A REVIEW ON TUBERCULOSIS: CURRENT CHALLENGES AND RECENT ADVANCES IN TREATMENT

Abstract

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis and remains one of the leading causes of morbidity and mortality worldwide. Despite the availability of effective chemotherapy, tuberculosis continues to pose a major public health challenge due to delayed diagnosis, poor treatment adherence, HIV co-infection, and the increasing prevalence of multidrug-resistant (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). According to the World Health Organization (WHO), approximately 10.8 million people developed tuberculosis globally in 2023, resulting in nearly 1.25 million deaths. Early diagnosis using rapid molecular diagnostic techniques such as GeneXpert MTB/RIF, along with appropriate chemotherapy, has significantly improved treatment outcomes. The standard treatment regimen for drug-susceptible tuberculosis consists of a six-month multidrug therapy, while newer drugs including bedaquiline, delamanid, and pretomanid have revolutionized the management of drug-resistant tuberculosis. Recent advances in host-directed therapy, nanotechnology-based drug delivery systems, artificial intelligence-assisted diagnosis, and novel vaccine candidates have shown promising results in improving disease control and patient outcomes. This review summarizes the epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, conventional treatment, drug-resistant tuberculosis, recent therapeutic advances, patient counseling, and future perspectives in tuberculosis management. Continuous research, early detection, effective treatment strategies, and global public health initiatives are essential to achieve the WHO End TB Strategy and reduce the worldwide burden of tuberculosis.