Tuberculosis

About Tuberculosis

Tuberculosis

Tuberculosis is a common infectious disease caused by bacteria called mycobacterium tuberculosis which affects the lungs. Main symptoms of TB are severe cough that lasts for three weeks or longer, bloody or discoloured sputum, night sweats, fever, fatigue and weakness, pain in the chest, loss of appetite, and pain during breathing or coughing.

India had the highest total number of TB cases worldwide in 2010. Serious forms of TB can be prevented by BCG vaccination and maintaining high levels of hygiene. Maintaining cough hygiene is most important to maintain the spread of the disease. One infected, the patient should follow the medication regimen properly. By not doing so, there are chances of developing resistance to anti-TB drugs resulting in an aggressive form of TB called MDR-TB (multi-drug resistant TB).

Risk factors

TB or tuberculosis is an infectious disease caused by a bacterium called mycobacterium tuberculosis. It is when our immune system becomes weak for some reason or is overwhelmed by the infection or any other cause, that we suffer the disease (reactivation).

It mostly affects people whose immunity is compromised. eg: Infants, old people, pregnant women, women who have recently delivered, people living in unsanitary conditions, uncontrolled diabetes patients, cancer patients, HIV-positive people.
Also, if you are in close contact (living together/working together) with people suffering from TB, you have more risk of developing TB. Here are 3 challenges facing treatment of TB in India.
Alcoholics, people using illegal drugs and narcotics and people who weigh 10% lower than the recommended body weight are also predisposed to develop TB.

Read to know why is drug-resistant TB such a big challenge for India?

Symptoms

Symptoms of tuberculosis

During this time, the TB patient may experience these top 9 symptoms such as –

Chest pain
Coughing blood
Recurrent and constant cough
Night sweats
Fever
Loss of appetite
Pain in breathing or coughing
Fatigue and weakness
Enlargement of lymph nodes (in the neck and inside the chest)

TB of other organ systems present with varied symptoms. For example:

TB of the skin could present with a non-healing ulcer.
TB of the lymph nodes can present with swellings at multiple sites of the body.
TB of the spine could present with a backache, stiffness or even swelling in the back/groin.
TB of the intestines could present with abdominal distension and absolute constipation. Even a non-healing anal fistula could be due to TB.
TB of the covering of the brain and spinal cord can cause TB Meningitis and presents a headache altered sensorium.

Here is why you should be worried about drug-resistant tuberculosis.

Diagnosis

Primary TB is usually diagnosed with a sputum test. A small sample of the patient’s spit is collected and examined under the microscope for the presence of the bacteria.

Chest X-ray is also used to diagnose TB.

The skin test or ‘Mantoux test’ in which inactivated bacteria are injected under the patient’s skin, can only test for the presence of immune response and expose to TB at some stage.

When TB affects organs other than the lungs, tests like CT scans, MRI, biopsy, immunohistochemical methods using antibodies etc may be required.

WHO now recommends the Xpert MTB/RIF test which is a fully-automated test which can diagnose drug-resistant TB (MDR-TB) is just two hours. This can be used to test spectrum also other biological specimens.

Here is a detailed information on common diagnostic tests for tuberculosis.

Treatment

The treatment for TB takes a long time and involves following the doctor’s instructions very carefully. The entire course of drugs needs to be completed even if the patient ‘feels’ better. Not doing so can lead to relapse and development of drug-resistant forms of TB. You may also like to read the 6 strategies that can battle India’s TB epidemic.

The WHO recommended strategy for tuberculosis control is DOTS – Directly Observed Treatment, Short-Course. Some newer drugs like Bedaquiline, Delaminid and PA-824, are also being tested in various centres across India to treat both drug sensitive and resistant TB.

Read about antibiotic resistance – why it is more dangerous than you think.

Complications

Here are a few complications of the disease you should know about.

MDR tuberculosis
Meningitis
Permanent lung damage
Bone and joint problem
Liver or kidney inflammation
Cardiac problems

Here is detailed information on complications of tuberculosis.

Prevention

Although almost all of us are potentially exposed to TB in our lifetime, only some people.

Vaccination: All new born and infants should be given the Bacillus Calmette-Guerin (BCG) vaccine to protect them against TB. The vaccine enables the child to develop antibodies against the causative organism (Mycobacterium tuberculosis) of TB.

Keep your immunity high: A healthy lifestyle may prevent TB. Include fresh fruits and vegetables in your diet. Eat a complete meal that includes carbohydrates, proteins and fats. Quit smoking and drinking alcohol, exercise regularly and stay fit.

Maintain good hygiene: ‘Simple hygienic practices like covering the mouth while coughing, refraining from spitting in public places are still ignored by people, including those infected with TB,’ says Dr Pradip Shah, consultant physician at Fortis Hospital, Mulund.

Go to the right kind of specialist: Early diagnosis and treatment is the key to lower the number of deaths due to TB. If you notice any of the symptoms of TB, visit a doctor immediately.

Adherence to medication: One of the major reasons for the increase in the number of deaths is the development of drug-resistant TB which mostly arises from the non-adherence to treatment. Complete and adequate treatment of patients of TB is the most important means of decreasing further spread of infection in the community. Read more on how to prevent TB.

The Content has been verified by Dr Mrinal Sircar, Director, Dept of Pulmonology & Critical care, Fortis Hospital, Noida.

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