Your Quick Guide to Tuberculosis

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More than 40% of the Indian population carry tuberculosis infection in their body, yet only 10% develop the disease. Read to know more about tuberculosis including its symptoms, diagnosis, treatment, and prevention.

What is tuberculosis?

Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis and most commonly affects the lungs (although other organs such as the spine, kidneys, and brain can also be involved).

Tuberculosis can be present in two different forms:

  • Latent TB: You are infected with TB-causing bacteria but your immune system is able to arrest its spread. You are neither contagious nor do you exhibit any symptoms. There is a possibility that the infection can get activated, though
  • Active TB: The bacteria increases in number and spreads to different body parts. You will experience the symptoms of TB

How does tuberculosis spread?

TB spreads through infected droplets released in the air that are carrying the invisible TB bacteria. When a person with active TB coughs or speaks and this air is inhaled by another healthy person, the bacteria enters the lungs, settles there, multiplies, causes symptoms of the disease, and spreads through the blood to other parts of the body such as the lymph nodes, spine, brain, kidney etc.

Who is at risk of developing TB?

  • People who come in contact with those infected with TB. This includes those living with infected people, healthcare workers who treat people with TB, etc.
  • HIV-positive persons
  • Substance abuse – alcohol, narcotics
  • Those under medicines that suppress their immune system
  • People who live in places with a high risk of TB transmission, such as slums, prisons, etc.

What are the symptoms of tuberculosis?

  • Persistent cough for more than 3 weeks
  • Chest pain
  • Coughing up blood or phlegm
  • Fever and chills
  • Night sweats
  • Loss of appetite
  • Weight loss
  • Tiredness
When the bacteria spread to other parts of the body, it causes other symptoms such as:
  • Back pain if the spine is involved
  • Headache and confusion due to brain involvement
  • Swelling of lymph nodes
  • Blood in the urine, burning sensation while urinating, abdominal pain, etc. if the kidneys are involved
  • Painless ulcers on the skin, tongue, etc.
TB

How is tuberculosis diagnosed?

If you’re experiencing persistent cough, fever, and night sweats for more than 2-3 weeks, you must consult a doctor for TB. After evaluating your symptoms and physically examining you, your doctor may advise you to undergo certain tests –

  • Blood tests
  • Sputum test: Your phlegm will be examined under the microscope to see if there are any bacteria
  • Chest X-ray
  • Culture: The TB bacteria from the patient are grown in the lab to find out which antibiotics are effective against them
  • Skin test (Mantoux tuberculin test): Your skin is injected with a small quantity of a fluid that contains purified proteins derived from the tuberculosis bacteria. After 48 to 72 hours, you will be asked to report back for measuring the size of redness and swelling in the area of injection to determine whether you are positive or negative. If your test comes back positive, further testing may be required. While Mantoux is useful in detecting exposure to tuberculosis, it is not very reliable in India, since it shows a positive result with the BCG vaccine as well.

How is tuberculosis treated?

Tuberculosis is treated aggressively through medicines taken through the mouth. In India, directly observed treatment (DOT) is a strategy used to ensure that all the patients diagnosed with TB are taking their full course of medicine.

Patients will report to a DOT centre daily and take the medicines under the direct observation of the DOT provider. There are 5 primary medicines used for the treatment of TB. These are:

  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol
  • Streptomycin

All these medicines are combined into one tablet. Your duration of treatment may vary between 6 to 8 months, depending on the severity of the infections. Additional medicines may be added if you are infected with drug-resistant TB, since it does not respond to normal treatment (fluoroquinolones, amikacin, kanamycin, etc.).

How will tuberculosis impact my pregnancy?

If you develop tuberculosis during pregnancy, it may give rise to complications in pregnancy such as:
  • Spontaneous abortion
  • Premature delivery of the baby
  • Low birth weight baby
  • Increased risk of infant death
  • Rarely, the baby may be born with TB
The medicines used for treatment are generally safe for the baby. However, some medicines may be harmful (streptomycin, kanamycin, amikacin, capreomycin, and fluoroquinolones) and hence, you need to let your doctor know if you are pregnant.

Is tuberculosis deadly?

If left untreated, TB can spread to different parts of the body and create multiple complications, ultimately leading to death. However, it can be completely cured if detected early and treated aggressively.

I have TB. How can I prevent the infection from spreading to others?

  • Seek medical care and complete the full course of medicines
  • Cover your mouth properly while you cough or sneeze
  • Do not spit in public places
  • Refrain from visiting others and do not invite people to your home until you are
  • completely cured of the infection
  • Wash your hands properly with soap after you cough and sneeze

What is the BCG vaccine?

The Bacillus Calmette–Guérin (BCG) vaccine is given to all infants born in India within a few days after birth. This vaccine protects babies from developing severe complications of tuberculosis such as brain and spine infections. The vaccine is given as an injection. It is not found to have much effect on adults.

What are the complications of tuberculosis?

  • Spinal tuberculosis(TB)  involves the spine resulting in back pain and stiffness
  • Tuberculous arthritis Joint damage affecting the hips and knees
  • Liver or kidney problems
  • TB meningitis is due to a brain infection resulting in headaches, confusion, etc
  • Heart problems
Dr. Sosa
WRITTEN BY

Dr. Sosa

MDS

An oral physician turned medical writer who writes profoundly about medicine and diseases. Read her contributions and writings about various healthcare topics.

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