TB or Tuberculosis: a disease which is still rampant in our society yet has been associated with significant stigma even at this juncture.
For sustained results on the goal towards elimination of TB,effective utilisation of resources must be carried out in ways acceptable to those affected.
What is TB?
TB is an infectious bacterial disease,that mainly affects the lungs.It is evident from this statement itself that TB is not limited to lung.That is to say,other forms of Tuberculosis are also there.However,the most common form is pulmonary Tuberculosis-that which affects the lungs-and is the most common cause for infection to spread from one person to another.Tuberculosis occuring in other parts of the body(Extrapulmonary TB) is not as infective as Pulmonary TB and hence will not spread in the usual fashion.
What is the prevalence of TB in our society?
Tuberculosis is considered as a disease of the developing nations.As per reports,the prevalence of all forms of TB in India for the year 2021 was 312 per lakh population with the highest prevelance in Delhi.
What are the symptoms of TB infection?
You should get yourself evaluated for TB if you have any of the following symptoms:
Cough lasting for more than 3 weeks
Fever with evening rise of temperature and night sweats
Coughing up blood in sputum
Unexplained weight loss
Loss of appetite
Any symptom with history of exposure to an active TB patient
These are the signs of pulmonary TB.Extrapulmonary TB presents with symptoms peratining to the organ systems invoolved.Some examples are:
Swelling on the side of neck in case of TB affecting lymph nodes of neck
Troubling backache in TB of Spine
Blood in urine and recurrent bouts of urinary infection in Tb of kidney
Pain in the abdomen and bowel irregularities in Abdominal TB,etc...
Who are at increased risk for contracting TB?
Centre for Disease Control(CDC)recommends screening of the following class of population to be screened for latent TB:
HIV positive individuals(AIDS)
Intravenous Drug Abusers
Exposure to active untreated cases of TB
Health care workers who are exposed such as respiratory physicians
People from places where TB is prevelant
Children of adults who have TB
However,remember that, although Tb is contagious,it is not that easy to catch.Most of the people with TB after initiation of the appropriate treatment regimen cease to be infectious within 10-14 days!Also,TB catches you when your immunity is weak such as in AIDS,Diabetes,cancer,malnutrition,immunosuppressant treatment regimens as well as in those using drugs,tobacco etc which adds to the insult.
TB and AIDS
HIV infection is one of the leading causes behind the emergence and progression of TB in developed countries.Naturally,all patients with HIV must be followed up for the same and vice-versa.
Drug resistant strains have been on the rise which are further classified into multidrug resistant and extremely drug resistant strains.These are bit difficult to treat and hence needs stringent adherence to treatment protocols.It is the same reason why patients are educated regarding the importance of taking the medications as advised even after resolution of symptoms.
How is TB diagnosed?
The crux of the diagnosis of TB lies in the detection of the tubercle bacteria(AFB)in the body secretions-sputum,urine,bronchial secretions etc.Imaging investigations such as chest X-ray,CT scan of chest or Abdomen can aid in the diagnosis to a great extent.
The most common extrapulmonary form of TB is that which affects the lymph nodes of the neck.The diagnosis in this case is dependent upon the pathological examination of the surgically removed node.Specific tests such as Gene Xpert studies can identify even minute traces of the bacteria in the specimens.
How is Tuberculosis treated?
Once the diagnosis is evident,early initiation of appropriate treatment is the key for complete recovery.The advent of ATT(Anti-Tubercular Therapy) sure did revolutionize the treatment of TB.Based on the category and type of TB,the regimen duration varies.Basically,ATT comprises of minimum of four antimicrobial for a minimum of six months.In Drug Resistant cases,more drugs or second generation drugs might be added and the duration also might be prolonged.Since these drugs can have potential adverse effects as well,it is important to have frequent and regular follow ups as advised by your doctor.In some cases,surgical management might be needed as in intestinal tuberculosis causing bowel obstruction.
COVID and TB
As Covid struck the world in 2020, initially there were setbacks in TB elimination strategies as the pandemic took centrestage.But once the first wave started settling,the Government could bring back the surveillance programmes effectively.It was essential to teach the public that prolonged cough and fever might be TB also and not always corona infection.There was a mild decrease in incidence of TB probably due to underreporting but it is possible that the incidence came down because of the mandatory mask up protocols as it could curb spread by droplets eventually.
Every year,March 24 is considered as 'World TB Day.' The theme for this year was : ‘Invest to End TB. Save Lives'.Efforts must be taken to ensure adequate utilisation of the facilities for diagnosis and management of TB at grassroot level of healthcare.The stigma against TB must be addressed properly.Tuberculosis is just another infectious disease like others which can be cured by correct management!
"TB Harega...Desh Jeetega!"
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