I have long suspected this as part of why the subject isn't much discussed, despite being more prevalent than most realize.
The elephant here is (aside from latent infection) the atypically long duration of treatment, which can exceed 6 months and is harsh. Many, even otherwise responsible people, will founder before the proper end of treatment and this, I think, is what terrifies health professionals - so much, that it almost seems to be avoided.
It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive.
Edit: I also think we'll be finding more about latent infections being involved in an array of other ailments, especially when mixed with the ultra prevalent EBV. And EBV is involved in a lot.
We are looking, quite hard, in fact. Mycobacterium tuberculosis is among the most studied microörganisms.
Like HIV, it is notable particularly for being able to defeat the attempts of the immune system cells to kill it, and it in fact infects and reproduces within macrophages. Medical researchers have done a lot to understand how this is possible and we (as in humanity) have identified several enzymes and related biomolecules which seem to be crucial to this process, which we might be able to inhibit with a targeted drug.
However, all of this scientific research has the usual problem that it is very difficult and expensive. In order to inhibit the enzyme, the drug must be absorbed by the body, and then make its way into the macrophages, and then it still must be active, and have no other toxicity to the host. It is easy to say "just inhibit isotuberculosinol synthase", but it is much harder to do.
As I understand it, this is also the reason why treating tuberculosis requires such long courses of antibiotics. When treating a normal infection, we are basically just killing most of the pathogens, and we hope that the immune system will mop up the rest. In the case of M. tuberculosis, the drugs have to kill all of the bacteria, which is why multidrug therapy is basically always used and the patient must continue treatment long after symptoms seem to have disappeared. Even when patients have recovered, they are always considered to be at risk of still having latent tuberculosis, which is why hospital screenings often feature a question like "have you ever had a positive test for tuberculosis?"
An example might be enzymes (notably in cancer research), where in the US there has been significantly less pursuit than elsewhere. To avoid attacks, I'll cite a source[0] which readers can maim rather than my comment.
0. Enzymes, The Fountain of Life DA, Lopez MD RM, Williams MD PhD K, Miehlke MD
In some pirtions of this book, entities other than pinata boy on HN, express concern regarding the quality, fairness or whatever's of research, with indications that 'research' may not always be equally noble or pragmatically guided. I suspect it's one of many where that particular subject is grazed upon. But my point is, if not overemphasized, that there may be quantity over quality issues, with viable options hiding in plain sight.
Antibiotics are found in, and derived from, nature.
Reflect for a moment on whether such a comment serves any positive purpose.
I was diagnosed with a latent TB infection received from a family member back in the early 1990's as a teen. I believe city and state departments of health must've tracked the "outbreak" back but I don't think it was ever on the news or made a big deal of. By the time we were diagnosed, the family member's symptoms weren't anything worse than their typical smoker's cough and was a heavy cigarette smoker anyway, not sure how active his infection actually was at the time but he never required hospitalization, just similar antibiotics, IIRC.
I was treated with Isoniazid (known as INH, one pill daily for a year), I never felt any symptoms from the infection or side effects from INH, they monitored monthly initially with skin prick tests then chest x-rays and after the year was up, I was done. This did prevent me from donating blood a few years after the infection was cleared; I assume there are still rules in place.
Neither the latent infection nor the year long treatment were harsh. IMHO, TB's a powerful but rather slow-moving internal infectant, and it was historically ravaging because of the earlier conditions of the world and lack of medicine at that time.
I enjoy discussions, but find it often tends to be argumentative here, so I avoid things I expect to go in that direction. Note the hostility to my use of the forbidden word in quotes. It's a thousand cuts with these kinds of compulsive prison shanks of logic that makes me awkward.
Is the idea that a different label would lead to higher compliance rates?
Compliance for a 6 month course of just about anything is difficult and more so for something that may seem asymptomatic. Oozing sores, foul oders and overt discomfort would probably help, but alas...
Natural means nothing in this context. Effective medicine is effective medicine, and there is nothing that makes TB less prone to developing a resistance to a 'natural' effective medicine over any other effective medicine.
The fear is overblown. I've known multiple people do the 9 month treatment and none had issues. One person had tingling sensation and that was resolved by an increase in vitamin intake after consulting with a neurologist.
They were in their early to mid thirties. Most problems occur when older people take the medication.
Again, this isn't some passive aggressive challenge. But I will be genuinely surprised to see this is indeed the case, which very well may be. I certainly know people who'd follow the course with perfection, and some who absolutely wouldn't.
