Tuberculosis

What is tuberculosis?

Tuberculosis is a contagious disease caused by Mycobacterium tuberculosis bacteria which affects lungs and may spread to other areas in the body like brain and spinal cord.

Tuberculosis, often abbreviated as TB, is a bacterial infection caused by Mycobacterium tuberculosis. It has plagued humanity for centuries and remains a global health concern despite advances in medicine. In this comprehensive article, we will delve into the world of tuberculosis, exploring its history, causes, symptoms, prevention, diagnosis, treatment, and the global efforts to control its spread.

A Historical Perspective

It is not a recent disease; it has been known to humanity for thousands of years. Historical references to TB can be found in ancient texts from India, Egypt, and Greece. In the 19th and early 20th centuries, tuberculosis, often referred to as “consumption,” was a leading cause of death in Europe and North America.

The Cause: Mycobacterium Tuberculosis

Mycobacterium tuberculosis, the bacterium responsible for TB, is a slow-growing, acid-fast bacillus. It primarily affects the lungs but can also target other organs, such as the kidneys, spine, and brain. The bacterium spreads through the air when an infected person coughs, sneezes, or talks, releasing tiny infectious droplets that can be inhaled by others.

Symptoms of Tuberculosis

Tuberculosis can manifest in various forms, depending on the stage of infection and the body’s response to the bacteria. Common symptoms include:

1. Persistent Cough: A cough that lasts for more than two weeks, often producing thick, sometimes bloody sputum.

2. Fever: Mild to high-grade fever, usually in the afternoon or evening.

3. Night Sweats: Profuse sweating, particularly at night.

4. Weight Loss: Unexplained weight loss and loss of appetite.

5. Fatigue: Persistent tiredness and weakness.

6. Chest Pain: Pain or discomfort in the chest, especially while breathing or coughing.

7. Shortness of Breath: Difficulty breathing, particularly with physical activity.

TB Diagnosis

Diagnosing tuberculosis requires a combination of clinical evaluation, laboratory tests, and imaging studies:

1. Tuberculin Skin Test (TST): Also known as the Mantoux test, this involves injecting a small amount of purified protein derivative (PPD) under the skin. A positive reaction indicates exposure to TB but doesn’t confirm active disease.

2. Blood Tests: Interferon-gamma release assays (IGRAs) measure the body’s immune response to TB and can help diagnose latent TB infection.

3. Chest X-ray: Imaging the chest can reveal abnormalities such as lung cavities or infiltrates, suggesting active TB.

4. Sputum Culture: A sample of sputum is cultured to identify the bacteria and determine drug susceptibility.

5. Molecular Testing: Polymerase chain reaction (PCR) tests can detect TB DNA, providing rapid results.

Types of Tuberculosis

TB exists in two primary forms:

1. Latent TB Infection (LTBI): In this state, the bacteria are present in the body, but the immune system keeps them in check. LTBI doesn’t cause symptoms and is not contagious, but it can progress to active TB if left untreated.

2. Active TB Disease: When the immune system is unable to control the bacteria, active TB disease develops. It is contagious and can affect various organs, with pulmonary TB being the most common.

TB Treatment

The treatment of tuberculosis involves a course of antibiotics to eliminate the bacteria. The specific drugs and duration of treatment depend on the type of TB and drug susceptibility. Commonly used antibiotics include isoniazid, rifampin, ethambutol, and pyrazinamide.

Treatment for active TB usually involves a combination of these drugs taken for six to nine months. It’s crucial for patients to complete the entire course of treatment, even if they start feeling better before it’s finished. Incomplete treatment can lead to drug-resistant TB, a more challenging and costly form to treat.

Preventing Tuberculosis

Preventing tuberculosis is a crucial component of global efforts to control the disease. Key prevention strategies include:

1. Vaccination: The Bacillus Calmette-Guérin (BCG) vaccine provides some protection against severe forms of TB, primarily in children. However, it is not universally effective and does not prevent all TB cases.

2. Identifying and Treating Latent TB: Identifying and treating individuals with latent TB infection can prevent the development of active TB and its transmission to others.

3. Infection Control: Implementing infection control measures in healthcare settings and congregate settings, such as prisons and shelters, can reduce the risk of TB transmission.

4. Contact Tracing: Identifying and testing individuals who have been in close contact with active TB cases can prevent further spread.

5. Education and Awareness: Public education about TB symptoms, prevention, and the importance of completing treatment is essential.

Global Impact and Challenges

Tuberculosis remains a significant global health issue, particularly in low- and middle-income countries. Challenges include drug-resistant TB strains, limited access to healthcare, inadequate funding for TB programs, and the impact of HIV/AIDS on TB incidence.

Efforts to combat tuberculosis include international initiatives like the World Health Organization’s (WHO) End TB Strategy, which aims to reduce TB deaths, incidence, and catastrophic costs related to TB by 2030.

Symptoms of tuberculosis:

1- The latent form of TB has no symptoms.

2- The Active TB symptoms are:

• Severe cough that lasts for a long time more than 3 weeks.
• Bloody cough in some cases.
• Chest pain.
• Feeling physically exhausted and tired all the time.
• High temperature and fever.
• Sweating, especially at night, and chills in the body.
• Loss of appetite, which causes weight loss.

Transmission of tuberculosis:

1- Tuberculosis can be transmitted by direct contact with an infected person during talking, sneezing and coughing, the small particles when entered the healthy person’s body, he might be infected.

2- Tuberculosis can be transmitted by indirect contact when using patient tools.

3- Smoking shisha.

Risk Factors of TB:

1- Contact for a long period with an infected person at home or in work.

2- Smokers specially shisha smokers.

3- The areas with high rates of TB like: South Africa and russia.

4- Doctors and nurses who are treating TB patients and their families.

5- Veterinary doctors because TB is one of the common diseases between humans and animals.

Diagnosis of tuberculosis:

1- Skin Test.

2- Blood test.

Prevention of TB:

1- Take care while talking, coughing or sneezing if you are an infected person.

2- Wear a face mask if you are infected or have an infected family member at home.

3- Avoid crowding areas if you live or have travelled to an area where TB is common.

Tuberculosis vaccine:

BCG is the tuberculosis vaccine which is given to children in some countries like the United States if one of their patients is infected or has a TB drug resistance.

Treatment of tuberculosis:

Some antibiotics are used for the treatment of TB under doctors prescription for several months such as: isoniazid, pyrazinamide, and rifampin.

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