CHAPTER ONE

1.0 INTRODUCTION

1.1 Background to the Study

Despite the fact that tuberculosis (TB) has been recognized for thousands of years and despite the fact that the etiological agent has been identified since earliest days of medical biology, the global the burden of TB continues to loom as one of the largest among infectious diseases, with an enormous toll in morbidity and mortality (Leonard and Rachael,2009).This disease which is caused by various strains of mycobacteria, usually Mycobacterium tuberculosis (MTB) isthe leading cause of death from a single infectious agent, after the human immuno deficiency virus (HIV) (WHO, 2013). Currently, one-third of the world harbors the latent form of Mycobacterium tuberculosis, with a lifelong risk of activation and disease development, particularly in people co-infected with HIV (Anil et al., 2011). The World Health Organization (2014) reported 1.5 million deaths from tuberculosis globally in 2013 andout of this number, 360,000 were HIV-positive. Ironically, available therapeutic agents are highly efficacious in TB treatment, withcure exceeding 95% during clinical trials (Frieden, 2003). The natural question is; why then has the control of TB been so problematic?

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