Research on tuberculosis: 75 years of IBIT contributions

In 1937, the foundation year of the Brazilian Institute for Tuberculosis Research, three questions persisted in the researchers’ mind: “What is the real value of BCG? How to solve the problem of the chest register of large communities? When will we have a specific drug for the treatment of tuberculosis?” Along with this line of thought, the author presents a list of the Institute’s main contributions, by pointing out the following topics: different diagnoses between pulmonary tuberculosis and pulmonary schistosomiasis; innocuity of iodine salts in pulmonary tuberculosis; relative value of Weltmann and Takata-Ara’s reactions, and of blood and lipase rates in bacillosis; the value of the bacteriologic diagnosis (method of precipitation, standardization of drug sensitivity tests; identification of non-pathogenetic germs not only in the sputum but also in gastric Broncho-Alveolar Lavage, playing an important role in the infection tropics; probable protective role of BCG in tuberculin positive individuals; increase in awareness of the value of tuberculin; comparative studies of several types of tuberculin; clinical and epidemiological importance of nontoxic drugs; tuberculin surveys in Salvador and Feira de Santana cities; proposed classification of clinical forms of pulmonary tuberculosis; increase in the value of selective miniature chest radiography; standardization of radiological shadows; and tests on the therapeutic value of the drugs. To SILVEIRA, IBIT’S contribution can be summarized in eight points: importance of bacteriology in the diagnosis and therapeutic procedures; increase in the value of tuberculin tests; selective miniature chest radiography; possibility of replacing the hospital by an ambulatory care center; BCG vaccination; wide and general indispensability of a well-done and well-balanced therapeutic scheme; simplified treatment; progressive shortening of the treatment program; no over optimism about the first victories in the bacilli therapy. veira elucidated some clinical and pathologic features. Silveira ntroduction n 1937, the year of establishment of IBIT, three questions peristed in the investigators’ minds: (1) What is the true use for he BCG? (2) How to solve the problem of thoracic investigation n large crowds? (3) How to get a specific medication for tuberulosis? The IBIT during its first fifty years, tried to answer hese questions. ∗ Correspondence address: Ladeira do Campo Santo, s/n, Federação, Pes E-mail address: [email protected] 413-8670/$ – see front matter © 2013 Elsevier Editora Ltda. All rights r ttp://dx.doi.org/10.1016/j.bjid.2013.01.003 © 2013 Elsevier Editora Ltda. All rights reserved. Tuberculosis and co-morbidities Belonging to a tropical country, the Institute began studying the correlation of tuberculosis with ascariasis,1 malaria,2 filariasis3 and schistosomiasis.4–9 About schistosomiasis, Silquisa Clínica, Salvador, BA 40210-320, Brazil. demonstrated that, in its lung location, it causes several vascular disorders2 and a pneumonitis image. The fact was