Tuberculosis Fact Sheet
Tuberculosis (TB) is an airborne bacterial infectious disease which usually attacks the lungs, but can also spread to other organs and parts of the body. It is passed from person to person by inhaling tiny droplets of saliva expelled through coughing, sneezing or talking to a person infected with tuberculosis. It is less contagious than a cold or influenza as repeated contact with a TB sufferer is required. It cannot be spread by sharing objects such as toothbrushes and spoons.
Once the tuberculosis bacteria reach the alveoli (tiny chambers in the lungs) they are attached by other cells called macrophage. In some cases they can be transmitted to the lymph system and bloodstream before going on to infect other organs. It is therefore very important to receive an early diagnosis and immediate treatment. Moreover, patients with tuberculosis remain infectious for about two weeks if they receive an appropriate treatment.
It has been calculated that about a third of the worlds’ population has been infected with tuberculosis. However, only small numbers of people who come into contact with tuberculosis go onto develop the symptoms of the disease. In most cases the bacteria remain latent within the immune system.
There are also some risks factors which increase the chances of catching tuberculosis.
These are:
- Geographic origin -being born or have resided for a long time in regions with high rate of tuberculosis, such as South-East Asia, Africa, Latin America and the former Soviet Union
- Age -elderly people are more at risk because of their lowered immune systems
- Acquired lowered immunity – having a condition that suppresses immunity such as HIV/AIDS or diabetes, or receiving treatments with corticosteroids, immune-suppressants and chemotherapy drugs
- Living in an over-crowded environment, such as a prison, a refugee camp or a shelter
- Substance abuse (drugs and alcohol)
- Malnutrition
- Prolonged contact with someone infected with tuberculosis
- It has been showen that people who suffer from protein malnutrition have an increased chance of contracting tuberculosis
Tuberculosis Symptoms
About a three-quarters of all tuberculosis cases are pulmonary and affect the lungs or the lining of the lungs (pleura).
Main symptoms include:
- fever
- weakness
- weight loss
- chest pain
- cough
- pallor
- loss of appetite
- night sweats
- fatigue
- coughing up blood.
In the remaining 25% of patients with tuberculosis – usually people with a lowered immune system or young children – the infection spreads to other organs causing serious complications. It can infect the lymphatic system causing scrofula of the neck; the central nervous system causing tubercular meningitis; the genitourinary system causing urogenital tuberculosis; bones and joints sites causing Pott’s disease of the spine and forms of arthritis and the abdominal cavity causing an infection of the peritoneum (peritonitis), skin and kidneys.
Extra-pulmonary tuberculosis is not contagious; it can however coexist with active pulmonary tuberculosis which is very contagious.
A very serious form of TB is called military tuberculosis, which is characterised by wide dissemination of diffused tiny lesions a few millimetres in diameter. The bacteria infect several organs and sometimes the entire body, including the brain.
Tuberculosis Diagnosis
The diagnosis of tuberculosis can be challenging, as it can often mimic other diseases like pneumonia, lung abscesses, tumour and fungal infections. When there is a suspicion of tuberculosis, doctors will evaluate on the basis of diagnostic tests, a physical examination and the medical history of the patient.
The most common test to diagnose tuberculosis is a skin test called……..
The Mantoux test
In this test a small quantity of a substance called PPD tuberculin is injected in the skin of the inside forearm. The test will be positive if after 48 to 72 hours a hard and raised bump appears on the injection site. This test is considered quite reliable. Although false-negative or false-positive results are possible, especially if the infection with tuberculosis has recently occurred.
Other tests include:
- Chest x-rays - usually prescribed after the skin test has come out positive.
- A culture test (sputum test) – a sample of the stomach secretion or the mucus that comes up when coughing is tested for tuberculosis bacteria. The result becomes available within a few hours of culture.
- A blood test to detect the presence of tuberculosis bacteria has been recently approved by the Food and Drug Administration of the USA.
Tuberculosis Treatments
Tuberculosis is always treated with antibiotics. As tuberculosis heals very slowly, treatments are lengthy. They must to be continued for at least six months – sometimes up to 12 months – in order to be effective. Different types of drugs are used. The two most commonly employed antibiotics are rifampin and isoniazidin. Usually antibiotics are prescribed in combinations of four to reduce the risk of developing resistance. However, these drugs can have serious side effects, including liver damage. Other common side effects are: nausea and vomiting, fever, loss of appetite, jaundice (yellow skin), and blurred vision.
Some strains of tuberculosis are drug resistant and cannot be treated with the usual antibiotics. They require about two years of therapy with alternative, very toxic drugs and sometimes surgery to remove areas of infection or repair lung damage.
It is very important to follow the treatment rigorously. Patients who skip doses or do not complete the full treatment can develop an acquired resistance to tuberculosis drugs.
It has also been proved that people who suffer from protein malnutrition have an increased chance of contracting tuberculosis.
The following drugs are used in the treatment of tuberculosis:
- Isoniazid (INH)
- Rifampin (RIF)
- Ethambutol
- Pyrazinamide
- Tuberculosis Prognosis
The prognosis of recovery from tuberculosis is good in the majority of patients. However, it can still be fatal in some cases such as military tuberculosis or strains of drug-resistant tuberculosis. Today military tuberculosis is very rare in developed countries.
Early diagnosis and a prompt treatment regimen are crucial to curing tuberculosis. It is also very important that the treatment is completed even if the patient has fully recovered.
Without proper treatment the life expectancy of patients with active tuberculosis does not usually exceed five years.
Tuberculosis Help Groups and Associations
Below are a list of useful help groups and asosciations.
TB Alert is a young charity, registered in late 1998 and launched at the Houses of Parliament on World TB Day (24th March) 1999. It was set up by people who felt that with its long tradition of TB work, there should be a greater response in Britain to the resurgent threat of tuberculosis – already declared a global emergency by the World Health Organisation (WHO) in 1993.
http://www.lunguk.org/
The British Lung Foundation is the only UK charity working for everyone affected by lung disease. It focuses its resources on providing support for people affected by lung disease today; and works in a variety of ways, including funding research to improve treatments, and care and support for people affected by lung diseases.
http://www.tbsurvivalproject.org/
The Tuberculosis Survival Project (TBSP) was launched on World TB Day 2006. The
project started out with several aims:
1) to raise awareness and provide information about tuberculosis and
multidrug-resistant tuberculosis (MDR-TB)
2) to offer a peer support service to those on the TB treatment journey
3) to provide country specific information so people can learn about the condition in thir own area of the world.
