Tuberculosis (TB) remains one of the leading infectious causes of death worldwide, despite being preventable and treatable. Caused by Mycobacterium tuberculosis, it spreads primarily through airborne transmission and disproportionately affects low- and middle-income countries.

This episode examines:

• Global epidemiology and high-burden regions• Latent versus active tuberculosis• Risk factors - HIV co-infection, malnutrition, overcrowding• Drug-sensitive and multidrug-resistant TB (MDR-TB)• Diagnostic strategies and laboratory capacity• Directly observed therapy and treatment adherence• Social determinants and housing conditions• TB in prisons and marginalised populations• Global End TB strategies and elimination goals

Tuberculosis highlights the enduring link between infectious disease and social inequality. Crowded housing, poor ventilation, undernutrition, and limited access to care sustain transmission cycles. While modern diagnostics and treatment regimens have improved outcomes, drug resistance poses a significant threat.

The episode explores both biomedical and structural responses - recognising that TB control requires strengthened health systems, poverty reduction, and sustained global coordination.

Tuberculosis persists not because it cannot be treated, but because its determinants extend beyond medicine.

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Key Takeaways

• Tuberculosis remains a leading cause of infectious mortality• Latent infection creates a large reservoir of potential disease• HIV co-infection significantly increases risk• Drug-resistant TB complicates treatment efforts• Early detection and treatment adherence are critical• Social determinants drive transmission patterns• Global elimination requires coordinated international effort

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