Tuberculosis: A Comprehensive Review of Diagnosis, Treatment, and Global Challenges

Tuberculosis (TB) is a communicable disease primarily caused by Mycobacterium tuberculosis, affecting millions globally. Despite being preventable and curable, TB remains one of the top 10 causes of death worldwide, especially in developing nations. It primarily attacks the lungs (pulmonary TB) but can affect other parts of the body (extra pulmonary TB), including the brain, kidneys, and spine. TB spreads through airborne droplets from infected individuals, making it a public health concern. Immunocompromised individuals, such as those with HIV/AIDS, are particularly susceptible. The pathogenesis involves the bacteria evading the host immune system, leading to granuloma formation and chronic inflammation. The disease's clinical manifestations include a persistent cough, weight loss, fever, night sweats, and fatigue. Diagnosis typically includes sputum smear microscopy, culture, chest X-rays, and advanced methods like GeneXpert and PCR tests. Treatment involves prolonged antibiotic regimens, with the first-line drugs being isoniazid, rifampicin, ethambutol, and pyrazinamide. Multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) complicate treatment efforts. Herbal medicine is gaining interest as an adjunct or alternative therapy due to the rising resistance to conventional drugs. Several medicinal plants, such as Ocimum sanctum, Curcuma longa, and Withania somnifera, have shown anti-TB potential. This review aims to provide a comprehensive overview of TB, covering its etiology, pathophysiology, diagnostic tools, treatment strategies, and comparison of herbal versus allopathic treatments. It further explores the future scope in TB management, emphasizing novel therapies and preventive strategies for global eradication.