“Contagious and bad”. The stigma of Mycobacterial infections
Two diseases caused by mycobacteria, Tuberculosis and Leprosy, not only are they quintessential in the history of infectious diseases and humanity, but have survived the passing of the centuries still affecting millions around the world. Being present this long with humankind, it is no surprise how much they have been represented in cultures across the globe, immersing in the life and folklore, especially amongst the less fortunate, as these are two diseases heavily associated with poverty.
This association is sadly not unidirectional, with the disease limiting the affected individuals, not only biologically but socially, as they become victims of stigma and discrimination, unable to transit, interact, being hired, or continue working. This vicious cycle affects these patients negatively in ways not limited to their psychological or monetary welfare. Unable to transit, by lack of money or because of ostracism, they fail to adhere to their treatment compliance, adding tremendous consequences to their prognosis, which could result in death in the case of extreme-drug resistant tuberculosis. Mycobacteria are slow growing bacteria that have to be treated using a combination of antibiotics for long periods of time. Less than optimal adherence and compliance to the treatment leads to the appearance of drug resistance, which sadly has a very poor prognosis and high mortality.
Coming from a developing country where these two diseases are endemic, I am conscious of how much the social aspects can affect our strategies to fight against them. It is our mission as scientists and physicians to always consider the social implications of an illness. Increase awareness of neglected infectious diseases, advocating for human rights, fighting poverty, and applying available advances of medicine and science should be part of everyone’s endeavor to eradicate tuberculosis and leprosy in our time.
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, USA
Tuberculosis. Digging deep in the soul of humanity.
Respir Med. 2016 Oct