What is Tuberculosis and How to Fight It?
Symptoms of Tuberculosis
TB can be divided into two stages: latent TB infection and active TB disease. Latent TB infection means that the bacteria are present in the body but not causing any symptoms or damage. People with latent TB infection are not contagious and do not need treatment, but they have a risk of developing active TB disease in the future. Active TB disease means that the bacteria are multiplying and causing symptoms and damage to the body. People with active TB disease are contagious and need treatment to stop the infection and prevent complications.
The symptoms of active TB disease depend on which part of the body is affected, but the most common ones are:
- Cough that lasts for more than three weeks, sometimes with blood or mucus
- Chest pain or difficulty breathing
- Fever, chills, or night sweats
- Weight loss or loss of appetite
- Fatigue or weakness
- Swollen lymph nodes
If TB affects other organs besides the lungs, it may cause additional symptoms such as:
- Headache, confusion, or seizures if it affects the brain
- Back pain or paralysis if it affects the spine
- Blood in the urine or kidney failure if it affects the kidneys
- Skin ulcers or nodules if it affects the skin
Causes of Tuberculosis
TB is caused by a type of bacteria called Mycobacterium tuberculosis (MTB) that can survive in harsh conditions and evade the immune system. The bacteria can enter the body through inhalation of infected droplets that are released into the air by a person with active TB disease. The bacteria can then travel to different parts of the body through the bloodstream or lymphatic system.
Not everyone who is exposed to TB bacteria will get infected or sick. Some factors that increase the risk of getting infected or developing active TB disease are:
- Having a weak immune system due to HIV/AIDS, diabetes, cancer, organ transplant, or certain medications
- Having close contact with someone who has active TB disease, such as a family member, co-worker, or friend
- Living or working in crowded or poorly ventilated places where TB is common, such as prisons, shelters, hospitals, or nursing homes
- Traveling to countries where TB is prevalent, especially in Africa, Asia, Eastern Europe, and Latin America
- Having a history of incomplete or interrupted TB treatment
Diagnosis of Tuberculosis
The diagnosis of TB involves a combination of tests that can detect the presence of TB bacteria in the body or the immune response to them. Some of the common tests are:
- Tuberculin skin test (TST): A small amount of purified protein derivative (PPD), which contains parts of TB bacteria, is injected under the skin of the forearm. After 48 to 72 hours, the injection site is checked for swelling or redness. A positive reaction indicates that the person has been exposed to TB bacteria at some point in their life.
- Interferon-gamma release assay (IGRA): A blood test that measures how much interferon-gamma, a type of immune protein, is released by white blood cells when they are exposed to parts of TB bacteria. A high level indicates that the person has been exposed to TB bacteria at some point in their life.
- Sputum smear microscopy: A test that examines a sample of sputum (mucus coughed up from the lungs) under a microscope for the presence of TB bacteria stained with a special dye. A positive result indicates that the person has active pulmonary TB disease and is contagious.
- Sputum culture: A test that grows a sample of sputum in a laboratory for several weeks to see if any TB bacteria grow. A positive result indicates that the person has active pulmonary TB disease and is contagious.
- Chest X-ray: An imaging test that takes a picture of the lungs and can show signs of damage or inflammation caused by TB bacteria. A chest X-ray cannot confirm or rule out TB by itself, but it can help support other tests.
- Other tests: Depending on which part of the body is affected by TB, other tests may be needed to confirm the diagnosis, such as urine test, spinal fluid test, biopsy, or CT scan.
Treatment of Tuberculosis
The treatment of TB involves taking a combination of antibiotics for several months to kill all the TB bacteria in the body and prevent the development of drug resistance. The most common antibiotics used for TB are:
- Isoniazid (INH)
- Rifampin (RIF)
- Ethambutol (EMB)
- Pyrazinamide (PZA)
The duration and dosage of the treatment depend on the type and severity of TB, the presence of drug resistance, and the patient’s age, weight, and medical history. The treatment may last from 6 to 24 months or longer. It is very important to take the antibiotics exactly as prescribed and to complete the full course of treatment, even if the symptoms improve or disappear. Stopping or skipping the treatment can lead to relapse, drug resistance, or death.
People with active TB disease need to isolate themselves from others until they are no longer contagious, which usually takes a few weeks after starting the treatment. They also need to follow up with their doctor regularly to monitor their progress and check for any side effects or complications.
People with latent TB infection may also benefit from preventive treatment to reduce the risk of developing active TB disease in the future. The preventive treatment usually involves taking one or two antibiotics for 3 to 12 months. The doctor will decide whether the preventive treatment is suitable and safe for each person based on their risk factors and medical history.
Prevention of Tuberculosis
The prevention of TB involves reducing the exposure to TB bacteria and strengthening the immune system. Some of the preventive measures are:
- Getting vaccinated with the bacille Calmette-Guérin (BCG) vaccine, which can protect against severe forms of TB in children, especially in countries where TB is common
- Practicing good hygiene, such as washing hands frequently, covering mouth and nose when coughing or sneezing, and disposing of tissues properly
- Avoiding close contact with people who have active TB disease or symptoms, such as coughing, fever, or weight loss
- Wearing a mask or respirator when working or visiting places where TB is common or where there is a high risk of exposure, such as hospitals, prisons, or shelters
- Getting tested and treated for latent TB infection if you belong to a high-risk group, such as people with HIV/AIDS, diabetes, cancer, organ transplant, or certain medications
- Eating a balanced diet, getting enough sleep, exercising regularly, and avoiding smoking and alcohol to boost your immune system and overall health
Tuberculosis is a serious but curable disease that can affect anyone at any age. By knowing the symptoms, causes, diagnosis, treatment, and prevention of TB, you can protect yourself and others from this deadly infection.
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