Tuberculosis or TB, as it’s commonly called, is an infectious disease that usually affects the lungs.
In 2015, 1.8 million people died from the disease, with 10.4 million falling ill.
Doctors make a distinction between two kinds of tuberculosis infection: latent and active.
Latent TB - the bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active.
Active TB - the bacteria do cause symptoms and can be transmitted to others.
About one-third of the world's population is believed to have latent TB. There is a 10 percent chance of latent TB becoming active, but this risk is much higher in people who have compromised immune systems i.e., people living with HIV or malnutrition, or people who smoke.
TB affects all age groups and all parts of the world. However, the disease mostly affects young adults and people living in developing countries.
In the 18th and 19th centuries, a tuberculosis epidemic rampaged throughout Europe and North America, before the German microbiologist Robert Koch discovered the microbial causes of tuberculosis in 1882.
Following Koch's discovery, the development of vaccines and effective drug treatment led to the belief that the disease was almost defeated. Indeed, at one point, the United Nations, predicted that tuberculosis (TB) would be eliminated worldwide by 2025.
However, in the mid-80s, TB cases began to rise worldwide, so much so, that in 1993, the World Health Organization (WHO) declared that TB was a global emergency; the first time that a disease had been labelled as such.
Fortunately, with proper treatment, the vast majority of cases of tuberculosis are curable. Without proper treatment, up to two-thirds of people ill with tuberculosis will die.
Causes of Tuberculosis
The Mycobacterium tuberculosis bacterium causes TB. It is spread through the air when a person with TB (whose lungs are affected) coughs, sneezes, spits, laughs, or talks.
TB is contagious, but it is not easy to catch. The chances of catching TB from someone you live or work with are much higher than from a stranger. Most people with active TB who have received appropriate treatment for at least 2 weeks are no longer contagious.
Since antibiotics began to be used to fight TB, some strains have become resistant to drugs. Multidrug-resistant TB (MDR-TB) arises when an antibiotic fails to kill all of the bacteria, with the surviving bacteria developing resistance to that antibiotic and often others at the same time.
MDR-TB is treatable and curable only with the use of very specific anti-TB drugs, which are often limited or not readily available. In 2012, around 450,000 people developed MDR-TB.
Symptoms of Tuberculosis
While latent TB is symptomless, the symptoms of active TB include the following:
Coughing that lasts three or more weeks, sometimes with mucus or blood
Chest pain, or pain with breathing or coughing
Loss of weight
Loss of appetite
Tuberculosis usually affects the lungs, but can also affect other parts of the body. When TB occurs outside of the lungs, the symptoms vary accordingly. Without treatment, TB can spread to other parts of the body through the bloodstream:
TB infecting the bones can lead to spinal pain and joint destruction
TB infecting the brain can cause meningitis
TB infecting the liver and kidneys can impair their waste filtration functions and lead to blood in the urine
TB infecting the heart can impair the heart's ability to pump blood, resulting in a condition called cardiac tamponade that can be fatal
Diagnosis of Tuberculosis
To check for TB, a doctor will use a stethoscope to listen to the lungs and check for swelling in the lymph nodes. They will also ask about symptoms and medical history as well as assessing the individual's risk of exposure to TB.
The injection site should be checked after 2-3 days, and, if a hard, red bump has swollen up to a specific size, then it is likely that TB is present.
Unfortunately, the skin test is not 100 percent accurate and has been known to give incorrect positive and negative readings.
However, there are other tests that are available to diagnose TB. Blood tests, chest X-rays and sputum tests can all be used to test for the presence of TB bacteria and may be used alongside a skin test.
MDR-TB is more difficult to diagnose than regular TB. It is also difficult to diagnose regular TB in children.
Treatments for Tuberculosis
The majority of TB cases can be cured when the right medication is available and administered correctly. The precise type and length of antibiotic treatment depends on a person's age, overall health, potential resistance to drugs, whether the TB is latent or active, and the location of infection (i.e. the lungs, brain, kidneys).
People with latent TB may need just one kind of TB antibiotics, whereas people with active TB (particularly MDR-TB) will often require a prescription of multiple drugs.
Antibiotics are usually required to be taken for a relatively long time. The standard length of time for a course of TB antibiotics is about 6 months.
TB medication can be toxic to the liver, and although side effects are uncommon, when they do occur, they can be quite serious. Potential side effects should be reported to a doctor and include:
Loss of appetite
Nausea and vomiting
It is important for any course of treatment to be completed fully, even if the TB symptoms have gone away. Any bacteria that have survived the treatment could become resistant to the medication that has been prescribed and could lead to developing MDR-TB in the future.
Directly observed therapy (DOT) may be recommended. This involves a healthcare worker administering the TB medication to ensure that the course of treatment is completed.
When to See a Doctor
See your doctor if you have a fever, unexplained weight loss, drenching night sweats or a persistent cough. These are often signs of TB, but they can also result from other medical problems. Your doctor can perform tests to help determine the cause.
The Centres for Disease Control and Prevention recommends that people who have an increased risk of tuberculosis be screened for latent TB infection. This recommendation includes:
People with HIV/AIDS
IV drug users
Those in contact with infected individuals
Health care workers who treat people with a high risk of TB
Prevention of Tuberculosis
If you test positive for latent TB infection, your doctor may advise you to take medications to reduce your risk of developing active tuberculosis. The only type of tuberculosis that is contagious is the active variety, when it affects the lungs. So if you can prevent your latent tuberculosis from becoming active, you won't transmit tuberculosis to anyone else.
Protect your family and friends
If you have active TB, keep your germs to yourself. It generally takes a few weeks of treatment with TB medications before you're not contagious anymore. Follow these tips to help keep your friends and family from getting sick:
Stay home. Don't go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.
Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn't move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside.
Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
Wear a mask. Wearing a surgical mask when you're around other people during the first three weeks of treatment may help lessen the risk of transmission.
Finish your entire course of medication
This is the most important step you can take to protect yourself and others from tuberculosis. When you stop treatment early or skip doses, TB bacteria have a chance to develop mutations that allow them to survive the most potent TB drugs. The resulting drug-resistant strains are much more deadly and difficult to treat.
In countries where tuberculosis is more common, infants often are vaccinated with bacillus Calmette-Guerin (BCG) vaccine because it can prevent severe tuberculosis in children.
Dozens of new TB vaccines are in various stages of development and testing.
The most important thing to do is to finish entire courses of medication when they are prescribed.
MDR-TB bacteria are far deadlier than regular TB bacteria. Some cases of MDR-TB require extensive courses of chemotherapy, which can be expensive and cause severe adverse drug reactions in patients.
Tuberculosis prevention and control efforts rely primarily on the vaccination of infants, early detection and appropriate treatment of active cases.
Countries with Higher Tuberculosis Rates
The following countries have the highest TB rates, globally:
Africa - particularly West African and sub-Saharan Africa
Southeast Asia - including Pakistan, India, Bangladesh, and Indonesia
Western Pacific region - including the Philippines, Cambodia, and Vietnam
Tuberculosis (TB) is one of the top 10 causes of death worldwide.
In 2015, 10.4 million people fell ill with TB and 1.8 million died from the disease (including 0.4 million among people with HIV). Over 95% of TB deaths occur in low- and middle-income countries.
Six countries account for 60% of the total, with India leading the count, followed by Indonesia, China, Nigeria, Pakistan and South Africa.
In 2015, an estimated 1 million children became ill with TB and 170 000 children died of TB (excluding children with HIV).
TB is a leading killer of HIV-positive people: in 2015, 35% of HIV deaths were due to TB.
Globally in 2015, an estimated 480 000 people developed multidrug-resistant TB (MDR-TB).
TB incidence has fallen by an average of 1.5% per year since 2000. This needs to accelerate to a 4–5% annual decline to reach the 2020 milestones of the "End TB Strategy".
An estimated 49 million lives were saved through TB diagnosis and treatment between 2000 and 2015.
Ending the TB epidemic by 2030 is among the health targets of the newly adopted Sustainable Development Goals.
....making effort to "STAYWELL"