Tuberculosis
Introduction
Tuberculosis
(TB) is an infection caused by a bacterium (germ) called Mycobacterium
tuberculosis. TB usually affects the lungs, (80%) but any part of the body can
be affected.
One third of the global population is infected with T.B. It is the commonest infectious killer in the world .Yet it is completely curable with proper treatment.
One third of the global population is infected with T.B. It is the commonest infectious killer in the world .Yet it is completely curable with proper treatment.
TB
bacteria are coughed or sneezed into the air by people with active TB disease
in the lungs. The bacteria are carried in the air in tiny water droplets. If
you breathe in some TB bacteria, they may multiply in your lung. There are then
three ways the infection may progress.
1. Minor
infection with no symptoms - occurs in most cases.
Most people in good health who breathe in TB bacteria do not develop active TB disease. The bacteria that you breathe in begin to multiply in the lung. This stimulates your immune system into action. The TB bacteria are killed or made inactive by the immune system (white blood cells, etc). There may be some mild symptoms for a short time, or no symptoms, and the infection is halted. These people are not infectious.
You are not usually aware that you have had this mild infection. A small scar on the lung may be seen on a chest X-ray. This shows that a 'battle' has occurred between the TB bacteria and the immune system.
This type of infection is the most common - so most people who breathe in TB bacteria will have no symptoms, and the infection is halted by your immune system.
Most people in good health who breathe in TB bacteria do not develop active TB disease. The bacteria that you breathe in begin to multiply in the lung. This stimulates your immune system into action. The TB bacteria are killed or made inactive by the immune system (white blood cells, etc). There may be some mild symptoms for a short time, or no symptoms, and the infection is halted. These people are not infectious.
You are not usually aware that you have had this mild infection. A small scar on the lung may be seen on a chest X-ray. This shows that a 'battle' has occurred between the TB bacteria and the immune system.
This type of infection is the most common - so most people who breathe in TB bacteria will have no symptoms, and the infection is halted by your immune system.
2. Infection
progressing into active TB disease - occurs in some cases.
Active TB disease with symptoms occurs in some people who breathe in some TB bacteria. In these people the immune system does not win the battle and halt the invading bacteria. The TB bacteria multiply further and spread to other parts of the lung and body. Symptoms of active TB then develop about 6-8 weeks after first breathing in some bacteria.
Active TB disease with symptoms occurs in some people who breathe in some TB bacteria. In these people the immune system does not win the battle and halt the invading bacteria. The TB bacteria multiply further and spread to other parts of the lung and body. Symptoms of active TB then develop about 6-8 weeks after first breathing in some bacteria.
3. Re-activated
(secondary) infection causing active disease.
Some people develop active TB months or years after a minor TB infection had been halted. The body's immune system at first stops the bacteria from multiplying (as above). However, not all the bacteria may be killed. Some bacteria may be 'walled off' in the scar tissue of the initial minor infection. They are stopped from multiplying by the immune system. They do no harm but can remain dormant (inactive) for many years. Dormant TB bacteria may start to multiply and cause active TB if the body's immune system becomes weaker for some reason. A weak immune system and re-activated TB is more likely to occur if you:
Some people develop active TB months or years after a minor TB infection had been halted. The body's immune system at first stops the bacteria from multiplying (as above). However, not all the bacteria may be killed. Some bacteria may be 'walled off' in the scar tissue of the initial minor infection. They are stopped from multiplying by the immune system. They do no harm but can remain dormant (inactive) for many years. Dormant TB bacteria may start to multiply and cause active TB if the body's immune system becomes weaker for some reason. A weak immune system and re-activated TB is more likely to occur if you:
o are
elderly or frail
o are
malnourished
o have
diabetes
o take
steroids or immunosuppressant medication
o have
kidney failure
o are
alcohol dependent ('alcoholic')
o have
AIDS
·
A cough which lasts for three or more weeks
·
Weight loss
·
Tiredness
·
Fever – rise in the temperature especially in the evening
·
Night sweats
·
Chest pain
·
Shortness of breath
·
Loss of appetite
·
Coughing up blood stained sputum
People
with weak immunity are at higher risk for developing T.B. Diabetes, being on
strong medication for cancer, asthma, chronic lung disease, already damaged
lungs, smoking, alcohol abuse, and kidney problems weakens your immunity and
increase the risk of developing T.B.
Treatment
- The T.B. bacillus causes destruction to the lungs. Therefore it
is important to detect T.B. early to avoid heavy destruction to your lungs
and to limit the spread of the disease. T.B. bacillus can infect many organs in
the body such as the brain, spine, kidneys, gut and the fallopian tubes.
Direct
observed treatment (DOT) It is essential to take the drug s
“Exactly ….Everyday ‘’ till the end of the recommended period of treatment to
get complete cure from the disease. The best treatment available is to take the
drugs in the presence of a health care worker. By this method, a patient is
ensured in taking the drugs “exactly ….Every day’ throughout the recommended
period of treatment. This method is called the Directly Observed Treatment
Short – course and the abbreviation used is “DOTS”. This ensures
that a T.B. patient takes the right anti-TB drugs, and doses at right intervals
completing the full course of treatment. Hospitalization is not necessary for
DOT. A center for DOT can be chosen by the patient for his/her convenience. The
Government supplies the drugs to the chosen DOT center free of charge.
The
duration of treatment depends on the site of TB infection .For lung infection
the treatment is usually for six months. If you have TB elsewhere your doctor
will decide how long you need to be on medication.
A newly diagnosed TB patient needs to undergo a continuous treatment of six months with combination of drugs. These drugs act on various stages of the germ .To achieve a complete cure it is essential to follow the full course of treatment.
A newly diagnosed TB patient needs to undergo a continuous treatment of six months with combination of drugs. These drugs act on various stages of the germ .To achieve a complete cure it is essential to follow the full course of treatment.
Treating
TB consists of two phases; the initial intensive phase and the continuation
phase. During the initial phase there is rapid killing of the TB bacilli.
Patients quickly become noninfectious within about two weeks and symptoms
improve. During the continuation phase less number of drugs is used for longer
periods of time. The sterilizing effect of the drugs eliminates the remaining
bacilli thus preventing subsequent relapses.
During
the course of treatment...
·
If you develop any of the following features inform your doctor
immediately.
·
Nausea or vomiting
·
Yellow discoloration of the eyes and skin
·
Itching of the body and urticarial
·
Impairment of vision
·
Patients on anti TB medication should not eat blood fish such as
kelawalla and Balaya because, of possible reactions.
·
While on treatment to make sure that you are getting better
phlegm/sputum will be checked at the chest clinic.
What
happens if you do not take drugs “Exactly……Every day”
·
Not being cured from the disease
·
Remaining as a person who spreads the disease
·
The disease becoming difficult to cure and may need more drugs
for longer periods to retreat the disease.
·
Germs can be removed or destroyed by having good ventilation and
sunlight to the place where the patients resides.
·
Take the drugs,” Exactly ….Everyday “for the recommended period
of treatment.
·
Collect phlegm (sputum) to a disposable container and either
bury or burn it.
·
Cover the nose and mouth while sneezing and coughing.