Tuberculosis occurs worldwide and remains a significant cause of morbidity and mortality in many countries, including India. There were an estimated 10.4 million new cases and 1.8 million deaths caused by TB globally in 2015. Of these, there were an estimated 2.8 million new cases in India, and 0.48 million people died in India due to TB in 2015.
It is a cause for concern as India stands first in terms of absolute number of cases. Let us dive deeper into the tuberculosis meaning and its other aspects.
What is tuberculosis?
Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. It primarily targets the lungs but can also affect other parts of the body. It spreads through the air when an infected person coughs or sneezes.
Only some people infected with tuberculosis bacteria become sick immediately. Some may develop latent TB infection, where the bacteria are present but do not cause illness. In such cases, tuberculosis causes no symptoms, and the person is not contagious.
Types of tuberculosis
There are several stages and forms of the disease:
- Primary TB: This is the first stage of a tuberculosis infection. Your immune system may be able to fight off the germs. But sometimes, it doesn’t destroy all of them, and they keep multiplying. You may not have any TB symptoms at this stage, or you might have a few flu-like symptoms.
- Latent TB Infection: Latent TB infection occurs when the TB bacteria are present in the body but are not actively causing illness. Individuals with latent TB do not experience symptoms and are not contagious.
- Active TB Disease: Active TB disease occurs when the bacteria become active and cause illness. Common symptoms include a persistent cough, chest pain, fatigue, weight loss, and fever.
- Active TB outside the lungs: A tuberculosis infection that spreads from your lungs to other parts of the body is known as extrapulmonary tuberculosis. Your symptoms will depend on which part of your body the infection affects.
Symptoms of tuberculosis
Active tuberculosis symptoms in the lungs include:
- A cough that lasts more than three weeks
- Chest pain
- Coughing up blood
- Feeling tired all the time
- Night sweats
- Chills
- Fever
- Loss of appetite
- Weight loss
When TB is outside the lungs, you may have these same symptoms, along with pain near the infected area.
Causes of tuberculosis
The bacteria Mycobacterium tuberculosis causes TB. It spreads when an infected person talks, coughs, or sneezes, releasing tiny droplets containing the bacteria into the air. People nearby can inhale these droplets and become infected.
Risk factors for tuberculosis
You're more likely to get tuberculosis if:
- A friend, co-worker, or family member has active TB.
- You live in or have travelled to an area where TB is common, like Russia, Africa, Eastern Europe, Asia, Latin America, and the Caribbean.
- You're part of a group in which TB is more likely to spread, or you work or live with someone who is diagnosed with TB. This includes unhoused people, people with HIV, those in jail or prison, and those who inject drugs.
- You work or live in a hospital or nursing home.
- You're a healthcare worker for patients at high risk of TB.
- You're a smoker.
You're at higher risk of developing active TB if you have:
- HIV or AIDS
- Diabetes
- Severe kidney disease
- Head or neck cancer
- Low body weight and poor nutrition
Or use:
- Cancer treatments such as chemotherapy
- Medications for organ transplants
- Certain drugs to treat rheumatoid arthritis, Crohn's disease, and psoriasis
Babies and young children are at higher risk of developing active TB because their immune systems aren't fully formed. Children under 5, teens and young adults aged 15-25, and adults aged 65 and older are most likely to get active tuberculosis.
Diagnosis of tuberculosis
Prompt and accurate diagnosis is essential for effective TB management. If someone shows symptoms or has been in contact with a TB-infected person, seeking medical attention for proper testing is crucial.
Tuberculin Skin Test (TST): This standard method involves a tuberculosis test by injecting a small amount of TB protein under the skin. After 48 to 72 hours, a healthcare provider checks for a raised bump at the injection site. This helps determine if the person has been infected with TB.
There are two common tests for tuberculosis:
- Tuberculosis skin testing
This is also known as the Mantoux tuberculin skin test. A technician injects a small amount of fluid into the skin of your lower arm. After 2-3 days, the person checks for swelling in your arm. You might have to undergo this test more than once.
- Tuberculosis blood testing
These tests, also called interferon-gamma release assays (IGRAs), measure the response when TB proteins are mixed with a small amount of your blood.
Treatment of tuberculosis
- Most cases are cured with antibiotics. But it takes a long time. You have to take medications for at least 6 to 9 months. Your tuberculosis treatment will depend on your infection. If you have latent TB, your doctor will give you medication to kill the bacteria so the infection doesn't become active.
- Your doctor may prescribe Isoniazid, Rifampin, or Rifapentin, either alone or combined. You'll have to take the drugs for three months or more. If you see any signs of active TB, call your doctor right away.
- A combination of medicines also treats active TB. The most common are Ethambutol, Isoniazid, Pyrazinamide, and Rifampin. You may have to take them for 6 to 12 months.
- If you have drug-resistant TB, your doctor might give you one or more different medicines. You may have to take them for up to 30 months, and they can cause more side effects.
However, some strains of TB are resistant to antibiotics. Bacteria become drug-resistant because of changes in their genetic makeup. That can happen randomly. But when antibiotics are overprescribed or misused, this speeds up the process.
Side-effects of tuberculosis
Like any medication, TB drugs can have side effects. Common Isoniazid side effects include:
- Numbness and tingling in your hands and feet
- Upset stomach, nausea, and vomiting
- Loss of appetite
- Weakness
Ethambutol side effects include:
- Chills
- Painful or swollen joints
- Belly pain, nausea, and vomiting
- Loss of appetite
- Headache
- Confusion
- Eye issues such as pain and vision problems
Some side effects of Pyrazinamide include:
- Lack of energy
- Nausea and vomiting
- Loss of appetite
- Muscle or joint pain
Common Rifampin side effects include:
- Skin rash
- Upset stomach, nausea, and vomiting
- Brown urine
- Yellowish skin or eyes (jaundice)
- Diarrhoea
- Loss of appetite
Complications of tuberculosis
Tuberculosis infection can cause complications, such as:
- Joint damage
- Lung damage
- Infection or damage of your bones, spinal cord, brain, or lymph nodes
- Liver or kidney problems
- Inflammation of the tissues around your heart
How can tuberculosis be prevented?
If you're travelling to a place where TB is common, avoid spending a lot of time in crowded places with sick people. If you have a latent infection, take all your medication so it doesn't become active and contagious.
In case you have active TB, you'll need to take care to protect others from infection during your first few weeks of treatment.
- Limit contact with other people
If you live with others, sleep in a separate room and isolate yourself as much as possible.
Cover your mouth when you laugh, sneeze, or cough. Wear a surgical mask when you're around other people.
- Keep your space ventilated
Open windows, and use a fan. Germs spread more easily in poorly ventilated places.
Conclusion
Understanding tuberculosis, its types, symptoms, and causes is crucial for early detection and effective management. Public awareness, vaccination, and improved living conditions play vital roles in preventing the spread of TB within communities. Additionally, having access to health insurance ensures that individuals can afford timely medical care.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.