World TB Day: Timely treatment is the key to overcome Tuberculosis

In the past year, covid-19 virus grabbed much of our attention. The collateral damage that it caused in one year is very unimaginable. But did you know, Tuberculosis (TB) kills a greater number of people in India every year, than the lives covid-19 has claimed over the past 12 months?

Tuberculosis continues to inflict a large quantum of socioeconomic cost on our nation. Although, TB has been curable and great strides have been made by our government to improve diagnosis and drug delivery mechanisms, our war with this deadly disease continues to exist. All we need today is a surge in our actions to reduce the TB burden intensely. But how is that possible?

Well, the best approach to this is to sensitize people with the growing burden of TB and empower them enough to identify symptoms, report it early, undergo timely diagnosis, and complete adherence to treatment. So, first things first.

WHAT IS TUBERCULOSIS AND HOW DOES IT AFFECT US?

TB is an infection caused by bacteria called Mycobacterium Tuberculosis and spreads through the air from one person to another when an infected person coughs, sneezes or laughs. Even though the bacteria travel easily, it’s not easy to be infected by TB.

Most often, it’s spread between family members, close friends, and people who live or work together. TB most commonly affects the Lungs but it can affect other parts of the body as well like Lymph Glands, abdomen, spine, joints, etc. There are two kinds of TB infections - latent TB and active TB disease.

WHAT IS LATENT TB?

In most healthy people, the body's natural immune system kills the bacteria and there are no symptoms. Sometimes, the immune system cannot kill the bacteria but manages to prevent it from spreading in the body. You will not have any symptoms, but the bacteria will remain in your body - this is known as Latent TB.

People with Latent TB are not infectious to others, and do not feel ill. This usually happens to children. But sometimes this dormant TB gets activated when the body’s immune system is extremely low, say in the case of HIV, Cancer, Diabetes, etc.

This may occur like a normal fever and can go unnoticed. In India, we do not treat latent TB, as most people would have been exposed to the bacteria at some point in time. Moreover, there is no good evidence that all these people will develop active TB disease in the future, or that treating Latent TB will prevent further reinfection.

WHAT IS AN ACTIVE TB?

When the immune system is unable to kill or contain the bacteria, Active TB develops. Active TB disease of the Lungs is contagious, which means it can be spread from one person to another. It is most often spread through the air; these bacteria may enter the air when a person with TB disease of the Lungs or throat coughs. People nearby may breathe in these bacteria and get infected. People get sick from the TB bacteria that are alive and active.

SO, WHAT ARE THE RISK FACTORS?

  • Being in close contact with a person with Active Lung TB disease is highly risky.

  • If you are in contact with any groups known for passing on TB, such as the homeless, injection drug users, and persons with HIV/AIDS.

  • If you are living or working with people who are at high risk for TB, such as those in hospitals, homeless shelters, prisons, slums, or refugee camps.

MAJOR SIGNS AND SYMPTOMS THAT YOU SHOULDN’T IGNORE:

  • A cough that lasts two-three weeks or more.

  • Pain in the chest, with cough or at rest.

  • Coughing up blood or thick mucous.

  • Night sweats.

  • Feeling weak or tired.

  • Weight loss.

  • Not wanting to eat.

  • Fever, mostly in the evening.

  • Swollen neck lymph-gland(s).

The longer people wait, the TB disease worsens. Although the stigma associated with TB has gone down significantly, there is a need for people to be alert, aware, and responsible when it comes to identifying symptoms and getting treated early. TB is treatable and curable. Treatment for drug-sensitive TB is a combination of antibiotics for 6 months. People with drug-resistant TB will need longer treatment with at least 5-6 drugs under expert supervision.

(The writer is a Consultant-Pulmonologist & Sleep Medicine Expert, Fortis Hospital, Mulund)

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