Doc Fio

Tuberculosis (TB) is one of the top 10 causes of death worldwide.

 

Seven countries account for 64% of the total, with India leading the count, followed by Indonesia, China, Philippines, Pakistan, Nigeria, and South Africa.

In 2016, an estimated 1 million children became ill with TB and 250 000 children died of TB (including children with HIV associated TB).

TB is a leading killer of HIV-positive people: in 2016, 40% of HIV deaths were due to TB

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Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.

 

Tuberculosis is curable and preventable.

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TB is an infectious disease. It is spread from person to person through the air.

When people with lung TB cough, sneeze or spit, they propel the TB germs into the air.

A person needs to inhale only a few of these germs to become infected.

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TB is contagious, but it’s not easy to catch. The germs grow slowly.

You usually have to spend a lot of time around a person who has it.

That’s why it’s often spread among co-workers, friends, and family members.

Tuberculosis germs don’t thrive on surfaces. You can’t get the disease from shaking hands with someone who has it, or by sharing their food or drink.

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How Does Tuberculosis Affect Your Body?

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A TB infection doesn’t mean you’ll get sick. There are two forms of the disease:

Latent TB.

You have the germs in your body, but your immune system stops them from spreading.

That means you don’t have any symptoms and you’re not contagious.

But the infection is still alive in your body and can one day become active.

If you are at high risk for re-activation — for instance, you have HIV, your primary infection was in the last 2 years, your chest X-ray is abnormal, or you are immuno compromised --- your doctor will treat you with antibiotics to lower the risk for developing active TB.  

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Active TB disease

This means the germs multiply and can make you sick.

You can spread the disease to others.

Ninety percent of adult cases of active TB are from the reactivation of a latent TB infection.

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What Are the Risk Factors of TB?

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Tuberculosis mostly affects adults in their most productive years.

However, all age groups are at risk.

Over 95% of cases and deaths are in developing countries.

People who are infected with HIV are 20 to 30 times more likely to develop active TB (see TB and HIV section below).

The risk of active TB is also greater in persons suffering from other conditions that impair the immune system.

Tobacco use greatly increases the risk of TB disease and death.

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The chances of getting infected by the TB germ are highest for people that are in close contact with others who are infected.

This includes:

• Family and friends of a person with infectious TB disease

• Persons who have immigrated from areas of the world with high rates of TB

• People in groups with high rates of TB transmission, including the homeless persons, injection drug users, and people living with HIV infection

• People who work or reside in facilities or institutions that house people who are at high risk for TB such as hospitals, homeless shelters, correctional facilities, nursing homes, and residential homes for those with HIV

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Not everyone who is infected with the TB germ (latent TB) develops clinically active TB disease.

People at highest risk for developing active TB disease are those with a weak immune system, including:

• Babies and young children, whose immune systems have not matured

• People with chronic conditions such as diabetes or kidney disease

• People with HIV/AIDS

• Organ transplant recipients

• Cancer patients undergoing chemotherapy

• People receiving certain specialized treatments for autoimmune disorders such as rheumatoid arthritis or Crohn's disease

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Symptoms 

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Common symptoms of active lung TB are :

• cough with sputum and blood at times,

• chest pains,

• weakness,

• weight loss,

• fever and

• night sweats.

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Diagnose

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Many countries still rely on a long-used method called sputum smear microscopy to diagnose TB

The use of the rapid test Xpert MTB/RIF® has expanded substantially since 2010, when WHO first recommended its use. 

Diagnosis can be made within 2 hours and the test is now recommended by WHO as the initial diagnostic test in all persons with signs and symptoms of TB.

Chest X-Ray is also a supporting test to diagnose Lung TB and to find severity of infection or to observe the improvement of the treatment

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Treatment

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If you have active TB disease, you must get treated right away.

This might involve taking a number of medications for 6 to 12 months.

It’s important to take all of your meds, as they’re prescribed, the entire time -- even if you feel better.

If not, you can get sick again, and potentially spread the disease to others around you

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Active, drug-susceptible TB disease is treated with a standard 6 month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer.

Without such support, treatment adherence can be difficult and the disease can spread.

The vast majority of TB cases can be cured when medicines are provided and taken properly.

With the proper treatment, tuberculosis (TB, for short) is almost always curable.

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If you do not take the drugs correctly, the TB germs that are still alive can become resistant to the drugs. Or, sometimes when antibiotics used to treat the disease don’t work this is called "drug-resistant" TB.

If you have this form of the disease, you may need to take stronger medications for longer.

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Prevention

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To prevent getting TB infection means to prevent its spreading. It is very essential to understanding the fact that even though TB disease is contagious, it is also can be prevented and prevention of TB is better that a cure.

1. BCG Vaccination

The BCG (Bacille Calmette-Guérin) is a live vaccine against tuberculosis. The vaccine is prepared from a strain of the weakened bovine tuberculosis bacillus, Mycobacterium bovis. It is one of the most widely used vaccines worldwide.

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2. Early diagnosis

Early diagnosis and treatment is the most effective way to prevent the spread of tuberculosis.

Once diagnosed with TB, and started on treatment, the majority of patients are no longer infectious after just two weeks of taking the medication.

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3. Case finding

Outreach workers and volunteers may work within communities with high rates of TB to find people with symptoms and refer them for testing.

Limiting the spread of TB depends on successfully finding and treating people with the illness, to prevent them from passing it on to others. This can be done through raising awareness of TB, so people with TB symptoms know to seek help. 

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4. Environment modification

As TB is an airborne infection, TB bacteria are released into the air when someone with infectious TB coughs or sneezes.

The risk of infection can be reduced by using a few simple precautions:

• maintain good ventilation: as TB can remain suspended in the air for several hours with no ventilation

• keep natural light: UV light kills off TB bacteria

• apply good hygiene attitude: covering the mouth and nose when coughing or sneezing reduces the spread of TB bacteria (Cough etiquet) . Wash hands after covering cough or sneeze (hand hygiene)

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In healthcare settings, the spread of TB is reduced through the use of protective masks, ventilation systems, keeping potentially infectious patients separate from other patients, and the regular screening of healthcare workers for TB.

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