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Tuberculosis: Causes, Symptoms & Treatment

Tuberculosis is an infectious disease which usually affects the lungs. It is caused by bacteria that get easily transmitted from person to person through coughs and sneezes.

According to the World Health Organisation, tuberculosis is one of the top 10 causes of death worldwide. In 2017, 10 million people fell ill and 1.6 million died from tuberculosis.

What Is Tuberculosis

Tuberculosis (TB) is a disease caused by the bacteria Mycobacterium tuberculosis and spreads through the air from person to person through sneezing, coughing, laughing, speaking or spitting. People infected with this bacteria have a 5 to 15 per cent lifetime risk of falling ill with this disease [1] .

There are different types of tuberculosis:

  • Latent TB infection - In this type of TB, the bacteria is inside the body, but in an inactive state which doesn't make you fall sick and there are no symptoms. The body is able to fight the bacteria to inhibit growth and prevent it from spreading. However, treatment is required for latent TB infection, so that the bacteria don't become active [2] . People with active TB who have received proper treatment for at least 2 weeks aren't contagious.
  • Active TB disease - If the bacteria become active in latent TB infection the next stage is TB disease. In this case, you fall sick and the disease spreads to others. The symptoms of TB disease include pain in the chest, a bad cough that lasts longer than 3 weeks, and coughing up blood.
  • Miliary TB - It is a rare form of TB disease that occurs when the bacteria enter the bloodstream. After which, it starts spreading quickly all over the body in tiny nodules and affects the organs [3] .

What Causes Tuberculosis

The bacteria that cause tuberculosis are spread through microscopic droplets released into the air by a person. Tuberculosis is contagious and the chances of getting it from another person are higher when you are in close proximity.

The drug-resistant bacteria strains develop when antibiotic medicines fail to kill the bacteria. The Multi-drug-resistant TB (MDR-TB) arises when the surviving bacteria develop resistance to antibiotics such as rifampin and isoniazid.

The HIV virus which causes AIDS suppresses your immunity, making it difficult for the body to control the TB bacteria. This is why most people with HIV are much more likely to get tuberculosis [4] .

Right Diet To Fight Tuberculosis

What Are The Symptoms Of Tuberculosis

  • Feeling sick and weak
  • Cough lasting for more than 3 weeks
  • Fever, chills and night sweats
  • Chest pain
  • Loss of appetite
  • Weight loss

When TB spreads to other parts of the body the symptoms include the following:

  • Spinal and joint pain
  • Meningitis
  • Improper function of the heart, liver and kidneys

What Are The Risk Factors

  • Smoking and ingesting tobacco-related products [5]
  • Diabetes [6]
  • HIV/AIDS
  • Malnutrition [7]
  • Kidney disease [8]
  • Certain cancers [9]
  • Some drugs to treat rheumatoid arthritis, psoriasis, Crohn's disease
  • Travelling to countries like Africa, Asia, Eastern Europe, Latin America, Russia, and the Caribbean Islands where tuberculosis is common [10] , [11]
  • Poverty and substance abuse
  • People who have spent time with someone having TB disease
  • Health care workers who look after TB patients [12]
  • Children and adolescent in contact with adults who have TB

When To See A Doctor

Consult a doctor if you experience high fever, sudden weight loss, night sweats and persistent cough. The doctor will then conduct some tests to find out the cause.

According to the Centers for Disease Control and Prevention, people who have HIV/AIDS, are in contact with infected people, use IV drugs, are from countries where TB are common should see a doctor.

Diagnosis Of Tuberculosis

A doctor will use a stethoscope to listen to the sounds of your lungs while you breathe and check for swelling in the lymph nodes. The most common diagnostic test for tuberculosis is a skin test where a small substance called PPD tuberculin, an extract of the TB bacterium is injected in the inside of the forearm.

The doctor will check your arm after 24 to 48 hours to see if there is any swelling in the area. If the area has a red, swollen bump it means you have contracted TB. But, the skin test isn't absolutely accurate in few cases when people with AIDS don't respond to the TB skin test and if you have been vaccinated recently with the Bacillus Calmette-Guerin (BCG) vaccine.

If your skin test result is positive, your doctor will conduct a chest X-ray or a CT scan. It will show the changes in the lungs caused by active TB. If the chest X-ray result is positive, your doctor will take samples of your sputum (mucus from your cough) to check for TB bacteria.

Blood tests are also done to confirm tuberculosis.

Treatment For Tuberculosis

The right medications can cure tuberculosis - which are mostly antibiotics. The antibiotic treatment depends on a person's age, overall health, possible resistance to drugs, TB bacteria is latent or active, and the location of the TB infection.

If you have latent TB, an individual needs to take one or two types of TB drugs. And if you have active TB, several antibiotics like rifampin, isoniazid, pyrazinamide and ethambutol are taken for at least six to nine months.

A new 2019 study shows that researchers have been exploring shorter, more effective and safer treatments for patients who have drug-resistant TB. The treatment duration is shorter from 9 to 11 months and is as effective as drug-resistant TB [13] treatment.

TB medicines can be harmful to the liver and cause various side effects as well like fever, jaundice, dark urine, nausea and vomiting, and loss of appetite.

The treatment course should be completed fully to cure the disease. Because any bacteria that have survived during the treatment could become resistant to antibiotic drugs and could lead to developing MDR-TB in the future. A directly observed therapy (DOT) is recommended to stick to your treatment program.

Prevention Of Tuberculosis

  • During the first few weeks of treatment, don't step outside and avoid contact with other people to minimize the risk of transmission of germs.
  • Cover your mouth while you sneeze and cough and ventilate the room as germs spread easily in closed spaces.
  • In some countries, children are given BCG injections for vaccination.
View Article References
  1. [1] Godreuil, S., Torrea, G., Terru, D., Chevenet, F., Diagbouga, S., Supply, P., ... & Banuls, A. L. (2007). First molecular epidemiology study of Mycobacterium tuberculosis in Burkina Faso.Journal of clinical microbiology,45(3), 921-927.
  2. [2] Kim, H. W., & Kim, J. S. (2017). Treatment of Latent Tuberculosis Infection and Its Clinical Efficacy.Tuberculosis and respiratory diseases,81(1), 6-12.
  3. [3] Sharma, S. K., Mohan, A., & Sharma, A. (2012). Challenges in the diagnosis & treatment of miliary tuberculosis.The Indian journal of medical research,135(5), 703-730.
  4. [4] Martinson, N. A., Hoffmann, C. J., & Chaisson, R. E. (2011). Epidemiology of tuberculosis and HIV: recent advances in understanding and responses. Proceedings of the American Thoracic Society,8(3), 288-293.
  5. [5] Jee, S. H., Golub, J. E., Jo, J., Park, I. S., Ohrr, H., & Samet, J. M. (2009). Smoking and risk of tuberculosis incidence, mortality, and recurrence in South Korean men and women. American journal of epidemiology,170(12), 1478-1485.
  6. [6] Dooley, K. E., & Chaisson, R. E. (2009). Tuberculosis and diabetes mellitus: convergence of two epidemics.The Lancet. Infectious diseases,9(12), 737-746.
  7. [7] Cegielski, J. P., & McMurray, D. N. (2004). The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals.The international journal of tuberculosis and lung disease,8(3), 286-298.
  8. [8] Shen, T. C., Huang, K. Y., Chao, C. H., Wang, Y. C., Muo, C. H., Wei, C. C., ... & Sung, F. C. (2014). The risk of chronic kidney disease in tuberculosis: a population-based cohort study.QJM: An International Journal of Medicine,108(5), 397-403.
  9. [9] Kamboj, M., & Sepkowitz, K. A. (2006). The risk of tuberculosis in patients with cancer.Clinical infectious diseases,42(11), 1592-1595.
  10. [10] Dye, C., Lönnroth, K., Jaramillo, E., Williams, B. G., & Raviglione, M. (2009). Trends in tuberculosis incidence and their determinants in 134 countries.Bulletin of the World Health Organization,87, 683-691.
  11. [11] Kyu, H. H., Maddison, E. R., Henry, N. J., Mumford, J. E., Barber, R., Shields, C., ... & Wang, H. (2018). The global burden of tuberculosis: results from the Global Burden of Disease Study 2015.The Lancet Infectious Diseases,18(3), 261-284.
  12. [12] Uden, L., Barber, E., Ford, N., & Cooke, G. S. (2017, July). Risk of tuberculosis infection and disease for health care workers: An updated meta-analysis. InOpen forum infectious diseases(Vol. 4, No. 3). Oxford University Press.
  13. [13] Nunn, A. J., Phillips, P. P., Meredith, S. K., Chiang, C. Y., Conradie, F., Dalai, D., ... & Mebrahtu, T. (2019). A trial of a shorter regimen for rifampin-resistant tuberculosis.New England Journal of Medicine.

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