Written by Narayana Health March 24, 2022
World TB Day
Tuberculosis (TB) is a contagious disease caused by a bacterium (Mycobacterium tuberculosis). The Mycobacterium mainly affects our lungs. But it can spread to other body parts (kidneys, brain, extraperitoneal, and spine).
Tuberculosis was once a terrifying disease globally, but now with the latest advancement in medical sciences, tuberculosis-related casualties are becoming less.
Tuberculosis is a contagious disease, but not everyone infected with Mycobacterium becomes sick. People with weakened immunity have high chances of getting TB. In our body, there can be two types of tuberculosis infections:
Latent TB infection (LTBI): When some people get exposed to the pathogen, they don’t show any signs of infection. The tuberculosis bacteria remain in a dormant stage in their system.
Active TB disease: This happens when a person shows symptoms of tuberculosis when exposed to bacteria.
How do we get tuberculosis infection?
TB is an air-borne infection. It spreads through the inhalation of bacteria-contaminated air droplets. When a person with an active tuberculosis infection sneezes or coughs, tiny bacteria-laden droplets get expelled into the surrounding air. And a person can develop TB from inhaling such infected air.
It sounds very fearsome, but the chances of getting an infection from a single exposure to these droplets are low in immune-rich people. The risk of tuberculosis may be higher in people who remain in constant contact with an active tuberculosis patient.
Who is more at risk for tuberculosis?
TB can affect people of any age, economic status, and race.
People who are at higher risk are:
People living with TB infected person
People working with TB infected co-worker
People with compromised lung conditions such as silicosis
Chronic smokers
Homeless poor people
A person residing in TB prevalent areas
Healthcare workers working in high-risk areas such as nursing homes
History of drug or substance abuse
People with weakened immunity
Old age people
A person with chronic medical conditions such as diabetes, severe kidney diseases, and cancer
New-borns and young children as they have weak immunity
People receiving steroid treatment like in case of organ transplant
What are the common symptoms of tuberculosis?
Tuberculosis mainly affects our lungs. So, the symptoms of TB can be easily confused with other lung diseases or conditions. However, each patient may feel symptoms differently.
Some common symptoms of TB are:
Cough more than three weeks. It is the most prominent symptom of TB
Pain in chest and back area
Mild to moderate fever
Sometimes blood in sputum
A feeling of fatigue the whole day
Loss of appetite
Unexpected weight loss
Feeling chills and sweating at nights
Children suffering from TB may show poor growth
How can we diagnose TB?
Case history:
Patients generally complain of having a cough for more than three weeks that is not improving or reoccurring after some medication. Chest pain, malaise, and unintentional weight loss are common complaints of patients suffering from TB.
Skin test (Mantoux test): In this test, a small amount of tuberculin extract inject under your forearm skin. If you are positive for infection, your skin at the injection site becomes red and inflamed. The test can be falsely positive if you have had the BCG vaccination.
Sputum test: It detects tuberculosis bacilli in sputum
Chest X-ray: It can show how much damage our lungs have suffered because of TB
Interferon-Gamma Release Assay (IGRA): It is a blood test and can diagnose latent TB
What is the treatment of TB?
Treatment of tuberculosis depends on many factors:
Age of the patient
General health
Severity of symptoms
Duration of the symptoms
Presence of other medical conditions like diabetes
Patient’s preference of treatment
After the complete analysis of case history and tests, your healthcare provider can suggest the best treatment that can include:
Short duration hospitalization for treatment of aggravated symptoms
For newly diagnosed latent TB cases: Two types of medical treatment are available for latent TB. Either of them is equally potential.
Antibiotic isoniazid course for 6 to 12 months to kill pathogenic bacteria
Combination of two antibiotics for three months
For active TB infection: According to your symptoms and recovery rate, your healthcare provider may prescribe three or more antibiotics in combination (isoniazid, rifampin, pyrazinamide, and ethambutol) for 6 to 9 months.
After starting treatment, patients feel improvement in their health. Do not discontinue your treatment in-between, as permanent damage to your lungs can occur.
Is TB preventable?
Yes, it is a preventable and curable disease. If you spend time with an active TB person, wear a mask and try to maintain distance. You should avoid staying in an enclosed space with poor ventilation with an infected person.
Childhood vaccination against TB (BCG vaccine) provides immunity against infection.
The long duration of the treatment and its damaging side effects can cause physical and emotional trauma to many patients. On this World TB Day, let’s join hands to prevent the spread of the disease and put an end to tuberculosis.
Dr. Nitin Rathi| Senior Consultant – Pulmonology| Dharamshila Narayana Superspeciality Hospital, Delhi
