Tuberculosis - Prevention and Management

What Is Tuberculosis?

Tuberculosis is an infectious disease caused by bacteria. This disease can affect the respiratory system as well as other tissues like the brain, kidney, spine, or stomach. But the most commonly seen type of tuberculosis is the one affecting the lungs. Tuberculosis is commonly known as TB. All people who get infected with TB might not be symptomatic, but if someone has symptoms then they must consult the doctor and get the appropriate treatment. When a person is infected with the bacterium Mycobacterium tuberculosis, and does not have symptoms, they are called inactive tuberculosis or latent tuberculosis infection (also called latent TB). It may be sometimes mistaken that the infection has subsided, but in fact, it is in the dormant state, which means it is inactive or sleeping inside the body. But when someone is infected and has the symptoms, and can spread the disease from one person to another, then they have active tuberculosis or tuberculosis disease (TB disease).

There are three stages of tuberculosis, and they are:

• Primary infection.

• Latent tuberculosis infection.

• Active tuberculosis disease.

What Causes Tuberculosis?

Tuberculosis is a bacterial infection. They are caused by bacteria called Mycobacterium tuberculosis. They can spread through the air, and the most commonly affected site is the lungs. But it can also infect other parts of the body. Even though it is an infectious disease, it does not spread easily from one person to another. One must be in contact with an infected person for a long time to get infected with tuberculosis.

What Are the Symptoms of Tuberculosis?

People in the latent phase of tuberculosis will not exhibit any symptoms, but when tested, they will come out positive. The symptoms seen in active tuberculosis patients are as discussed below:

• Cough that lasts for more than two weeks.

• Pain in the chest.

• Cough with expectoration of either blood or sputum.

• Fatigue or weakness.

• Loss of appetite.

• Fever with chills.

• Weight loss.

• Night sweats.

How Is Tuberculosis Diagnosed?

For diagnosing the tuberculosis, there are some tests that are currently done and they are:

• Mantoux Tuberculin Skin Test (TST)- In this test, a doctor will inject something called purified protein derivative (PPD) beneath the skin of the forearm. Then two to three days after the injection, one must get back to the healthcare provider who will inspect the site of injection for any changes developed.

• Interferon Gamma Release Assay (IGRA)- This test is done by collecting the blood from the patient and sending them to laboratories for further investigation.

Other tests done to see if the lungs are infected with active tuberculosis include:

• Sputum and lung fluid examination.

• Chest X-ray.

• Computed tomography (CT) scans.

How Is Tuberculosis Treated?

Tuberculosis infection is treated with the following drugs:

• Isoniazid.

• Rifampin.

• Ethambutol.

• Pyrazinamide.

• Rifapentine.

The healthcare provider will prescribe these medicines, which should be taken as prescribed by them. All these medicines need to be taken for treating tuberculosis, or else all the bacteria will not be killed. These medicines can even be prescribed up to a period of nine months. Some of the tuberculosis strains may be resistant to these medications. So the healthcare provider might use a combination of drugs to treat in such cases. It is also important to complete the course duration as prescribed by the doctors to avoid recurrence of the infection.

What Are the Side Effects or Complications of Tuberculosis Treatment?

Some people have side effects from the drugs used to treat TB that may include:

• Skin rashes.

• Nausea.

• Stomach upset.

• Itchiness.

• Yellow skin or eyes (jaundice).

• Dark urine.

Consult with the doctor when one notices such side effects of the medication, as some of them might mean that there is liver damage.

How to Know if One Should Get Tested for Tuberculosis?

One can get tested for tuberculosis if:

• There are chances for developing tuberculosis when a person is working in the field of healthcare facilities where tey come in contact with different patient who may or may not be TB positive.

• Person working in microbiology laboratories as they are exposed to the samples.

• A person gets in contact with a person having the tuberculosis.

• The individual in question possesses diminished immunity due to the presence of underlying health conditions or as a result of undergoing immunosuppressive treatments.

• When someone has symptoms similar to tuberculosis.

• When the person is from an area where there is prevalence of diseases, like Caribbean, Africa, Asia, Latin America, Eastern Europe and Russia.

• The doctor recommends undergoing tuberculosis testing.

Others who are at risk for tuberculosis include:

• Infants and young children with an immature immune system.

• People with comorbidities like kidney disease, diabetes, or other chronic illness.

• Someone who had organ transplants.

• People being treated with chemotherapy for cancer or other types of treatments for immune system disorders.

How Is Tuberculosis Prevented?

Tuberculosis is widely spread in the world, and an estimated one quarter of the world’s population is prone to this infection. The immune system plays a major role in the spread of this infection. Also they depend on various other factors. There are treatments and vaccines available, which can be made use of, so that the infection can be prevented to a certain extent in regions where they are most prevalent. This way, both the individual and the community can be protected from getting this infection. WHO has developed certain guidelines to be followed in areas where they are more susceptible to spread faster like the healthcare facilities, congregate settings, and tuberculosis affected households. Tools such as the Prevent TB platform supports the national health systems to strengthen their strategic information. Apart from that, WHO also promotes preventive action by early screening of the condition and treatment for active cases, by considering the comorbidities and providing access to healthcare facilities for all.

Is There a Vaccine to Prevent Tuberculosis?

Some countries use the vaccine called Bacillus Calmette-Guerin (BCG) for preventing tuberculosis. These vaccines are given to children in countries where there is high prevalence of tuberculosis to prevent serious forms of TB and other complications from it. But this vaccine may make them eligible for the skin test for tuberculosis when done later in life.

Conclusion

Tuberculosis is a bacterial infection that can spread from person to person. This infection is seen mainly in the developing countries of the world. The infection can affect any tissue of the body but is mainly seen affecting the lungs. A person with tuberculosis may or may not show the symptoms but still be tested positive for tuberculosis, which will depend on the stage of infection they are in. When someone suffers from a prolonged cough, it is better to get tested for tuberculosis after consulting with a doctor.