DEPARTMENT OF PHARMACEUTICAL SCIENCE

MAHARSHI DAYANAND UNIVERSITY

ROHTAK- 124001 (HARYANA)
(‘A+’ GRADE UNIVERSITY ACCREDITED BY NAAC)

CERTIFICATE

This is certified that the project report entitled a

review on TUBERCULOSIS embodies the compiled work
carried out for the PROJECT WORK in the BACHELOR
OF PHARMACY 8TH SEMESTER done by AJAY under
my direct guidance and supervision.

Supervised by

Dr. Neeta Solanki

Department of pharmaceutical science
Maharshi Dayanand University Rohtak
 ACKNOWLEDGEMENT

It has been an honour to carry out the project work under

the rich guidance and supervision of Dr. Neeta Solanki. My
experience has been amazing, productive, and stimulating.
The enthusiasm, integral view of the project, and mission for
providing high-quality work left us with a lifelong impact. The
work culture availed by my mentor is praise worthy. Thank
you for the support, guidance, thought- provoking criticism,
your untiring efforts, and for encouraging and facilitating all
the requirements.
My sincere thanks to the Head of the Department, Prof.Harish
Dureja for providing me with all the necessary facilities during the
project. My wish to extend our regards to the Departmental and
University Administration for providing me with a significant
chance and accepting my project in the desired field of work. I
would like to sincerely thank the faculty members of the
department for being a constant moral support and source of
guidance and support.
Although I respect my mentor and supporting staffs to stand with
me in this encouraging and wonderful journey.

AJAY
INDEX
https://www.metropolisindia.com/blog/preventive-healthcare/tuberculosis-decoded-
understanding-the-origins-signs-and-remedies

Overview
Tuberculosis (TB) is an infectious disease that most often affects the lungs
and is caused by a type of bacteria. It spreads through the air wheninfected
people cough, sneeze or spit.

Tuberculosis is preventable and curable.

About a quarter of the global population is estimated to have been infected

with TB bacteria. About 5–10% of people infected with TB will eventuallyget
symptoms and develop TB disease.
Those who are infected but not (yet) ill with the disease cannot transmit it.
TB disease is usually treated with antibiotics and can be fatal without
treatment.

In certain countries, the Bacille Calmette-Guérin (BCG) vaccine is given to

babies or small children to prevent TB. The vaccine prevents TB outside of
the lungs but not in the lungs.

Tuberculosis Causes:

https://prevent-and-protect.com/pathogen/mycobacterium-tuberculosis-complex-
tuberculosis/

Tuberculosis is caused by a bacterium known as Mycobacterium

tuberculosis. (The related bacteria Mycobacterium bovis and
Mycobacterium africanum can also cause tuberculosis.) The body's
response to active TB infection produces inflammation that can damage the
lungs. Areas affected by active TB gradually fill with scar tissue.

Tuberculosis (TB) is a contagious or infectious disease. It is spread from

person-to-person. A person is often infected by inhaling the germs. These
 germs have been sprayed into the air by someone with the active disease
who coughs.

However, inhaling the germ does not mean you will develop active disease.
A person's natural body defenses are often able to control the infection so
that it does not cause disease. In this case, the person would be infected,
but does not have active disease. Only about 10% of those infected will
develop TB in their lifetimes.

Active disease can occur in an infected person when the body's resistance
is low or if there is a large or prolonged exposure to the germs that
overcome the body's natural defenses. The body's response to active TB
infection produces inflammation that can damage the lungs. The amount of
damage may be quite extensive even though the symptoms may be
minimal.

Classification of Tuberculosis:
Tuberculosis (TB) can be classified in several ways based on
different criteria such as anatomical site of infection,
microbiological characteristics, and clinical presentation.
Here are some common classifications:

1. Anatomical Classification:
 Pulmonary TB: Involves the lungs and is the most
common form of TB.
 Extra-pulmonary TB: Affects other parts of the body
such as lymph nodes, pleura, bones, joints, genitourinary
tract, gastrointestinal tract, meanings, etc.
2. Microbiological Classification:
 Drug-Sensitive TB: TB caused by strains of
Mycobacterium tuberculosis that are susceptible to the
standard first-line anti-TB drugs.
 Drug-Resistant TB: TB caused by strains of
Mycobacterium tuberculosis that are resistant to one or
more anti-TB drugs. This can be further classified into:
  Multi-Drug Resistant TB (MDR-TB): Resistant to
at least isoniazid and rifampicin, the two most
potent anti-TB drugs.
 Extensively Drug-Resistant TB (XDR-TB):
Resistant to isoniazid and rifampicin, plus resistant
to any fluoroquinolone and at least one of three
injectable second-line drugs (i.e., amikacin,
kanamycin, or capreomycin).
3. Clinical Classification:
 Latent TB Infection (LTBI): The person is infected with
M. tuberculosis but does not have active disease and
cannot spread TB to others. However, there's a risk of
the infection becoming active.
 Active TB Disease: The person is infected with M.
tuberculosis and has symptoms of TB. This can be
further classified based on the severity and extent of the
disease.
4. Epidemiological Classification:
 Primary TB: TB occurring in a person who has not been
previously infected with M. tuberculosis.
 Reactivation TB: TB occurring in a person who has
been previously infected with M. tuberculosis, but the
infection has become active due to factors such as
weakened immune system or other diseases.
5. Drug Susceptibility Testing (DST):
 TB strains can also be classified based on their
susceptibility to various anti-TB drugs, which is
important for guiding treatment.

Global TUBERCULOSIS 2023 REPORT:

The World Health Organization (WHO) typically releases annual
reports on the global TB situation, providing updates on TB incidence,
prevalence, mortality, and progress towards global TB control targets.
These reports often include data up to the previous year, such as the
Global Tuberculosis Report.

To find the Global Tuberculosis Report for 2023 or any other recent
TB reports, you can visit the official website of the World Health
Organization (WHO) or search for it using reputable sources such as
government health agencies, international health organizations, or
academic institutions. These reports offer comprehensive analyses of
the TB situation worldwide, including trends, challenges, and
recommendations for TB control and elimination efforts.

WHO End TB Strategy: 2025 milestones

The WHO End TB Strategy includes milestones for 2025 aimed at

accelerating progress towards ending the global TB epidemic:

Reduce TB deaths by 95% compared to 2015 levels.

Decrease TB incidence rate by 90% compared to 2015 levels.
Ensure no TB-affected household faces catastrophic costs due to TB-
related expenses.
Provide access to appropriate diagnosis, treatment, and care services
for all TB-affected individuals.
Accelerate TB research and innovation to develop new tools for
prevention, diagnosis, and treatment, as well as improve
implementation strategies for existing interventions.

2018 UN high-level meeting on TB: treatment targets

The 2018 UN High-Level Meeting on TB set ambitious treatment

targets: to treat 40 million people with TB and provide preventive
treatment to 30 million by 2022. Additionally, it aimed to ensure
access to TB care for 3.5 million children and address the needs of
1.5 million people with drug-resistant TB during the same period.
These targets underscored global commitments to accelerate efforts
against TB, focusing on expanding access to quality care, prevention,
and treatment services, particularly for vulnerable populations, in order
to effectively combat the TB epidemic and work towards its eventual
elimination.

Global TB commitments, strategy and targets:

Global commitments, strategies, and targets aim to combat
tuberculosis (TB) effectively:
Commitments: Nations pledge to end the TB epidemic, aligning with
Sustainable Development Goals and WHO's End TB Strategy.
Strategy: Employing a multi-faceted approach, strategies focus on
prevention, diagnosis, treatment, and research, emphasizing equity,
human rights, and political will.
Targets: Include reducing TB deaths and incidence rates, ensuring
access to quality care for all, preventing catastrophic costs for affected
households, and accelerating research for innovative tools. Specific
goals aim to treat millions with TB, provide preventive therapy,
address pediatric TB, and manage drug-resistant cases.
These initiatives drive global collaboration, resource mobilization, and
action towards TB elimination.
Deaths caused by TB:

Estimated number of excess TB deaths during the COVID-19

pandemic and its aftermath
The blue shaded area represents the 95% uncertainty interval of the
actual number of deaths estimated to have been caused by TB; the
red line shows the estimated number of deaths that would have been
caused by TB in the absence of the COVID-19 pandemic; the red
shaded area shows the excess number of deaths caused by TB due
to disruptions associated with the COVID-19 pandemic.
 Estimates of the number of deaths caused by TB in
India revised downwards:
Estimates of the number of deaths caused by TB in India have been
revised downwards. This revision reflects improvements in data
collection, reporting, and analysis methodologies. While previous
estimates may have overestimated TB-related deaths, the revised
figures provide a more accurate representation of the true burden of
TB mortality in India. These downward revisions underscore the
importance of robust surveillance systems and continuous efforts to
improve the accuracy of TB mortality data. Additionally, they highlight
progress in TB control efforts, although challenges remain in achieving
further reductions in TB-related deaths and ultimately eliminating TB
as a public health threat in India.
Updated WHO estimates of the number of deaths caused by TB
in India, 2000–2022
Estimates of the percentage of deaths in India caused
by TB, alternative sources
proportion of GBD 2019 estimates in the three years for which IHME
has unpublished, detailed SRS datasets i.e. 2005, 2008 and 2012.
Based on these values, the upward adjustment for all years was
approximated as a uniform distribution with bounds of 0.70 and 0.85.
The second step was to multiply the upward-adjusted SRS values by
WHO estimates of the total number of deaths in India.
The resulting estimates of the number of deaths caused by TB
between 2000 and 2019 are considerably lower than the “interim”
estimates published in 2022 (15). For example, the revised estimate
for 2019 is about 120 000 lower.
Estimates for 2020–2022 were produced using a countryspecific
dynamic model that accounts for disruptions to TB diagnosis and
treatment during the COVID-19 pandemic (Box 3), with the model
calibrated to the new SRS-based estimates for 2015 and 2019.
The updated estimates of the number of deaths caused by TB in India
between 2000 and 2022 are shown in fig.
Transmission and Pathogenesis of Tuberculosis:
Tuberculosis (TB) is caused by infection with the bacterium
Mycobacterium tuberculosis. Understanding the transmission and
pathogenesis of TB is crucial for controlling the spread of the disease.
Here's an overview:
1. Transmission:
o TB is primarily transmitted through the air when a person with active
TB disease in the lungs or throat coughs, sneezes, speaks, or sings.
o When an infected person releases tiny droplets containing M.
tuberculosis into the air, others nearby can inhale them. If the inhaled
bacteria reach the lungs, they can establish infection.
o Close and prolonged contact with someone who has active TB
disease increases the risk of transmission, especially in households,
healthcare settings, and other crowded environments.
o Transmission can also occur through ingestion of contaminated food
or milk containing M. tuberculosis, although this is rare.
2. Pathogenesis:
o Once inhaled, M. tuberculosis bacteria can reach the alveoli (small air
sacs) of the lungs, where they are taken up by alveolar macrophages, a
type of immune cell.
o Within alveolar macrophages, M. tuberculosis can evade destruction and
replicate, leading to the formation of primary TB infection.
o The immune system responds to the infection by recruiting more immune
cells, forming granulomas, which are collections of immune cells, that wall
off the bacteria.
o In most cases, the immune response controls the infection, leading to
latent TB infection, where the bacteria are contained within granulomas but
remain viable.
o However, in some individuals, particularly those with weakened immune
systems, the bacteria can reactivate and cause active TB disease, leading
to symptoms such as cough, fever, weight loss, and fatigue.
o Active TB disease can affect not only the lungs but also other parts of the
body, such as the lymph nodes, bones, joints, kidneys, and brain, resulting
in extrapulmonary TB.
Signs and symptoms:
Tuberculosis (TB) can affect various parts of the body, most
commonly the lungs. The signs and symptoms of TB can vary
depending on whether the infection is latent (inactive) or active.
Here are the typical signs and symptoms of active TB disease:

1. Pulmonary TB (TB in the lungs):

o Persistent cough that lasts for more than three weeks

o Coughing up blood or sputum (phlegm or mucus) that may be
bloody
o Chest pain, particularly when breathing or coughing
 o Fatigue and weakness
o Weight loss
o Loss of appetite
o Fever, often low-grade
o Night sweats

2. Extra pulmonary TB (TB outside the lungs):

o Symptoms depend on the site of infection and may include:

o Swelling or pain in the affected area (e.g., lymph nodes, bones,
joints)
o Neurological symptoms (e.g., headache, confusion, weakness,
numbness, seizures) in cases of TB meningitis
o Blood in urine or pain during urination in cases of genitourinary
TB
o Abdominal pain, diarrhea, or other gastrointestinal symptoms in
cases of abdominal TB
o Symptoms related to spinal TB, such as back pain, stiffness, or
neurological deficits (if the spinal cord is affected)
3. General symptoms that may be present in both pulmonary and
extra pulmonary TB include:

o Malaise (general feeling of being unwell)

o Chills
o Loss of energy
o Night sweats
Diagnosis:
Diagnosing tuberculosis (TB) typically involves a combination
of medical history, physical examination, imaging tests, and
laboratory tests. Here's an overview of the diagnostic
process:

1. Medical History and Physical Examination: The healthcare

provider will ask about symptoms such as persistent cough (often
with blood-tinged sputum), weight loss, night sweats, fever, and
fatigue. They will also inquire about any risk factors for TB, such as
 recent travel to areas with high TB prevalence, close contact with
someone known to have TB, or a weakened immune system.

2. Tuberculin Skin Test (TST) or Interferon-Gamma Release

Assay (IGRA): These tests help identify whether a person has
been exposed to the bacteria that cause TB. The TST involves
injecting a small amount of fluid (called tuberculin) into the skin of
the forearm and checking for a reaction after 48 to 72 hours. IGRA
blood tests detect the release of interferon-gamma by T-cells in
response to TB antigens.

3. Chest X-ray: A chest X-ray can reveal signs of TB infection, such

as abnormal lung markings, nodules, or cavities. However, a
normal chest X-ray does not rule out TB.

Normal chest x ray: Tuberculosis chest x ray:

4. Sputum Culture: This test involves collecting a sample of sputum
(mucus coughed up from the lungs) and culturing it in a laboratory
to check for the presence of TB bacteria. It usually takes several
weeks to get results from a sputum culture.

5. Nucleic Acid Amplification Tests (NAATs): NAATs are

molecular tests that can rapidly detect the genetic material (DNA or
RNA) of TB bacteria in sputum samples. These tests are faster
than traditional culture methods and may be used alongside or
instead of sputum culture.
6. Drug Susceptibility Testing: If TB bacteria are found, drug
susceptibility testing is performed to determine which antibiotics will
be effective in treating the infection.

7. Blood Test: A sample of blood is sent to a lab. One lab test finds
out whether certain immune system cells can "recognize"
tuberculosis. A positive test shows that you have either a latent TB
infection or active TB disease. Other tests of the blood sample can
help determine if you have active disease.
A negative result means you likely do not have a TB infection.

8. Other lab Tests:

Other lab tests that may be ordered include:
o Breath test.
o Procedure to remove sputum from your lungs with a special
tube.
o Urine test.
o Test of the fluid around the spine and brain, called
cerebrospinal fluid.

It's essential to diagnose and treat TB promptly to prevent its spread

and complications. Treatment typically involves a combination of
antibiotics taken for several months under the guidance of a
healthcare provider.

Treatment:
Treatment for tuberculosis (TB) usually involves a combination of
antibiotics taken for an extended period. The exact regimen and
duration of treatment depend on factors such as the type of TB (latent
TB infection or active TB disease), drug resistance patterns, and
individual patient factors. Here's an overview of the treatment process:
1. First-Line Anti-TB Agents: The most common approach to
treating TB involves a regimen of multiple antibiotics. The standard
treatment for drug-susceptible TB typically includes a combination
of four antibiotics:
o Isoniazid (INH)
o Rifampin (RIF)
o Pyrazinamide (PZA)
o Ethambutol (EMB)

This combination is known as the "first-line" treatment regimen and is

often given as a fixed-dose combination (FDC) to improve adherence
and reduce the risk of drug resistance.
Marketed formulation:
Akt 4 Kit

MARKETER
 Lupin Ltd

SALT COMPOSITION
Isoniazid (300mg) + Rifampicin (450mg) + Ethambutol (800mg) +
Pyrazinamide (750mg)

STORAGE
Store below 30°C

PRODUCT INTRODUCTION
Akt 4 Kit is a combination medicine used in the treatment of
tuberculosis. It prevents the growth of the microorganisms that cause
the infection.

USES OF AKT 4 KIT

 Treatment of Tuberculosis (TB)

SIDE EFFECTS OF AKT 4 KIT:

 Nausea
 Vomiting
 Peripheral neuropathy (tingling and numbness of feet and hand)
 Abdominal pain
 Skin rash
 Hepatitis (viral infection of liver)

SAFETY ADVICE

 Alcohol
 UNSAFE
 Consuming alcohol while taking Akt 4 Kit may cause symptoms
such as flushing, increased heart beat, nausea, thirst, chest pain
and low blood pressure (Disulfiram reaction).

 Pregnancy
 CONSULT YOUR DOCTOR
  Akt 4 Kit may be unsafe to use during pregnancy. Although there
are limited studies in humans, animal studies have shown
harmful effects on the developing baby. Your doctor will weigh
the benefits and any potential risks before prescribing it to you.
Please consult your doctor.

 Driving
 UNSAFE
 Akt 4 Kit may cause side effects which could affect your ability to
drive.
Akt 4 Kit occasionally causes sight problems and tingling or
numbness in hand or feet. After taking this medicine you should
not drive until you know how it affects you.

 Kidney
 CAUTION
 Akt 4 Kit should be used with caution in patients with kidney
disease. Dose adjustment of Akt 4 Kit may be needed. Please
consult your doctor.
2. Second-Line Anti-TB Agents: Second-line anti-TB agents are
used to treat drug-resistant forms of tuberculosis (TB), including
multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB
(XDR-TB). These agents are typically reserved for cases where the
TB bacteria are resistant to one or more of the first-line antibiotics
(isoniazid, rifampin, pyrazinamide, ethambutol). Second-line drugs
are often less effective, have more side effects, and are more
expensive than first-line drugs. Here are some examples of second-
line anti-TB agents:

Aminoglycosides

 In the revised grouping, it currently belongs to group C for use

in susceptible MDR-TB and RR-TB patients in longer
treatment regimen
 Eg Amikacin, Streptomycin
 o Amikacin is preferred over Streptomycin
o Have been used extensively for the treatment of MDR-TB
o Capreomycin and Kanamycin are no longer included in any
regimen for MDR-TB due to increased risk of treatment
failure, relapse or death

Streptomycin (S)

 An aminoglycoside antibiotic derived from Streptomyces

griseus that is used for TB and gram-negative sensitive
infections
 Streptomycin and Ethambutol are approximately equivalent
when used in the initial treatment phase but Streptomycin use
may be limited based on local M tuberculosis resistance
patterns
o Has high resistance in drug-resistant TB
o Streptomycin may be substituted if Ethambutol is
contraindicated
o Although it is not usually part of the second-line agents in the
long-term duration of MDR-TB therapy, it may be used instead
if the other three drugs in group B are contraindicated
 Not absorbed from the gastrointestinal (GI) tract but after
intramuscular (IM) administration, it diffuses readily into the
extracellular component of most body tissues and attains
bactericidal concentrations, particularly in tuberculous cavities

Bedaquiline

 Recently approved treatment for adult patients with pulmonary

MDR-TB and RR-TB
o Given as part of the combination therapy for XDR-TB and
MDR-TB allergic to >2 drugs
o In the revised grouping, it is currently under group A for the
longer regimen of MDR-TB and RR-TB treatment
 Delamanid

 A nitro-dihydro-imidazooxazole that inhibits mycolic acid

synthesis and has been recently approved for the treatment of
MDR-TB and RR-TB patients aged ≥3 years on longer
regimens
o Given as part of the combination therapy for MDR-TB in adult
patients who are intolerant or resistant to standard effective
treatment regimen
o In the revised grouping, it is currently under group C, as part
of the add-on medications to complete the longer regimen of
MDR-TB and RR-TB treatment when group A and B agents
cannot be used
o May be useful in patients with increased risk for poor
outcomes (eg drug intolerance or contraindication, extensive
or advanced disease, resistance to fluoroquinolones and/or
injectable drugs, and XDR-TB)
 May now be used in patients 6-17 years of age in the longer
regimen of MDR-TB and RR-TB therapy

Fluoroquinolones

 Belong to group A drugs used to treat MDR-TB and RR-TB

under the longer treatment regimen
 Eg Levofloxacin, Moxifloxacin
 Ofloxacin and Ciprofloxacin are removed from the list of
medications approved for MDR-TB and RR-TB because of
lack of information regarding their effectivity
Advanced drug delivery and therapeutic strategies for
tuberculosis treatment:
Advanced drug delivery and therapeutic strategies for tuberculosis (TB)
treatment are continuously evolving to improve treatment outcomes, reduce
side effects, enhance patient compliance, and combat drug resistance.
Here are some advanced approaches being explored:
 LIPOSOMES:

Liposomes have emerged as a promising drug delivery system in

tuberculosis (TB) treatment due to their ability to improve the
pharmacokinetics and therapeutic efficacy of anti-TB drugs. Here's how
liposomes are utilized in TB treatment:

Improved Drug Delivery: Liposomes can encapsulate anti-TB drugs,

including first-line drugs like isoniazid, rifampicin, pyrazinamide, and
ethambutol, as well as second-line drugs for drug-resistant TB.

Enhanced Drug Penetration: Liposomal formulations can improve the

penetration of anti-TB drugs into TB-infected tissues, including lung
granulomas where TB bacteria reside. Liposomes can fuse with cell
membranes, facilitating drug uptake by TB-infected cells and improving
treatment efficacy.

Targeted Drug Delivery: Liposomes can be surface-modified with ligands,

antibodies, or peptides that target specific receptors or antigens expressed
on TB-infected cells. Targeted liposomal delivery systems enhance drug
accumulation at TB infection sites while minimizing off-target effects,
thereby improving treatment efficacy and reducing systemic toxicity.

Sustained Drug Release: Liposomal formulations can be designed to

release anti-TB drugs in a controlled and sustained manner, prolonging
their therapeutic effects and reducing the frequency of dosing. Controlled
drug release kinetics can improve patient compliance and minimize
fluctuations in drug concentration, optimizing treatment outcomes.

NIOSOMES:

Niosomes, similar to liposomes but composed of non-ionic surfactants

instead of phospholipids, have also shown potential for tuberculosis (TB)
treatment. Niosomes offer several advantages in drug delivery, including
improved drug solubility, stability, and controlled release. Here's how
niosomes are utilized in TB treatment:

Drug Encapsulation: Niosomes can encapsulate a variety of anti-TB

drugs, including first-line drugs like isoniazid, rifampicin, pyrazinamide, and
ethambutol, as well as second-line drugs for drug-resistant TB.
Encapsulation within niosomes protects the drugs from degradation and
enhances their stability in physiological conditions.

Enhanced Drug Penetration: Niosomal formulations can improve the

penetration of anti-TB drugs into TB-infected tissues, including lung
granulomas where TB bacteria reside. Niosomes can fuse with cell
membranes, facilitating drug uptake by TB-infected cells and improving
treatment efficacy.

Sustained Drug Release: Niosomal formulations can be designed to

release anti-TB drugs in a controlled and sustained manner, prolonging
their therapeutic effects and reducing the frequency of dosing. Controlled
drug release kinetics can improve patient compliance and minimize
fluctuations in drug concentration, optimizing treatment outcomes.

NANOPARTICLES:

Nanoparticles have garnered significant interest in tuberculosis (TB)

treatment due to their potential to improve drug delivery, enhance treatment
efficacy, and address challenges associated with conventional TB therapy.
Here's how nanoparticles are utilized in TB treatment:

Improved Drug Delivery: Nanoparticles can encapsulate anti-TB drugs

i.e.- isoniazid, rifampicin, pyrazinamide, and ethambutol, protecting them
from degradation and enhancing their stability in physiological conditions.
This encapsulation allows for controlled drug release and prolonged drug
circulation, improving drug bioavailability and distribution to TB infection
sites.

Enhanced Drug Penetration: Nanoparticles can penetrate biological

barriers more effectively than conventional drug formulations, enabling
better drug distribution within TB-infected tissues, including lung
granulomas. This enhanced penetration improves drug efficacy and
reduces the likelihood of drug resistance.

Targeted Drug Delivery: Nanoparticles can be functionalized with ligands,

antibodies, or peptides that selectively bind to receptors or antigens
expressed on TB-infected cells. Targeted nanoparticle delivery systems
enhance drug accumulation at TB infection sites while minimizing off-target
effects, improving treatment efficacy and reducing systemic toxicity.

GOLD NANOPARTICLES:
Gold nanoparticles have shown potential in the treatment of tuberculosis
(TB) due to their unique properties. While gold itself isn't directly used in TB
treatment, researchers have been exploring the use of gold nanoparticles
as carriers for delivering anti-TB drugs more effectively.

Here's how it works:

Drug Delivery: Gold nanoparticles can be loaded with anti-TB drugs,

acting as carriers. These nanoparticles have a high surface area-to-volume
ratio, which allows for a higher drug payload.

Targeted Delivery: Functionalized gold nanoparticles can target specific

cells or tissues infected with TB bacteria, reducing the systemic side effects
of the drugs.

Enhanced Penetration: Gold nanoparticles can penetrate cell membranes

more easily due to their small size, allowing them to reach intracellular TB
bacteria.

Diagnostic Applications: GNPs can also be utilized in the diagnosis of

TB. Functionalized GNPs can be designed to detect specific biomarkers or
antigens associated with TB infection. This approach enables the
development of sensitive and rapid diagnostic assays for TB detection,
which is crucial for early diagnosis and treatment initiation.

Immunomodulation: Additionally, GNPs have been explored for their

immunomodulatory properties in TB treatment. They can interact with the
immune system, potentially modulating the host immune response to TB

infection. This aspect is particularly relevant for enhancing the

effectiveness of TB vaccines or immunotherapies.

CONCLUSION

Tuberculosis remains a major global health threat, but concerted efforts

from governments, healthcare providers, researchers, and communities are
essential for its control and elimination.
This project has provided a comprehensive overview, causes,
classification, global TB report, global TB commitment s, death causes,
transmission and pathogenesis, sign and symptoms, diagnosis, treatment,
advanced drug delivery and therapeutic strategies. By raising awareness
and implementing evidence-based interventions, we can work towards a
world free of TB.

REFRENCES

Certainly! Here are some references that can be used for the project on
tuberculosis:
1.World Health Organization (WHO). (n.d.). Tuberculosis (TB). Retrieved
from https://www.who.int/news-room/fact-sheets/detail/tuberculosis

2.Mayo Clinic. (n.d.). Tuberculosis (TB). Retrieved from

https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-
causes/syc-20351250

3.MedlinePlus. (n.d.). Tuberculosis. Retrieved from

https://medlineplus.gov/tuberculosis.html

4.Tuberculosis. (n.d.). NHS. Retrieved from

https://www.nhs.uk/conditions/tuberculosis-tb/

5.Tuberculosis (TB). (n.d.). Centers for Disease Control and Prevention

(CDC). Retrieved from https://www.cdc.gov/tb/default.htm

6.National Institute of Allergy and Infectious Diseases (NIAID). (n.d.).

Tuberculosis (TB). Retrieved from https://www.niaid.nih.gov/diseases-
conditions/tuberculosis-tb

7.American Lung Association. (n.d.). Tuberculosis (TB). Retrieved from

https://www.lung.org/lung-health-diseases/lung-disease-lookup/tubercul
osis

8.Journal of Nanobiotechnology . Retrieved from

https://jnanobiotechnology.biomedcentral.com/articles/10.1186/s12951-
023-02156-y

9.MIMS. Retrieval from https://www.mims.com/specialty/tuberculosis

%20-%20pulmonary/treatment?channel=respirology