Tuberculosis

Tuberculosis is an infectious disease of respiratory system which mainly affects lungs.

It is mostly associated with HIV/AIDS virus. It may affect people of all ages.

Many strains of tuberculosis bacteria are becoming resistant to drugs used for its treatment nowadays.

Chronic treatment is required to completely treat tuberculosis. Treatment may continue for several months.

Tuberculosis infection began increasing from 1985 but was decreased in 1993 due to strong control programmes.

Symptoms of tuberculosis depends on stage of the disease. There are 2 stages of this infection.

Latent TB

In this stage, bacteria are present in the body but in an inactive form. Infection does not spread in this stage. There are no noticeable signs and symptoms at this stage.

Active TB

In this stage, infection can spread from person to person via airway.

Signs and symptoms of active TB include:

• coughing for 3 or more weeks,
• coughing up blood,
• chest pain,
• weight loss,
• fatigue,
• fever,
• night sweats,
• chills
• and loss of appetite.

Tuberculosis can spread to other organs as well. Depending on the organ infected symptoms vary from back pain to blood in urine.

Tuberculosis is caused by mycobacterium tuberculosis.

Common way of acquiring of this infection is through airways when an infected person:

• coughs,
• speaks,
• sneezes,
• spits,
• laughs
• and sings.

It is also noted that tuberculosis infection occurs after weakening of immune system in cases like immune suppressive therapy, HIV/AIDS virus and cancer.

Diagnosis of tuberculosis starts with physical examination in which doctor examines for swelling of lymph nodes.

With the use of stethoscope, doctor performs auscultation of lungs. A simple skin test in which a substance called PPD tuberculin is injected just below skin of the forearm.

Within 48-72 hours, the injected site is checked for swelling. If there is a hard raised red bump, it means that, the person is likely to have TB infection.

Tb skin test is not accurate always, so further investigations are required to confirm the diagnosis.

Some of the tests include:

Blood test

Atent or active tuberculosis can be identified.

Imaging tests

A positive skin tests leads to chest X-ray or CT scan. They show white spots in lungs where immune system has walled off the TB bacteria. CT scan provides more detailed picture of the disease.

Sputum test

If chest X-ray shows signs of tuberculosis, sputum tests are recommended. The sputum samples are sent to laboratory to test for the presence of TB bacteria. These test can also be used to test for the presence of drug resistant strains of TB bacteria.

Treating tuberculosis takes much longer than treating other infections.

To treat tuberculosis, it takes at least 6-9 months. Course of the treatment depends on distribution of bacteria in the body and presence of drug resistant strains.

Most common TB drugs are:

• Isoniazid,
• Rifampicin,
• Ethambutol
• and Pyrazinamide.

A drug resistant TB infection requires combination of antibiotics commonly fluoroquinolones and amikacin are used. Some of the new drugs to treat resistant strains include Bedaquiline and Linezolid.

Common side effects of the medications include:

• nausea,
• loss of appetite,
• dark urine,
• yellow color of skin
• and fever. 

If latent tuberculosis was diagnosed, doctor will recommend medications to prevent the development of active tuberculosis.

Using personal protective equipment such as mask and gloves when working with patients with TB.

Infants must be vaccinated with BCG vaccine to prevent tuberculosis in children. BCG vaccine should be given according to schedule.

Maintaning proper hygienic circumstances is very important to prevent infections.    

Some popular home remedies for tuberculosis are:

• Garlic: Sulfuric acid of garlic kills germs of TB.
• Bananas: Tey boost patient’s immune system to fight the infection.
• Drumstick: It has anti-inflammatory and anti-bacterial properties.
• Indian gooseberry: Its anti-inflammatory and anti-bacterial properties can be used against TB bacteria.

Some of the additional home remedies are:

• oranges
• and custard apple.

Lifestyle modifications are necessary in order to cope with tuberculosis.

Treating tuberculosis is a very long process.

Maintaining the schedule of treatment will be helpful.

Denial, anger and frustration can develop during the course of treatment so it is important to be patient and not lose hope.

Seeking help of professionals such as behavioral psychologists and therapist will help to develop positive feelings and provide better coping strategies.   

There are several risks and complications associated with tuberculosis.

Risks

Anyone can contract tuberculosis infection. But certain factors increase the risk they include:

• Weakened immune system: A healthy immune system often successfully fights TB bacteria. A number of diseases and underlying medical conditions can weaken the immune system such as:
  • HIV/AIDS,
  • Diabetes,
  • Kidney disease,
  • Cancer,
  • Chemotherapy,
  • Immunosuppressant’s,
  • and malnutrition.
• Travelling to a new place: Travelling to certain new places in which rate of tuberculosis is high can increase the risk of a person to contract tuberculosis. Places include:
  • Africa,
  • Europe,
  • Asia,
  • Russia,
  • Latin America
  • and Caribbean Islands.
• Poverty and substance abuse: Lack of medical care due to poor income can be considered as a risk factor, substance abuse such as alcohol or intravenous drug abuse makes immune system weaker and more vulnerable to tuberculosis, use of tobacco greatly increases the risk of TB.
• Circumstances: Regular contact with people infected with TB increases the risk of contracting infection:
  • people who work in prisons,
  • immigration centers
  • and nursing homes are at high risk of acquiring TB infection.

Tuberculosis can spread to other internal organs from lungs through blood stream.

Complications

Some of the complications include:

• Spinal pain - back pain and stiffness are common complications.
• Joint damage: Tuberculous arthritis affects hips and knees.
• Meningitis: Swelling of membranes that cover brain can cause:
  • headache,
  • mental illness is also possible.
• Liver or kidney problems: Function of liver and kidneys can be impaired.
• Heart disorders: Pericarditis can occur if tuberculosis infects heart. This interferes with heart’s ability to pump blood.