Tuberculosis
Tuberculosis (TB) is a disease caused bybacteria called Mycobacterium Tuberculosis that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine, bone, tissues etc.
TB is treatable and curable with timely and proper medical management.
A look at public statistics!!
the WHO are alarming
new cases
deaths
cases
TB has also ravaged India.
As of 2018, India was home to the world’s largest number of patients suffering from TB. And at 2.74 million reported cases every year, India has the world’s highest share of all TB cases.
TB has also ravaged India.
TB spreads through direct close contact with someone who is infected with the disease. TB can be passed off to another healthy person as an air-based droplet infection.
When coughing, sneezing, and laughter, the patient with an open form of tuberculosis emits small droplets of phlegm containing tubercle bacilli into the air. which arescattered around at a distance of up to 1.5 m and are kept in air in the form of a suspension up to 30 minutes.
Modes of TB transmission
Ref: Adapted from Critical Reviews in Therapeutic Drug Carrier Systems, 29(4), 299-353 (2012)
Signs and Symptoms
Types of TB disease
Pulmonary TB or TB of the lungs – The most common site of infection for TB are the lungs. This is a highly contagious form of TB, if the patient is not under effective medical therapy.
Extra pulmonary TB – TB can occur in several other parts of the body. Extra pulmonary TB is also a serious infection and requires urgent medical attention. The common sites of the body that can get involved in this form of TB have been shown below:
MDR and XDR TB are a major concern for HIV positive patients
XDR TB is of special concern for persons with HIV infection or other conditions that can weaken the immune system. These persons are more likely to develop TB disease once they are infected, and also have a higher risk of death once they develop TB.
Ref: Adapted from https://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm
Drug Resistance has become a huge menace in the management of TB
Drug resistance is more common in people who
Ref:Adapted from https://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm
The clinical suspicion of TB begins with the symptoms. symptoms and the personal and medical history of the patient. Often TB outside the lungs, may present as a lump or an overgrowth. In the case of TB of the lungs, the doctor would want to take a radiograph (X-ray) of the lungs, perform certain lab tests on the sputum of the patient and if need be more advanced investigations like a bronchoscopy, testing of lung fluid, biopsy / CT scan may also be advised. A sputum culture is often the confirmatory test for TB of the lungs.
In case of TB suspected in areas other than the lung, the doctor may want to perform certain lab tests like the TB PCR or GeneXpert. This in addition to certain lab tests like blood culture which can confirm TB. A CT scan of the involved area may also be advised,
TB can be treated with antibacterial drugs. Around 10 such antibacterials have been approved for use by the FDA. The most common ones are isoniazid, rifampicin, ethambutol and pyrizinamine. These are called as first line drugs. In addition to these, there are other higher anti bacterials that are given to patients that do not respond to these drugs, especially those patients who are also HIV positive or those who have a drug resistant form of TB. While your doctor perform culture tests to diagnose TB through a blood sample, the culture report can also tell your doctor the specific drugs that would work in your case. In this way, the drugs suitable for every patient can be tailored from case to case, depending on the culture report.
• more effective against complex forms of TB inchildren
• of limited effectiveness in people over the age of 35
• less effective when given in equatorial regions (due to high levels of naturally occurring environmental mycobacteria)
• Good ventilation: As TB can remain suspended in the air for several hours with no ventilation
• Natural light: UV light kills off TB bacteria
• Good hygiene: covering the mouth and nose when coughing or sneezing reduces the spread of TB bacteria
• Use of protective masks, ventilation systems, keeping potentially infectious patients separate from other patients, and the regular screening of healthcare providers
