Tuberculosis is curable.But you need to be aware. World wide during the COVID 19 Pandemic, all other infectious diseases took a backseat. But we need to keep our health care goals with TB online. Because while COVID 19 is an immediate problem, TB is a problem for a very long time. The two diseases together can cause a lot of havoc on the body. I have a personal history with Tuberculosis and the nature of my profession puts me in a unique position to share a few things about this disease which is still a great cause for concern, worldwide.
Table of contents
1)What is TB
TB or Tuberculosis is also known as Koch’s disease. The Bacteria Mycobacterium tuberculosis was first discovered by Dr.Robert Koch on March 24th and World TB day to commemorate that day and spread awareness.
2)TB and COVID 19
With COVID 19, precautions like wearing a mask, social distancing, improved cough etiquette, hand washing can all act as preventive measures for Tuberculosis, whose primary mode of entry is the airway.People with TB may have a worse course of disease with COVID19.
3)Any vaccine for Tuberculosis?
The BCG vaccine in childhood acts as a protection against severe forms of Tuberculosis.
4)Where does TB occur?
The disease can affect all the systems of the body, most commonly the lungs.
Extrapulmonary TB includes
Lymph nodes,Larynx,pharynx, nasopharynx, skin, nose, ear ,bone, brain, miliary,disseminated.
5) What are the symptoms of TB?
Cough for more than two weeks
Bloodstained sputum
Fever
weakness,
loss of weight
neck swelling
Other TB manifestations
Tuberculous meningitis
Bone pain, swelling, nonhealing ulcer
Tuberculosis in ENT and Head Neck region
Swelling in the neck or lymph node lumps is the most common extrapulmonary TB symptom.
Later-cervical lymph gland
Larynx
Tonsil Pharyngeal TB (tonsil ,adenoids
Oral cavity
Ear discharge hearing loss, facial nerve palsy, ear polyp+
Nose: Lupus vulgaris (apple jelly nodule).septal ulcers, scrofuloderma
Laryngeal TB
6)How is TB diagnosed?
In all cases, early diagnosis and treatment with appropriate antitubercular drugs are life-saving.
Early detection includes various tests:
Lungs: Sputum is tested for AFB. In the case of kids, gastric lavage is needed for testing.
Chest Xray PA view
Extrapulmonary lymph node-FNAC
Computed Tomography
Specific tests depending on the location of symptoms, but in all cases, pulmonary TB needs to be ruled out
About Mantoux test-
Mantoux test is a skin test to detect the level of sensitivity to tuberculous bacilli antigen. It indicates past exposure to the bacteria but not present active infection. All those with BCG vaccination will have a positive Mantoux. In case of negative Mantoux, HIV and other causes of immunocompromised status needs to be ruled out
7)Treatment of TB
Timely treatment With the right drugs and in a suitable duration is a must.The most common drugs used are Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol. Free testing and ATT are available at all Government Hospitals in India.
8)Contact tracing is essential for controlling the community load of disease.
9)Counselling and Empathy
Counseling of patient and family regarding the need for precautions, treatment, and regular follow-up prevents complications and spread.
10) Prevention of TB
Various steps have been taken by Central TB Division (CTD), MoHFW, and State TB Cells to ensure continuity of TB services. There are no interruptions of National Tuberculosis Elimination Program (NTEP) activities during COVID-19 pandemic and lockdown situations.
The primary health care intervention available to reduce the risk of TB infection progressing to active TB disease is TB preventive treatment.
If someone has a latent infection, treatment to prevent active infection is essential.WHO guidance recommends TB preventive treatment for people living with HIV, household contacts of bacteriologically confirmed pulmonary TB cases and clinical risk groups (e.g., those receiving dialysis).
Wearing a mask and cough etiquette goes a long way in preventing spread.
Other interventions are TB infection prevention and control; and vaccination of children with the bacille Calmette–Guérin (BCG) vaccine, which gives protection from severe forms of TB in children.
TB education is crucial.
Young children should not be in direct contact with MDR or XDR TB patients.
Patients with XDR TB need to be isolated at all times, and caregivers need to wear protective masks and maintain adequate distance.
HIV-positive people and other immunocompromised patients should not be caregivers for active cases of Tuberculosis.
People saved since 2000 due to global efforts 63,000,000.
The theme of World TB Day 2021 – ‘The Clock is Ticking, and we all need to do our part. Share this post and help spread awareness.
Resources:
https://www.who.int/campaigns/world-tb-day/world-tb-day-2021#:~:text=Each%20year%2C%20we%20commemorate%20World,end%20the%20global%20TB%20epidemic.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639956/
I knew about TB but not so much in detail. This blog has given me a more detailed idea about TB and how to identify and treat it. Thanks for sharing this.
There is so much I wasnt aware about TB and this post helped me understand. Right now with covid its easy to mix the sympotms and get worried. I guess its better if we can do proper test and take care to recover.
Even now the complete awareness about TB is not there. Posts like your would be helpful for many people out these to even rethink and do the health checks
It would be a surprise to many that TB is still looming around no matter how hygienic we are. Two my close relatives had this and then only I.realised it.
I have only heard about TB never knew it in detailed as in your post. Thanks for sharing about the disease, reasons, symptoms as well as treatment.
Thanks a lot doctor, this is such informative post which shares significant facts about Tuberculosis. I am sharing this with my friends.
From decades we have listened to the myths and somewhere started believing them as facts. Your post has cleared many myths and will create awareness about TB.
For a large part of my life I thought TB is a lung disease, till I found out that it can affect many parts of the body. My dad had potts spine disease which is TB in the bones. It was quite a tough time.
This is vital info doc, thanks a lot for sharing it in so much details. I am sharing the post with my readers too.
In fact TB still is claiming a large proportion of morbidity in the communicable diseases. I have been seeing a resurgence despite the BCG vaccinations being a routine. Timely diagnosis in fact can help a lot.
I really like how you use your knowledge in breaking down complicated terms /diseases and explain it in simple terms. I didn’t know this much about TB. Thanks for educating me Amrita.