TB

Tuberculosis (TB): overview

Introduction

Tuberculosis is an undoubtedly grave infectious disease caused by the bacterium Mycobacterium tuberculosis. In general, it affects the lungs, though it may also affect other parts of the body such as the kidneys, spine and the brain. TB is still a major international health issue with millions of new cases reported yearly, mostly in developing countries.

Symptoms of Tuberculosis

TB symptoms vary between latent and active infections.

Latent TB infection (LTBI)

Latent TB is a condition whereby the bacterium lies dormant in the body and presents no symptoms whatsoever. As such, people suffering from latent TB do not have feelings of illness, and thus, they cannot pass the bacterium on to anyone else. However, latent TB can become active and progress into actual TB.

TB active disease

As long as TB will be active, it develops various manifestations and symptoms, which may include: 

1. Coughing:

A persistent cough for more than three weeks, commonly followed by sputum or blood.

2. Chest pain: 

discomfort or pain in the chest, most often when coughing or breathing deeply.

3. Fatigue:

 It's a very common feeling of tiredness or energy loss.

4. Weight loss:

 Unexplained weight loss in a short term.

5. Fever: 

low-grade fever, which may be intermittent.

6. night time Sweats:

 excessive sweating sometime during the nighttime, which makes clothing or bedding drenched.

7. loss of appetite:

 A decrease in appetite and subsequent weight loss.

8. Chills:

 Episodes of shivering or feeling cold.

Those symptoms can come and go and may be easily mistaken for other diseases, making early identification difficult.

Diagnosis of Tuberculosis

TB diagnosis requires several steps and exams, as symptoms alone are not good enough for a confirmed diagnosis.

Intake assessment

A healthcare provider will take an extensive medical history and do a physical examination. they may request information about signs and symptoms, exposure to TB, and previous TB infections.

Finding out tests

1. Mantoux test, or tuberculin skin test:

 a purified protein derivative (PPD) is injected beneath the skin. Strong reaction implies exposure to Mycobacterium tuberculosis but does not mean active disease.

2. Interferon Gamma launch Exams (IGRAs): 

Blood tests which measure the body's immune reaction to exact TB proteins. these assessments can provide a better correct outcome than the skin check, particularly in people who have had the BCG vaccine or are immunocompromised.

3. Chest X-ray:

 An X-ray will reveal abnormalities in the lungs that are consistent with active TB, including cavitation or nodules.

Sputum evaluations : 

Sample of sputum or mucus from the lungs to diagnose Mycobacterium tuberculosis. This may include:

 Acid-fast bacilli (AFB) smear: 

A quick test for TB bacteria in sputum.

Sputum culture:

 it is also a confirmatory test that takes growth of bacteria in a laboratory, though this takes many weeks.

NAAT: 

these tests pinpoint the genetic material from the bacteria and give a faster result.

5. Bronchoscopy: 

in some instances, bronchoscopy can be done to collect samples directly from the lungs.

Treatment and management of Tuberculosis

TB is curable and manageable with appropriate medical treatment. treatment usually consists of a combination of antibiotics for an extended time period.

First-Line treatment

the regular treatment for active TB involves a course of first-line antibiotics, usually which involve:

1. Isoniazid (INH)

2. Rifampin (RIF)

3. Ethambutol (EMB)

4. Pyrazinamide (PZA)

Treatment regime

Early phase: 

The first two months are treated by all four antitubercular medicine drugs to eradicate the maximum number of TB bacterium.

Continuation phase:

 After the early stage, the continuation of treatment is done in the next four to six months using the drugs isoniazid and rifampin in combination.

Directly observed treatment (DOT)

Drug companies may also use DOT, wherein the patient is observed by a health care provider in taking his or her medication to ensure compliance with treatment. This does not only reduce the possibility of therapy failure but also drug-resistant TB.

Drug-Resistant Tuberculosis

At times, TB bacteria grow to become resistant to the drugs commonly used to treat the infection. Multidrug-resistant TB can be divided into  two types:

1. Multidrug-Resistant TB (MDR-TB):

 resistant to at least isoniazid and rifampin.

2. extensively drug-resistant TB (XDR-TB):

 resistant to isoniazid, rifampin, and at least 2 second-line drugs.

On the other hand, drug-resistant TB is much more difficult to treat and requires a longer treatment interval with opportunity medicinal drugs, often causing more aggressive side effects.

Ends

Tuberculosis is a major but curable disease. Early diagnosis, appropriate diagnosis, and adherence to treatment are the important factors that would help control and eradicate TB. The initiative in public health encompasses education, vaccination-which can include the use of BCG vaccine-and better healthcare access are the primary forms to prevent a new case of TB from occurring.