Understanding Tuberculosis (TB)
Introduction
Tuberculosis (TB) remains one of the world’s deadliest infectious diseases despite being both preventable and curable. According to the World Health Organization (WHO), in 2022 alone, approximately 10.6 million people fell ill with TB, and about 1.3 million died from the disease, making it one of the top 10 causes of death worldwide. TB is caused by the bacterium Mycobacterium tuberculosis and primarily affects the lungs, although it can attack other parts of the body such as the kidneys, spine, and brain.
What Is Tuberculosis?
Tuberculosis is an infectious disease that typically attacks the lungs (pulmonary TB), but it can also affect other parts of the body (extrapulmonary TB). The causative agent, Mycobacterium tuberculosis, is a slow-growing bacterium that spreads through the air when an infected person coughs, sneezes, or speaks.
Types of TB
- Latent TB Infection (LTBI): The person is infected with Mycobacterium tuberculosis, but the bacteria are inactive. They do not feel sick, do not have symptoms, and are not contagious. However, latent TB can become active later, especially if the immune system becomes weakened.
- Active TB Disease: The bacteria are active and multiplying. The person shows symptoms and can spread the disease to others. Immediate treatment is required to prevent complications and further transmission.
Causes and Risk Factors
Causes
TB is caused by the bacterium Mycobacterium tuberculosis. It spreads from person to person through airborne droplets released when an infected person talks, coughs, or sneezes.
Risk Factors
- People with weakened immune systems
- Malnourished individuals
- People living in crowded conditions
- Health care workers
- Substance abusers
- Young children and the elderly
Symptoms of TB
The symptoms of TB depend on where the bacteria are growing in the body.
Pulmonary TB (affecting the lungs)
- Persistent cough lasting more than three weeks
- Coughing up blood or sputum
- Chest pain or pain with breathing
- Unexplained weight loss
- Fever and chills
- Night sweats
- Fatigue
Extrapulmonary TB
Depending on the organ affected, symptoms vary:
- TB of the spine: Back pain
- TB of the kidneys: Blood in urine
- TB of the brain (TB meningitis): Headaches, confusion, neck stiffness
How TB Spreads
TB is spread through the air from person to person. When someone with active TB coughs, sneezes, or speaks, they release tiny droplets that contain the bacteria. These droplets can be inhaled by others nearby, infecting their lungs.
Important:
- TB does not spread through shaking hands, sharing food, or touching surfaces.
- People with latent TB do not spread the disease.
Diagnosis
Early detection is crucial for effective treatment and to prevent transmission.
Diagnostic Tests
- Tuberculin Skin Test (TST): Also known as the Mantoux test.
- Blood Tests: Interferon-gamma release assays (IGRAs).
- Chest X-ray: Used to detect abnormalities in the lungs.
- Sputum Test: Microscopic examination and culture of sputum.
- Molecular Tests (e.g., GeneXpert MTB/RIF): Rapid detection of TB and drug resistance.
Treatment
TB is treatable and curable with proper medication and adherence to treatment guidelines.
Drug Treatment
- Standard TB Treatment: 6-month regimen with isoniazid, rifampicin, pyrazinamide, and ethambutol.
- Drug-Resistant TB: Requires longer treatment with second-line drugs.
Directly Observed Therapy (DOT)
A healthcare worker supervises the patient taking each dose of medication. Ensures adherence and reduces drug resistance.
Prevention
BCG Vaccine
The Bacille Calmette-Guérin (BCG) vaccine protects infants and young children from severe forms of TB.
Infection Control
- Early diagnosis and treatment
- Isolation of contagious patients
- Good ventilation
Preventive Therapy
- Latent TB patients may receive antibiotics to prevent activation.
- High-risk groups should be screened and treated accordingly.
TB and HIV Co-Infection
HIV increases the risk of active TB. TB is the leading cause of death among people with HIV.
Integrated treatment and simultaneous administration of ART and TB medications are essential.
Global Efforts to Fight TB
WHO's End TB Strategy
- Integrated, patient-centered care and prevention
- Bold policies and supportive systems
- Intensified research and innovation
Challenges
- Drug-resistant TB
- Lack of access to healthcare
- Stigma and discrimination
- Underfunding of TB programs
Conclusion
Tuberculosis remains a serious global health issue despite medical advances. It disproportionately affects vulnerable populations, especially in low- and middle-income countries. However, with proper diagnosis, treatment, and public health strategies, TB can be controlled and eventually eliminated. Public awareness, political commitment, and continued investment in TB programs and research are essential in the global fight against this deadly disease.
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