Tuberculosis: Causes, Symptoms, Diagnosis, and Treatment
World Tuberculosis (TB) Day on March 24 established to raise awareness about the devastating health, social, and economic impacts of tuberculosis and to accelerate efforts to eliminate the disease. The day marks the discovery of the TB-causing bacterium (Mycobacterium tuberculosis) by Dr. Robert Koch in 1882, which paved the way for diagnosing and treating the disease.
Tuberculosis (TB) is a highly infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can spread to other organs. Despite significant advancements in medicine, TB remains a global health concern, particularly in low- and middle-income countries.
Transmission : TB spreads through airborne droplets when an infected person coughs, sneezes, or speaks. Individuals with weakened immune systems, such as those with HIV/AIDS or malnutrition, are at higher risk of contracting TB. Close and prolonged exposure to an infected person increases the likelihood of transmission.
Symptoms : The symptoms of TB vary depending on whether the infection is latent or active:
• Latent TB: Individuals show no symptoms and are not contagious.
• Active TB: Symptoms include chronic cough, chest pain, fever, night sweats, weight loss, and fatigue. In severe cases, TB can affect the kidneys, spine, or brain, leading to additional complications.
Diagnosis : Diagnosing TB involves multiple methods:
• Tuberculin Skin Test (TST): A small amount of tuberculin is injected under the skin to check for a reaction.
• Interferon-Gamma Release Assays (IGRAs): Blood tests that measure immune response to TB bacteria.
• Chest X-ray and CT Scan: Imaging to detect lung abnormalities.
• Sputum Smear Microscopy and Culture: Identifies TB bacteria in respiratory secretions.
Treatment: TB is treated with a combination of antibiotics over a period of at least six months. The standard regimen includes:
• Isoniazid (INH)
• Rifampin (RIF)
• Ethambutol (EMB)
• Pyrazinamide (PZA)
For multidrug-resistant TB (MDR-TB), second-line medications such as fluoroquinolones and injectable agents are required, extending treatment duration to 18-24 months.
Prevention and Control :
• Vaccination: The Bacille Calmette-Guérin (BCG) vaccine is used in many countries to prevent severe forms of TB in children.
• Early Detection and Treatment: Screening programs, especially for high-risk populations, help identify cases early, allowing for timely treatment.
• Treatment of Latent TB Infection (LTBI): Treating latent TB infection with antibiotics can prevent progression to active TB.
• Infection Control Measures: Implementing proper infection control measures in healthcare settings helps prevent transmission.
• Addressing Social Determinants: Improving access to healthcare, housing, nutrition, and sanitation can help reduce TB incidence.
Challenges in TB Control:
Despite ongoing efforts, several challenges hinder progress toward eliminating TB:
• Inadequate Diagnostics and Treatment: Current diagnostic tools are often slow and insensitive, and treatment adherence is crucial to prevent the development of drug-resistant strains.
• Multidrug-Resistant Tuberculosis (MDR-TB): The emergence of MDR-TB strains poses a serious challenge, making treatment longer, more complex, and expensive.
• HIV Co-infection: People living with HIV are more susceptible to developing TB, and TB can worsen the course of HIV infection.
• Limited Resources: Many low- and middle-income countries lack the financial and human resources needed to effectively implement TB control programs.
• Social Determinants of Health: Factors such as poverty, malnutrition, and crowded living conditions increase the risk of TB transmission.
While TB remains a major global health issue, advancements in diagnosis and treatment have significantly improved outcomes. Increased awareness, early detection, and adherence to treatment protocols are essential to controlling and eventually eradicating the disease.
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