In the middle of the cage, three white mice play together. They run in circles, reach out for one another, and climb over each other as if playing a rowdy game of tag. In the corner of the cage, another mouse sits alone, avoiding the others. When one of its siblings comes over, perhaps checking up on the mouse to see what's wrong, the lone mouse beings to dart wildly around the cage, doing everything it can to avoid contact with its littermates.
They come ten days after the full moon, swarming to shore, nearly invisible and wielding poison-loaded tentacles. A few days later, they disappear just as mysteriously as they had come, leaving behind their microscopic spawn. No, this isn't the plot of another science-fiction movie; it is a real, monthly occurrence on the beaches of Oahu, Hawaii. These creatures are aliens, but they aren't from space. They are an alien species of box jellyfish that has been invading Hawaii's waters for almost two decades. Lifeguards, tourists, and scientists all keep a wary vigilance for this particular box jelly, called Carybdea alata.
In Sanskrit, tuberculosis (TB) is known as Rajyachhyama, or "the king of diseases." It is one of the world's most serious infectious threats. Globally it has been estimated that 1.7 billion people are infected with tuberculosis, a third of them in Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. TB infection is very common, and it continues to be the major public health problem in Nepal. About 60% of the economically active population has been infected. Published data about the epidemiology of TB in children is scarce in Nepal, though it is considered one of the most common causes of childhood morbidity in the country. One study has shown that in a developing country such as Nepal, the annual risk of getting TB infection in children is 2-5%, but 8-20% of the deaths are children.
In 1983, Australian doctors J. Robin Warren and Barry Marshall isolated Helicobacter pylori, the bacterial cause of peptic ulcer disease (P.U.D.). However, decades passed before most doctors prescribed antibiotics to their afflicted patients. Why didn't the medical community hit itself on its collective head? After all, most bacterial diseases had been discovered a century before during Robert Koch's golden age of bacteriology. Why didn't doctors laud Warren and Marshall for their findings?
The fear and stigma of tuberculosis is apparent both in the community and among medicos. The incidence of tuberculosis in developed countries had been declining due to improved sanitation and socioeconomic conditions long before the necessary medicines were discovered. After the discovery of anti-tubercular drugs and multi-drug regimen, the Directly Observed Treatment Scheme (DOTS) was launched in 1991 as the most effective measure in combating TB in developing nations. Today, DOTS still has many woes to share. Directly Observed Treatment for eight months often hinders complete treatment and reduces compliance due to inaccessibility of health services or time constraints. Passive case detection strategy in DOTS is only a curative strategy and only prevents the epidemic outbreak of the disease it does not eliminate it.