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Tuberculosis: Overview, Causes, Symptoms and Treatment

Overview

Tuberculosis is among 10 causes of death and the leading cause of a single infectious agent (above HIV/AIDS). In 2018, an aggregate of 1.5 million people died from TB and almost 10 million people fell ill with TB worldwide. However, TB is curable and preventable. Globally, nearly 1.1 million children fell ill with TB and the death rate in the child was 2 lakhs due to TB. Child and adolescent TB is often ignored by healthcare professionals and can be problematic to diagnose and treat. Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. Approximately, 484 000 new cases with resistance to rifampicin – while 78% had MDR-TB. The Tb incidence rate is falling 2% per year. An estimated 58 million lives were protected through the proper diagnosis and treatment of TB between 2000 and 2018.

How Tuberculosis spreads?

TB is caused by the bacteria named Mycobacterium tuberculosis that most often affects the lungs. However, this is curable and preventable. TB is spread from one person to another person through the air. When people with TB cough, speak, sneeze or spit, they spread the germs into the air. A person who inhales only a few of these germs become infected.

TB is NOT spread by

  • shaking hand
  • sharing food or drink
  • touching clothes or toilet seats
  • sharing toothbrushes
  • kissing

About one-quarter of the population of the world has latent TB, which means individuals have been infected by TB but are not ill with this disease and also cannot convey the disease.

Types of TB

It may be considered in two categories i.e. active disease or latent infection. The most common type of active TB is lung disease but it may also attack other organs, so-called “Extrapulmonary TB.”

Active TB Disease

An active TB is a disease in which the bacteria are quickly multiplying and attacking multiple organs of the body. The usual symptoms of active TB irregularly include cough, mucus, chest pain, faintness, weight loss, fever, chills and sweating at night. A person with active pulmonary TB disease may spread TB to others.

Miliary TB

This is a rare form of the disease that happens when the bacteria get their way into the bloodstream. In this type, the bacteria rapidly spread all over the body in tiny nodules and affect the multiple organs. This TB can be deadly.

Latent TB Infection

The people who are infected with TB do not develop the disease. They have no signs and their chest x-ray is normal. The only indicator may be a reaction to the tuberculin skin test (TST). On the other hand, there is an ongoing risk that the latent infection may increase to active disease.

Who is most at risk?

  • Tuberculosis mostly affects all age groups. People who are ill with HIV are nineteen times more probable to have active TB.
  • The people with undernutrition are three times more likely to develop the disease. There were 2.3 million new TB cases in 2018 that contributed to undernutrition.
  • In alcohol users.
  • In smokers.
  • Persons who have been recently infected with TB.
  • Persons with diseases that weaken the immune system.

Global status of TB

TB happens in every part of the world. The prime number of new TB cases happened in the South-East Asian region (44 new cases), followed by the African region (24% new cases) and the Western Pacific (18% new cases). In 2018, about 87% of new TB cases happened in the 30 high TB burden countries. including India, Indonesia, Philippines, Pakistan, Bangladesh, Nigeria, China, and South Africa.

Symptoms

Common symptoms of active lung TB are

  • cough with sputum and blood at times,
  • chest pain
  • weakness,
  • weight loss,
  • fever and
  • night sweats.
  • a cough that lasts more than 3 weeks
  • feeling tired all the time
  • chills
  • fever
  • loss of appetite

Diagnosis

Sputum smear microscopy to diagnose TB

The highly Skilled laboratory specialists look at sputum samples under a microscope to observe the TB bacteria and their presence. This microscopy notices only half the number of cases while cannot detect drug-resistance.

Mantoux tuberculin skin test (TST) or the TB blood test

They can be used to test for M. tuberculosis infection. In the Mantoux tuberculin skin test, inject a small quantity of fluid called tuberculin into the skin in the lower portion of the arm. The test is read within 48 to 72 hours by a skilled healthcare worker who will look for a response on the arm. However, the TB blood test measures the patient’s immune system reaction to M. tuberculosis.

Treatment

TB is an improvable and curable disease. The TB disease is treated with a typical 6-month course of four antimicrobial drugs. There are two phases of treatment i.e. intensive and continuous phase.

  1. Rifampicin
  2. Isoniazid
  3. Pyrazinamide
  4. Ethambutol

Prevention

If the patient is diagnosed with TB, he/she will be infectious up to about 2 to 3 weeks during the course of treatment. However, that is imperative to take some elementary precautions to stop spreading TB in society. The following are the precautionary measures.

  • The patient should stay away from the workplace, school or university.
  • The patient should always cover the mouth, if possible with a throwaway tissue while coughing, sneezing or laughing.
  • The proper disposal of any used tissues in a sealed plastic bag.
  • You should open the windows to ensure a virtuous supply of fresh air in the zones where you pass time.
  • They should sleep in an isolated room for avoiding the spread of the disease.

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