Tuberculosis

Tuberculosis (TB) is an infectious disease that primarily affects the lungs.  Later the disease can affect other parts of the body including the brain and spine. Earlier, tuberculosis was known as “consumption” due to its nature of consuming an infected human body from within. Tuberculosis is contagious but it is not easy to catch, as you are likely to get it from someone.

Types

• Tuberculosis can be divided into three categories:
• Active Tuberculosis: In this type the TB bacteria gets rapidly multiplied and invades different organs of the body
• Miliary Tuberculosis: It is a rare form which occurs when the TB bacteria spreads into the bloodstream of the person 
• Latent Tuberculosis: In latent tuberculosis, the infected person do not develop an overt disease and do not show any symptoms and the chest x-ray is also normal

Tuberculosis is caused due to bacteria known as Mycobacterium tuberculosis that spreads from person to person through airborne particles i.e. when people infected with the bacilli cough, sneeze, talk or spit, they propel TB germs known as TB bacilli into the air. When the bacilli are inhaled by a healthy person, he or she gets infected. Even a small number of the bacilli can cause the infection. There are some people who do not respond adversely to the infection at all, while in some the tuberculosis bacteria is destroyed very soon after it enters the human body. It depends on the immune system of the person.

Some of the risk factors which can increase the risk Tuberculosis of may include: 

Weak Immune System: Your immune system can be week due to many reasons like alcohol abuse, drug abuse, unhealthy lifestyle, living close to unsanitary conditions, medications that suppress the immune system or chronic health condition that mars immunity like diabetes or HIV. In any such circumstance the chances of being infected with tuberculosis increases.

Ageing: Aged people are at an increased risk of tuberculosis as they have a greater probability of having a medical condition which weakens their immune system.

Exposure to Infected People: Continuous exposure to a person infected with TB increases the risk of contracting it. It is one of the major risk factors. Nursing homes, immigration centres, hospital or prison have inadequate ventilation or overcrowded environments may increase the exposure to infected people.

Poor Healthcare: Individuals with poor access to quality health and medical care are naturally at an increased risk of this disease. This is simply because they cannot bear the expense involved in diagnosis and treatment of the disease.

Traveling: The tuberculosis bacteria are present in only 1-3rd of the global population which remains suppressed by a good immune system in most of them. Now, if someone were to travel from one region of the world where the incidence of this bacterium is less to a region where it is prominent, the risk of exposure naturally increases.

Some chronic diseases can also increase the risk of developing tuberculosis like diabetes, head or neck cancer, HIV or AIDS and kidney diseases.

There are no initial symptoms of tuberculosis but some usual signs and symptoms may include:

• A cough that lasts more than 3 weeks
• Constant tiredness
• Chest pain
• Coughing up blood
• Chills
• Fever
• Night sweats
• Loss of appetite
• Weight loss

These are the initial symptoms but if not treated on time it can affect other parts of the body as well apart from lungs through the bloodstream. Symptoms on other parts of the body include:

• Bones: Spinal pain and joint destruction or weak bones
• Brain: It can trigger meningitis
• Liver and kidneys: It can disturb the waste filtration functions and a person may notice blood in the urine
• Heart: It can impair the heart's ability to pump blood which can result in cardiovascular diseases

Tuberculosis can be treated with a combination of medications. The treatment continues for a time period of nine to ten months.

Medications for Tuberculosis  

Some of the commonly used medications for treatment of TB include Isoniazid, Rifampin, Ethambutol and Pyrazinamide. Unlike most other bacterial infections in which one or two drugs are prescribed for a short duration (5-7 days), treatment of TB needs multiple medicines for months. Multiple medicines are given to prevent the emergence of drug resistance and treatment failure. Most cases of TB are given a combination of 3 or 4 drugs for 2 to 3 months, which is followed by 2 or 3 medications for few more months. Single medicines are never given as the TB bacilli develop resistance to the drug quite rapidly.

Duration of treatment: Most people improve after a few weeks upon starting treatment, but the TB bacteria are still active in their bodies. Complete cure of infection needs months of treatment (in most cases 6-9 months). Your doctor will recommend drugs and the length of treatment depending on your age, overall health, possible drug resistance, the form of TB (latent or active) and its location in the body. Taking all the recommended drugs in the recommended dose for the entire duration of treatment is important for cure. The main cause of treatment failure is non-compliance (missing dose, not taking medications for the recommended duration etc) with treatment.

Drug-resistant TB: Drug-resistant TB has increased considerably in the past few years. Some factors that contribute to drug resistance include not taking medications as recommended, not completing the treatment and having HIV/AIDS. Drug-resistant TB does not respond to the standard medications, needs more number of medications, is much harder to treat and has a higher risk of death than non-drug-resistant TB.

Latent TB: If you have latent TB, the doctor may prescribe just one or two types of TB drugs for a few months.

Medication for TB can cause serious complications. Discuss with your doctor the possible side effects of TB drugs and consult your doctor immediately if you experience any of them. If you are pregnant, inform your doctor as some drugs increase the risk of complications in the baby. TB must be treated urgently in pregnancy as the disease may progress rapidly and increase the risk of TB complication for the mother and the baby.