Tuberculosis

Live without TB and live forever. Early diagnosis and treatment can help eradicate TB.

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis.
The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain.
Not everyone infected with TB bacteria becomes sick.
As a result, two TB-related conditions exist: latent TB infection (LTBI) and TB disease.
If not treated properly, TB disease can be fatal.

Data and Statistics

The WHO TB statistics for India for 2021 give an estimated incidence figure of 2,590,000 million cases.
This is a rate of 188 per 100,000 population. The TB incidence is the number of new cases of active TB disease during a certain time period (usually a year).
India has the highest burden of this disease worldwide. The estimated TB incidence rate in the year 2017 for India is 204 per 1 lakh population with approximately 2.7 million people being newly diagnosed with TB. Within TB, the phenomenon gaining precedence is multi-drug resistant (MDR) and in India, about 2.8% of new cases and 11.6% of previously treated cases are MDR. India is the second-largest country with highest human immunodeficiency virus (HIV) associated TB incidence contributing to 10% of the global burden of the same. During 2000–2015, accumulating evidence infers that there were upward revisions in the estimates of the burden of TB disease. Evidence from household surveys, state-wide TB prevalence surveys, studies of anti-TB drug sales in the private sector, notification data, and new analysis of mortality data show that TB epidemic is more significant than previously estimated.⁽¹⁾

How TB Spreads

TB is an airborne disease in which bacteria spread through the air from one person to another. When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.
People nearby may breathe in these bacteria and become infected. People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates.

TB is not spread by

Shaking someone’s hand
Sharing food or drink
Touching bed linens or toilet seats

When to see a Pulmonologist/ Lungs doctor?

Symptoms of TB depend on where in the body the TB bacteria are growing.

TB bacteria usually grow in the lungs (pulmonary TB). TB disease in the lungs may cause symptoms such as:

A bad cough that lasts 3 weeks or longer
Pain in the chest
Coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms of TB disease are

Weakness or fatigue
Weight loss
No appetite
Chills
Fever
Sweating at night

Symptoms of TB disease in other parts of the body depend on the area affected.

Risk factors for TB

People may develop TB soon after becoming infected (within weeks) before their immune system can fight the TB bacteria.
Other people may get sick years later, when their immune system becomes weak for another reason

People who are more prone to TB

HIV infection (the virus that causes AIDS)
Substance abuse
Silicosis
Chronic liver disease
Diabetes mellitus
Severe kidney disease
Low body weight
Organ transplants
Head and neck cancer
Medical treatments such as corticosteroids or organ transplant
Specialized treatment for rheumatoid arthritis or Crohn’s disease.

Factors Contributing to the Spread of TB

Several factors contribute to the prevalence and spread of TB

City’s rapid urbanization
Overcrowding
Inadequate sanitation facilities
Poor ventilation, creating an environment conducive to the transmission of the bacteria
Socio-economic disparities and limited awareness about TB symptoms, prevention, and treatment hinder early diagnosis and contribute to the spread of the disease.

Treatment of TB

Treatment is possible if the patient has good compliance to (ATT) Anti tubercular treatment.

Six to 24 months duration medication can be planned depending on the resistance pattern of the organism.

TB Disease in Pregnancy

TB diagnosis in pregnancy is not easy, there is a greater risk to the pregnant woman and her baby if TB disease is not treated.
Babies born to women with untreated TB disease may have lower birth weight than those babies born to women without TB.
Rarely, a baby may be born with TB.

Testing for TB Infection for Pregnant Women

Pregnant women at high risk for developing TB disease should be tested for TB. Generally, pregnant women at high risk for developing TB disease include:

Persons who have been recently infected with TB bacteria
Persons with medical conditions that weaken the immune system

Chest x-rays should be avoided, ultrasound of chest can be done in suspected patients for tubercular infection in the lungs.

Treatment for TB in Pregnancy

Pregnant women who are diagnosed with TB disease should start treatment as soon as possible.
Although the TB drugs used in treatment cross the placenta, these drugs do not appear to have harmful effects on the baby.

Conclusion

It is always better to cure TB at early stages by identifying the symptoms and a reach out to a better care provider. The more sooner the treatment will start the better treatment outcomes will be there. It is possible to fight TB and give a good life if it its cured at its early stages.

References

Sharma P, Verma M, Bhilwar M, Shekhar H, Roy N, Verma A, Pardeshi G. Epidemiological profile of tuberculosis patienin Delhi, India: A retrospective data analysis from the directly observed treatment short-course (DOTS) center. J Family Med Prim Care. 2019 Oct 31;8(10):3388-3392. doi: 10.4103/jfmpc.jfmpc_409_19. PMID: 31742174; PMCID: PMC6857397.

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