The tremendous advances in the treatment of tuberculosis (TB) beginning with the advent of streptomycin, followed by a whole range of highly effective anti-tuberculosis therapies, many of which were studied in high quality randomised clinical trials conducted in Singapore have largely removed TB from the public imagination as a feared and deadly contagious disease. However, in the 1990s, highly publicised nosocomial outbreaks of multidrug-resistant tuberculosis (MDR-TB) in New York City which led to mortality even among healthcare workers brought TB back onto the radar screen. Tuberculosis (TB) was declared a global health emergency by the World Health Organisation in 1994, and it continues to kill 1.5 million people per year. It is estimated that one third of the world’s population is infected with the causative organism, Mycobacterium tuberculosis. Seventeen years after the global health emergency was declared, there are expected to be 9.8 million new cases worldwide in 2010, more than any other year in history. In Singapore, the number of newly diagnosed TB cases rose in 2008 after a period of steady decline; although the incidence of TB in Singapore is higher than in developed countries, it is much lower than in the developing countries around us.
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