“It is not the strongest of the species that survive, nor the most intelligent but the one most responsive to change.” Charles Darwin the Father of Evolution (Charles, et al., 2014) For organisms to be able to adapt in this ever-changing world, one must evolve. Evolution, however, is not as simple as it seems, it is a battle between species, species battle it out and the species more willing to change wins, and it looks like Mycobacterium Tuberculosis did just that, it won. To many Africa is known as the home to wild animals, slaves and a variety of cultures, but what we did not know is that Africa was the home of Mycobacterium Tuberculosis, so without Africa, the evolution of Mycobactrium Tuberculosis would have never happened. (Pruitt, 2013) The evolution of Mycobacterium Tuberculosis the bacterium that causes Tuberculosis, the number one leading cause of human death worldwide, surpassing the deadly sexually transmitted HIV Virus. But what is Mycobacterium Tuberculosis? Well, Mycobacterium Tuberculosis being a non-pathogenic bacteria of the family Mycobactriaceae. This small non-motile, non-spore forming bacteria with its waxy mycolic acid coat plays a role in the formation of Tuberculosis. (Todar, 2008-2012) Being an airborne disease Tuberculosis primarily affects the lungs of Animals and Humans, a hole eventually develops in the patient’s lungs causing air or fluid to accumulate between the chest walls and lungs. (Christiano & Murrell, 2018) Patients then experience chest pains and shortness of breath. Tuberculosis has not only has caused millions of deaths worldwide, but it has also reached high stages of resistance that scientists have never seen before due to is a co-existing relationship with humankind. It has been found that many non-pathogenic mycobacteria are found in normal human flora. (Todar, 2008-2012) Tuberculosis With resistance levels so tremendously, failure to Tuberculosis treatment is common. In this research project, we will learn a little more about the history of Mycobacterium Tuberculosis. Its history relationship and co-evolution with humans. We will also learn about the drug-resistance TB a disease formed by Mycobacterium Tuberculosis. and most importantly the factors that caused such an increase in its resistance. This research project is of importance for it can help raise awareness of the Mycobactrium Tuberculosis to both privileged and unprivileged individuals. Not only are we raising awareness, but we are also further educating ourselves to help the future generation. This research project can aid those who already have Mycobacterium Tuberculosis, expanding their knowledge on Tuberculosis a little bit more. since “1” /”3″ of the world’s population are infected with TB, research projects can prevent the remainder of the population from being infected too, teaching them how to handle people with Mycobactrium Tuberculosis and areas with high rates of Mycobactrium Tuberculosis. Figure 3: Estimated TB population; Figure 4: TB awareness Poster History of the Disease Tuberculosis What is Tuberculosis? It is a chronic infectious disease that usually affects the lungs. but can also affect other parts of the body. It is caused by the Mycobactrium Tuberculosis When inhaled the bacterium settles in the lungs and starts growing, if not properly treated it will become life-threatening. Being an airborne bacterium Mycobacterium Tuberculosis can be transferred easily from the TB patient to a non-TB patient. During the 18th and 19th century Mycobacterium Tuberculosis was the cause of the “White Plague”, the Tuberculosis epidemic that rampaged North America and Europe. Nearly 100% of Europe’s population was infected with Mycobacterium Tuberculosis, killing 25% of the adult population. (Todar, 2008-2012) Tuberculosis cases began to increase rapidly worldwide that in 1993 the Worldwide Health Organization (WHO), had declared TB a global emergency, the first time any disease had been labelled such. (McIntosh, 2018) The discovery of Mycobacterium Tuberculosis, the bacterium that causes Tuberculosis, was announced on March 24, 1882, by Dr Robert Koch, his amazing discovery not only won him a Nobel prize, but it was the most important step towards gaining control and eliminating this deadly disease. During the time of his discovery, TB had already killed one out every seven people living in the united states of America and Europe. (Anon., 2016) The 24 of March 1992, a century later after Koch’s discovery, was designated as World TB day, a day of awareness of the TB, a day to educate the public on the impact of TB around the world, until TB this day won’t be a celebration but a day to help us be one step closer to eliminating Mycobacterium Tuberculosis. But what most people didn’t know is that Mycobacterium came from the heart of the Earth, Africa. Africa, known for its huge cultural heritage, the hot African sun and the home of the ancient Egyptian pyramids, but as of the 1st of September 2013 Africa is the new home of the Mycobactrium Tuberculosis, (Pruitt, 2013) without Africa, slave trading and colonization M. Tuberculosis would not have been ruling and killing the people of this Earth. Before the team of international researchers led by Sebastian Gagneux of the Swiss tropical and Public Health Institute (Swiss TPH), could create a family tree using 259 samples of TB bacteria collected from different parts of the world, indicating that TB Mycobacterium had emerged some 70 000 years ago among humans in Africa, (Anon., 2013) everyone had believed the bacterium had originated in animals and then passed on to humans. Scientists believed animals transmitted Mycobactrium Tuberculosis to us, as they traced origins back to the Neolithic Transition which took place in Africa 10 000 years ago. During this period humans began cultivating agricultural and domesticating animals, which is why such was believed. Without Africa, the spreading of Mycobacterium Tuberculosis would have not happened. The Spread of Mycobacterium Tuberculosis TB is an airborne disease; Mycobacterium Tuberculosis can be spread in the air. non-contaminated TB patients can catch TB by breathing the same air a TB infected patient has contaminated through breathing, coughing, talking, singing or spitting. (Rodriguez, 2009). After breathing in the bacterium, the MBT multiplies within the inactivated macrophages of the patient’s tissue, since the macrophages are not activated they cannot destroy the MBT. The MBT uses the macrophages to replicate itself allowing it to grow and weaken the patient’s immune system. (Todar, 2008-2012) A hole eventually forms in the lungs causing the chest walls and lungs to fill up with either air or fluids. The patient starts to experience constant chest pains and shortness of breath. The MBT can also spread to the kidneys, brain and spine. TB is therefore spread between humans, during normal interactions After the theory that Mycobacterium Tuberculosis was transmitted to us by animals was debunked, Evolutionary Biologist Sebastian Gagneux compared the genetic evolutionary tree of the Mycobacterium to the genetic evolutionary tree of humans, his discovery was surprising, “The evolutionary path of humans and the TB bacteria shows striking similarities”. This discovery helped scientist make the conclusion that Mycobacterium had a close relationship with humans lasting thousands of years. Not only did they both emerge from Africa, but they migrated together and expanded all over the world. (Anon., 2013) Evolutionary biologist Sebastian Gagneux further explained “That the diversity of Tuberculosis Bactria has increased markedly when human populations expanded”. (Anon., 2013) The increase in the spread of Mycobacterium Tuberculosis can be blamed on several things: the slave trade caused people of colour to migrate to different areas of the world; colonization caused newcomers to enter Africa, the industrial revolution etc. What all these things have in common is that it caused a rise in the population which later caused overcrowding to take place. the more people settled in the same region the more overcrowded it became, and we all know that at M. Tuberculosis spreads much faster in overly crowded areas. Since TB is a pulmonary disease it is much easier for it to spread in crowded areas than vacant areas. The M. Tuberculosis gained the opportunity to spread more due to its ability to lie latent and reemerge decades later once the population size had increased. Line Graph representing the spread of Mycobacterium Tuberculosis due to the increase of in Population size between the years 1800 1920 Human Immunodeficiency Virus (HIV) patients are more prone to being infected with Tuberculosis than people that don’t have HIV. In 2015, an estimated amount of 10.4 million cases of Tuberculosis worldwide was recorded, of that 10.4 million, 1.2 million deaths among HIV-negative people were recorded. Almost 60% of the Tuberculosis cases among people living with HIV were not diagnosed or treated, resulting in 390 000 Tuberculosis-related deaths amongst HIV-positive people. (WHO, 2015) In 2017, an estimated 10 million Tuberculosis cases were recorded of that 10 million”,1.3 million deaths among HIV-negative people were recorded and there were an additional 300 000 deaths from Tuberculosis amongst HIV-positive people. (WHO, 2017) A Bar graph representing the Tuberculosis Worldwide Death Cases between HIV-negative patients with TB and HIV-positive patients with TB in the years 2015 and 2017 The relationship between Mycobacterium Tuberculosis and humankind When we hear Mycobacterium Tuberculosis we immediately think about the millions of lives it has taken, an increasingly deadly disease that keeps on evolving. The relationship between M. Tuberculosis is both deadly and slightly beautiful, without humans M. Tuberculosis would not have reached such levels of evolution and possibly without M. Tuberculosis humans would not have survived some environments. M. Tuberculosis is a human pathogen that needs a human host to survive. (Pruitt, 2013) About 70 000 years ago humans were the known only hosts to the M. Tuberculosis, sticking with humans for a much longer period than we expected, evolving along with us. To not kill its human host M. Tuberculosis about 20 000 to 30 000 years ago developed the ability to go dormant and only reemerging only after the immune system of the host weakens. (Gagneux & Brites, 2015) This ability allows the M. Tuberculosis and the Human to co-exist, for a specific amount of time, as the dormant Mycobacterium can become active once the host becomes old or their immune system weakens. It seems that MBT and mankind had formed a relationship, humans dependent on the M. Tuberculosis for the pathogens that kill disease far more dangerous than itself and M. Tuberculosis depend on humans for hosts so that it can replicate itself. Our migratory behaviour and the changes in the lifestyle helped create favourable conditions for the dead M. Tuberculosis seeing as the Mycobacterium increased as the population size increased. Developing countries have high rates of overcrowding, due to having much larger population sizes than developed countries. Kenya a developing country in Africa has a total TB incidence of 158 000, countries with a high rate of humans, have higher TB incidences as the M. Tuberculosis has much more hosts. Also, people who are HIV positive have a higher risk of having TB as their immune systems are much weaker than an average human’s immune system. Sebastian Gagneux also suggested that the latent Mycobacterium may have provided immunity against much more lethal pathogens, helping humans to evolve. How Mycobacterium Tuberculosis became resistant As humans, we tend to believe that once you are well you can stop taking a pill, whether our treatments are over or not. This causes more M. Tuberculosis to become resistant. Diagram (England, 2018) 1. 2. 3. 4. How improved Technology has provided insight into the evolution of Mycobacterium Tuberculosis The technology the world’s greatest invention, not only has it helped us adapt and evolve in this world it has allowed us to understand the many diseases that roam around and evolve with us, the application of technology in medicine has been successful in detecting, identifying and treating any type of diseases. Diseases that have been co-existing with us since the beginning of time can finally be understood. The introduction of new and improved tools for Tuberculosis control and presentation can be regarded to meet needs of communities with or at risk of a TB infection. (WHO, 2007) Evolutionary Biologist Sebastian Gagneux would not have figured out that M. Tuberculosis and humans co-existed, that humans were the main cause the increase in M. Tuberculosis. Sebastien Had lead a group of international researchers from the Swiss Tropical and Public Health Institute (Swiss TPH), using technology he had figured out that M. Tuberculosis and humans have similar evolutionary paths. Thanks to technology, even a simple microscope, we have learnt more about the origin of M. Tuberculosis. With technology, our knowledge and better understating of M. Tuberculosis expands, allowing us to gather more information about the bacterium which will later be used to raise awareness to the public. Information on TB can be shared and viewed digitally, TB awareness companies can advertise their posters online and donations to areas of high TB risk can be done digitally. As the technology improves the treatment improves too, not only are we learning about M. Tuberculosis more, we are treating it better thanks to better-improved technology. 58 programs work on TB in 33 countries, these programs use technology to improve the performance of the antibiotics on the TB bacterium, they also help with diagnosing the patient, using x rays. (Zieve, 2018) The present and the future including the impact of climate change the evolution of Mycobacterium Tuberculosis Back in the past, M. Tuberculosis was viewed as a death sentence, the ‘white plague’ it had caused a decrease in population size and an increase in mortality rates, no technology was available to help diagnose patients, awareness on TB wasn’t available. Fortunately, as time went on our knowledge on Mycobacterium Tuberculosis improved, the technology we used to diagnose patients improved, awareness on TB was now available to the public, even though TB is rapidly getting deadly we have hope that we will be able to eliminate it. The United Nation (UN) predicted that TB would be eliminated by 2025, with enough global work it can still be done (McIntosh, 2018). Global warming, however, stands in the way of the possibility of M. Tuberculosis free world. Dormant TB bacteria only become active due to some favourable conditions. humid and warm areas are great areas for the M. Tuberculosis to form.Much change of the M. Tuberculosis distribution is due to climate change. Seasonal variation can also cause some new M. Tuberculosis resistance to form. (Anon., 2017) Conclusion In conclusion, Mycobacterium Tuberculosis is a very deadly bacterium that causes spreading of Tuberculosis worldwide, killing victims with its symptoms of tiredness, weakness, weight loss and fevers. Not only is Tuberculosis sucking the life out of its victims, but it is also sucking their bank accounts dry. TB victims. Lose most of their income to pay for hospital bills, treatments and pills, they are also unable to carry on working as they may be too sick. TB is also associated with a stigma, many TB patients lose their friends and family because their family members and friends fear they will get contaminated with TB too, not knowing that with the right treatment TB cannot be transmitted. So, TB patients go through their treatments alone and ashamed That is why it is important to raise awareness against Mycobacterium Tuberculosis and Tuberculosis, so TB patients won’t struggle alone. The better the TB patient’s family member understands TB, the more at ease the TB patients will be. Mycobacterium Tuberculosis, a bacterium that grows dangerous every day can one day be cured if we work together we can figure out a way to eliminate Mycobacterium Tuberculosis because two heads are always better than one.