic minorities in Africa where tuberculosis rates are high. But in the context of tuberculosis rates in the U.S., African immigrants are ethnic minorities, and would be part of a high risk group. Here is the relevant paragraph: Tuberculosis is closely linked to both overcrowding and malnutrition, making it one of the principal diseases of poverty.[9] Those at high risk thus include: people who inject illicit drugs, inhabitants and employees of locales where vulnerable people gather (e.g. prisons and homeless shelters), medically underprivileged and resource-poor communities, high-risk ethnic minorities, children in close contact with high-risk category patients, and health-care providers serving these patients.[38] 2605:E000:5B01:FB00:E025:192C:FD59:8049 (talk) 09:00, 7 October 2015 (UTC)

This is many aboriginal populations in many areas of the world. It is also some immigrant groups. What wording do you wish to see used? Doc James (talk · contribs · email) 11:30, 11 October 2015 (UTC)

I am changing the answered parameter to yes as this request has been pending the response to Doc James's question for a few days now. OP is more than welcome to reactive this request if/when they respond. --Stabila711 (talk) 01:43, 16 October 2015 (UTC)

Lancet

Seminar doi:10.1016/S0140-6736(15)00151-8 JFW | T@lk 23:55, 19 March 2016 (UTC)

And this in the Lancet Infectious Diseases in the same week. doi:10.1016/S1473-3099(16)00070-0 JFW | T@lk 07:41, 23 March 2016 (UTC)

sentence "However, existing data suggest that patients taking bedaquiline in addition to standard TB therapy are five times more likely to die than those without the new drug,"

The sentence "However, existing data suggest that patients taking bedaquiline in addition to standard TB therapy are five times more likely to die than those without the new drug," is so badly organized that one readily reads the exact opposite of what it is trying to convey. This sentence should be put out of its misery. Please take it out the back and shoot it. Then rewrite it. — Preceding unsigned comment added by Redreinard (talk • contribs) 23:12, 10 May 2016 (UTC)

Semi-protected edit request on 27 May 2016

In the first sentence:"Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium tuberculosis (MTB)."the word "usually" shouldn't be there. Even in the given reference it states clearly that Mycobacterium tuberculosis is the agent causing the disease, not one of many. MateiHermina (talk) 16:12, 27 May 2016 (UTC)

Done Sir Joseph ^(talk) 16:20, 27 May 2016 (UTC)

Each fact in the article is well referenced and the references seem to be reliable. Some of the data is dated and could be updated to portray numbers effected today and the problems the disease imposes on our present day world and future. Mablythe (talk) 18:35, 6 September 2016 (UTC)

Semi-protected edit request on 1 November 2017

M. tuberculosis complex (MTBC) should be linked to https://wiki.riteme.site/wiki/Mycobacterium_tuberculosis_complex

GregMo72 (talk) 18:07, 1 November 2017 (UTC) GregMo72 (talk) 18:07, 1 November 2017 (UTC)

Done Minor edit only, and appropriate. —KuyaBriBri^Talk 18:24, 1 November 2017 (UTC)

Semi-protected edit request on 2 November 2017

On 27 May 2016, a change was made to remove the word 'usually' from the first sentence:"Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium tuberculosis (MTB)." This implies that Mycobacterium tuberculosis is the only causative agent which is clearly not the case as pointed out further down in the article. Specifically, under the heading of 'Causes', it is pointed out that M. bovis, M. africanum, M. canetti, and M. microti are also causative agents. This first sentence should be changed back to include 'usually' as it is more correct this way. GregMo72 (talk) 18:49, 2 November 2017 (UTC)

Done as the proposed wording agrees with what is stated in the "Causes" section. —KuyaBriBri^Talk 21:28, 2 November 2017 (UTC)