Tuberculosis (TB) is an airborne infectious disease that is preventable and curable. The World Health Organization (WHO) is working to dramatically reduce the burden of TB, and halve TB deaths and prevalence by 2015, through its Stop TB Strategy and supporting the Global Plan to Stop TB.
How common is TB, and who gets it?
Over eight million new cases of TB occur each year worldwide. Anyone can get TB, but certain people are at higher risk, including:
- people who live with individuals who have an active TB infection,
- poor or homeless people,
- people from countries that have a high prevalence of TB,
- nursing home residents and prison inmates,
- alcoholics and intravenous drug users,
- people with diabetes, certain cancers, and HIV infection (the AIDS virus), and
- health-care workers.
There is no strong evidence for a genetically determined (inherited) susceptibility for TB.
How is tuberculosis TB spread?
Tuberculosis (TB) is an infection, primarily in the lungs (a pneumonia), caused by bacteria called Mycobacterium tuberculosis. It is spread usually from person to person by breathing infected air during close contact.
The risk factors for acquiring TB include close-contact situations, alcohol and IV drug abuse, and certain diseases (for example, diabetes, cancer, and HIV) and occupations (for example, healthcare workers).
What are the symptoms of TB?
In healthy people, infection with Mycobacterium tuberculosis often causes no symptoms, since the person’s immune system acts to ‘fend off’ the bacteria. The body’s immune system, can stop the bacteria from continuing to reproduce, making the lung infection inactive (dormant).
On the other hand, if the body’s immune system cannot contain the TB bacteria, the bacteria will reproduce (become active or reactivate) in the lungs and spread elsewhere in the body.
TB infection usually occurs initially in the upper part (lobe) of the lungs. It may take many months from the time the infection initially gets into the lungs until symptoms develop.
The usual symptoms that occur with an active TB infection are:
- coughing, sometimes with sputum (mucous) and blood,
- chest pains,
- a generalized tiredness or weakness,
- weight loss,
- fever, and
- night sweats.
Although TB is commonly known as an infection or disease of the lungs, once inside the human body these bacteria start multiplying in number. The infection can spread beyond the lungs to any organ of the body via blood. TB of the lungs is contagious, whereas TB of other organs, is not contagious.
How does a doctor diagnose tuberculosis?
The diagnosis usually involves a tuberculin skin test or a blood test, a chest x-ray, and examination and culture of a sputum (mucous) sample.
X-rays: Sometimes, the chest x-rays can reveal evidence of active tuberculosis pneumonia. Other times, the x-rays may show scarring (fibrosis) or hardening (calcification) in the lungs, suggesting that the TB is contained and inactive.
Sputum (mucous) smear: Examination of the sputum on a slide (smear) under the microscope can show the presence of the tuberculosis-like bacteria.
Skin test: Several types of skin tests are used to screen for TB infection. These socalled tuberculin skin tests include the Tine test and the Mantoux test, also known as the PPD (purified protein derivative) test.
If the infection with tuberculosis has occurred recently, however, the skin test can be falsely negative. The skin test can also be falsely negative if a person’s immune system is weakened or deficient due to another illness such as HIV/AIDS or cancer, or while taking medications that can suppress the immune response, such as cortisone or anticancer drugs.
How is TB treated?
Inactive tuberculosis may be treated with an antibiotic, isoniazid (INH), to prevent the TB infection from becoming active (turning into TB disease).
Active TB is treated, usually successfully, with INH in combination with one or more of several drugs, including rifampin, ethambutol, pyrazinamide, and streptomycin (two or more antibiotics are always given to reduce the chances of bacterial resistance).
Treatment is usually over a period of months and patients need to take all the medication as prescribed, for as long as prescribed regardless of whether they are feeling better or not.
How can TB be prevented?
Early diagnosis and treatment, plus isolation of people with the active disease until they have responded to treatment, help prevent TB from spreading.
- High-risk persons with TB infection must complete their preventive therapy medicines.
- Persons with TB disease must take all of their anti-TB medicine exactly as prescribed.
- Whenever a TB patient coughs, sneezes or speaks he/she should cover their mouth and nose with a tissue. The tissue should be disposed of carefully in a dustbin and the patient should wash his/her hands with soap afterwards.
- The patient should maintain a physical distance from family members and friends.
- Within a period of few weeks from the start of treatment the bacteria will disappear from the sputum and risk of transmission of TB is markedly reduced.
By Laura Evans. Information sourced from: www.medicinenet.com/tuberculosis, www.dhpe.org, www.merck.com, www.healthinitiative.org, www.who.int
7 FAST FACTS ABOUT TB
Fact 1: Tuberculosis (TB) is an infectious bacterial disease caused by Mycobacterium tuberculosis, which commonly affects the lungs.
Fact 2: TB is contagious and spreads through the air. If not treated, each person with active TB can infect on average 10 to 15 people a year.
Fact 3: More than two billion people; one third of the world’s total population, are infected with TB bacilli, the microbes that cause TB. One in every 10 of those people will become sick with active TB in his or her lifetime.
Fact 4: TB is a disease of poverty, affecting mostly young adults in their most productive years. The vast majority of TB deaths are in the developing world, with more than half occurring in Asia. People living with HIV are at a much greater risk.
Fact 5: It is very easy to mistake the symptoms of active TB of the lung, but these may include coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats. If you have these symptoms don’t panic, but have them checked out.
Fact 6: TB is preventable and curable.
Fact 7: Multidrug-resistant TB (MDR-TB) is a form of TB that does not respond to the standard treatments using first-line drugs. Multidrug-resistant TB is a serious publichealth problem with key causes: poor patient compliance to treatment, lack of detection of resistant strains, and unavailable therapy.
| SITE INFECTION | SYMPTOMS OR COMPLICATIONS |
| Abdominal cavity | Fatigue, swelling, slight tenderness, and appendicitislike pain |
| Bladder | Painful urination and blood in urine |
| Bones (mainly children) | Swelling and minimal pain |
| Brain | Fever, headache, nausea, drowsiness, and, if untreated, coma and brain damage |
| Pericardium (the membrane around the heart) |
Fever, enlarged neck veins, and shortness of breath |
| Joints | Arthritis-like symptoms |
| Kidneys | Kidney damage and infection around the kidneys |
| Lymph nodes | Painless, red swollen lymph nodes, which may drain pus |
| Reproductive organs in men | Lump in the scrotum |
| Reproductive organs in women | Sterility |
| Spine | Pain, leading to collapsed vertebrae and leg paralysis |
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