sravanthikrishna
TB is a serious infectious disease that mainly affects the lungs. It is caused by a bacterium called Mycobacterium tuberculosis. TB is largely preventable and curable, yet it remains one of the significant global health issues, especially in developing countries. The causes, preventive measures, and treatments of this disease are to be understood so that the fight against the disease can be taken seriously.
Spread
TB spreads when a person who is infected with TB disease coughs, sneezes or speaks and releases these tiny droplets. A person who inhales such droplets gets infected. Infection is caused by Mycobacterium tuberculosis bacteria; not all persons who become infected develop active TB disease. Most infections do not involve other parts of the body and can only occur in the lungs-pulmonary TB, while it may involve some other part of the body which is extrapulmonary TB.
Latent TB infection
In many cases, the body's immune system is able to fight off the TB bacteria, preventing the disease from becoming active. This is known as latent TB infection. People with latent TB infection do not feel sick and cannot spread the disease to others.
Active TB disease
If the immune system is weak or unable to regulate the TB bacteria, the infection can develop into active TB disease. Symptoms of active TB disease can include:
Coughing persistently
Coughing up blood or mucus
Chest pain
Weakness or fatigue
Weight loss
Fever
Night sweats
Risk Factors
Certain factors increase the risk of contracting TB:
Weakened Immune System: Conditions like HIV/AIDS, diabetes, malnutrition, or undergoing treatments like chemotherapy can impair immunity.
Close Exposure to Infected People: Spending time in crowded places, such as prison, shelters, or dorms, increases exposure.
Travel to or Live in High-Risk Areas: Places where TB rates are high, including Africa, Asia, and Eastern Europe are at a higher risk.
Substance Abuse: Smoking, alcoholism, and drug use create an environment where the body's defenses weaken.
Age: Children and the elderly are at higher risk due to weaker immune systems.
Malnutrition: Poor nutrition can compromise the immune system and make one vulnerable to TB.
Prevention of Tuberculosis
Prevention of TB is through the reduction of transmission and enhancing individual immunity.
1. Vaccination
The BCG vaccine prevents severe forms of TB, especially in children. Though it does not give complete immunity, it greatly reduces the chances of meningitis and disseminated TB in young people.
2. Early Diagnosis and Treatment
Active TB needs timely detection and treatment. Early diagnosis reduces the probability of transmission to others.
Programs for screening: Screening regularly in populations known to be at a higher risk detects cases early.
Contact tracing is identifying and testing those who had close contact with a patient so that the chain of transmission will not continue
3. Infection Control Measures
Hygiene Practice: Coughing or sneezing covering the mouth and nose reduces the spread of droplets.
Ventilation: Improving air circulation in crowded spaces dilutes airborne bacteria.
Isolation of Active Cases: Individuals with infectious TB should be isolated until they are no longer contagious.
4. Addressing Social Determinants
Improving living conditions, nutrition, and access to healthcare can reduce TB incidence. Public awareness campaigns also play a vital role in educating communities about the disease.
Treatment of Tuberculosis
TB is curable by proper medical treatment. Antibiotics are taken in combination over several months to treat TB.
1. Intensified Treatment for TB
Intensified treatment of drug-susceptible TB consists of four first-line antibiotics used together:
Isoniazid (INH)
Rifampin (RIF)
Pyrazinamide (PZA)
Ethambutol (EMB)
The above four drugs are divided into two phases:
Intensive Phase: 2 months; All the above four drugs are administered in combination to kill the majority of bacteria.
Continuation Phase (4-6 months): A less-intensive regimen (commonly isoniazid and rifampin) is used to eradicate remaining organisms and prevent reactivation.
2. Drug-Resistant TB
Drug-resistant TB (DR-TB) refers to TB in which the organisms fail to respond to first-line antibiotics. The treatment of DR-TB is complex and involves drugs such as fluoroquinolones and injectable agents, for a minimum of 9-20 months. MDR-TB and XDR-TB are highly difficult to treat.
3. Latent TB Infection
Patients with latent TB infection (LTBI) are not infectious but harbor the bacteria in a latent form. Isoniazid or rifampin for 3-9 months prevents the progression of LTBI to active TB, especially in high-risk groups such as those with HIV.
4. Supportive Care
Nutritional Support: Nutritional support enhances the patient's immune system during treatment.
Psychosocial Support: Psychosocial issues must be addressed and adherence to long-term treatment programs ensured for successful outcomes.
Global Efforts to Combat TB
Global efforts, such as the World Health Organization's (WHO) End TB Strategy, which aims at reducing TB incidence by 90% and deaths from TB by 95% by 2035, call for universal access to diagnosis, treatment, and preventive care.
Key Challenges
Stigma: TB carries a stigma in society that makes many patients hide their diagnosis.
Drug Resistance: The DR-TB rate has been rising, threatening progress achieved in the control of the disease.
Health care access: There is a scarcity of resources in the low-income areas that would limit the proper management.
Conclusion
Tuberculosis is preventable and treatable, but it remains one of the greatest public health problems. Its control can be ensured by dealing with the causes, improving prevention, and ensuring that the treatment provided is effective. A TB-free world is a step closer by integrating medical progress with public health interventions.
