Preface

Tuberculosis (TB), which is caused by the infectious agent *Mycobacterium tuberculosis* (MTB), is a major global public health problem that infects one third of the world's population. However, TB is a curable and preventable disease. The World Health Organization (WHO) estimates that 10 million new cases of TB and 1.2 million deaths due to TB occurred in 2019. Globally, in 2019, close to half a million people developed rifampicin-resistant TB (RR-TB), 78% of whom had multidrug-resistant TB (MDR-TB). Molecular genotyping of MTB has been well developed over the years. This book provides an overview of the molecular epidemiology pattern, transmission dynamics, host response, evolution, and pathogenesis mechanisms of TB. It also examines mechanisms associated with increasing trends of drug-resistant TB and explores the development of anti-mycobacterial drugs. It presents updated research for policymakers and planners on diagnosis and treatment, genotyping tools, and control and prevention of MTB disease. The book also explores vigorous approaches in designing novel anti-tubercular drugs, diagnosis and treatment of latent tuberculosis infection, laboratory diagnosis via identifying novel singlenucleotide polymorphism, tracing of outbreak isolates, molecular characterization of *Mycobacterium* spp. isolated from cattle and wildlife in Poland, challenges in drug discovery against tuberculosis, and genealogy of resistant TB in Latin American territories.

**II**

**Section 5**

Tuberculosis and Behçet's Disease

*Khalil Amri, Raja Amri and Mohamed Ali Sbai*

Other TB **99**

**Chapter 7 101**

Humeral Artery Aneurysm Revealing a Rare Association between

*by Rabie Ayari, Ramy Triki, Youssef Mallat, Achraf Abdennadher,* 

**Yogendra Shah** COVID-19 PCR Laboratory and Seti Provincial Hospital, Dhangadhi, Nepal

**1**

Section 1

Introduction

Section 1 Introduction

**3**

push them further into poverty [6].

**Chapter 1**

*Yogendra Shah*

Introductory Chapter: Plan to

Drug-Resistant Tuberculosis/

Zoonotic Tuberculosis

**1. Molecular Epidemiology of MTB drug resistant**

Prevent and Combat against the

Tuberculosis (TB) is a primary cause of death from a single infectious agent by *Mycobacterium tuberculosis* complex (MTBC) remains a major global public health problem which infects one thirds of world's population. Despite being largely TB is a curable and preventable disease, WHO estimates that 10 million new cases and 1.2 million deaths occurred in 2019 [1]. Majority of deaths were in developing countries with more than half occurring in Asia and Africa. TB is spread when people who are sick with TB expel bacteria into the air; for example, by coughing. TB usually affects the lungs (pulmonary TB), although other organs are involved in 15–30% of other sites (extra pulmonary TB) [2]. *Mycobacterium tuberculosis* (MTC or MTBC) is a genetically related group of *Mycobacterium* species that can cause tuberculosis in human or other animals i.e. *M. tuberculosis*, *M. africanum*, *M. orygis*, *M. bovis*, *M. microti*, *M. canetti*, *M. caprae*, *M. pinnipedii*, *M. suricattae*, *M. mungi* [3].

The emergence of drug resistant including multi-drug resistant (MDR-TB: It means that the TB bacteria that a person is infected with are resistant to two of the most important TB drugs, isoniazid (INH) and rifampicin (RMP) [4] and Extensively drug-resistant TB (XDR-TB) is a rare type of multidrug-resistant tuberculosis (MDR TB) that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin) [5] are also poses a serious public health threat to the success of TB treatment and control programs across worldwide. Globally in 2019, close to half a million people developed rifampicin-resistant TB (RR-TB), of which 78% had multidrug-resistant TB (MDR-TB). Molecular genotyping of MTB has been well developed over the years. WHO has developed the End TB strategy, which was endorsed by the sixty-seventh world health assembly in 2014. According to WHO, strategy ambitiously proposes to "end the global TB epidemic" by 2035. The strategy targets a 90% reduction in patients suffering from TB, and a 95% reduction in deaths from TB by 2035-all while protecting families from catastrophic costs that

The main genotyping typing methods mainly IS6110 restriction fragment length polymorphism (RFLP), spoligotyping and mycobacterial interspersed repeat unit variable-number tandem repeat (MIRU-VNTR) analysis, are commonly used for fingerprinting MTB strains to detect recent transmission [7]. However, the discriminatory power of these genotyping methods is not sufficient in countries such as South East Asia, South Africa and Russia including Nepal where MTB of Beijing

## **Chapter 1**
