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Tuberculosis

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By Isatou Nyang,
5th year medical student

UTG Medical Students’ Association

Tuberculosis (TB) is a serious illness that mainly affects the lungs. The germs that cause tuberculosis are a type of bacteria.

Transmission

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Tuberculosis can spread when a person with the illness coughs, sneezes or sings. This can put tiny droplets with the germs into the air. Another person can then breathe in the droplets, and the germs enter the lungs.

It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen), glands, bones and nervous system.

Tuberculosis spreads easily where people gather in crowds or where people live in crowded conditions. People with HIV/AIDS and other people with weakened immune systems have a higher risk of catching tuberculosis than people with typical immune systems.

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Drugs called antibiotics can treat tuberculosis. But some forms of the bacteria no longer respond well to treatments.

Symptoms of TB

Typical symptoms of TB include:

o          a persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody

o          weight loss

o          night sweats

o          high temperature

o          tiredness and fatigue

o          loss of appetite

o          swellings in the neck.

Tuberculosis Causes

Tuberculosis is caused by bacteria that spread through the air, just like a cold or the flu. You can get TB only if you come into contact with people who have it.

Tuberculosis Risk Factors

You could be more likely to get TB if:

o          A friend, co-worker, or family member has active TB.

o          You live in or have traveled to an area where TB is common.

o          You’re part of a group in which TB is more likely to spread, or you work or live with someone who is. This includes homeless people, people who have HIV, people in jail or prison, and people who inject drugs into their veins.

o          You work or live in a hospital or nursing home.

o          You’re a health care worker for patients at high risk of TB.

o          You’re a smoker.

A healthy immune system fights the TB bacteria. But you might not be able to fend off active TB disease if you have:

o          HIV or AIDS

o          Diabetes

o          Severe kidney disease

o          Head and neck cancers

o          Cancer treatments such as chemotherapy

o          Low body weight and poor nutrition

Tuberculosis Types

A TB infection doesn’t always mean you’ll get sick.

Primary TB infection

The first stage is called the primary infection. Immune system cells find and capture the germs. The immune system may completely destroy the germs. But some captured germs may still survive and multiply.

Most people don’t have symptoms during a primary infection. Some people may get flu-like symptoms, such as

Low fever

Tiredness

Cough

Latent TB

You have the germs in your body, but your immune system keeps them from spreading. You don’t have any symptoms, and you’re not contagious. But the infection is still alive and can one day become active.

Active TB disease

Active TB disease happens when the immune system can’t control an infection. Germs cause disease throughout the lungs or other parts of the body. Active TB disease may happen right after primary infection. But it usually happens after months or years of latent TB infection.

Active TB disease outside the lungs

TB infection can spread from the lungs to other parts of the body. This is called extrapulmonary tuberculosis. Symptoms vary depending on what part of the body is infected.

Common sites of active TB disease outside the lungs include:

o          Kidneys

o          Liver

o          Fluid surrounding the brain and spinal cord

o          Heart muscles

o          Genitals

o          Lymph nodes

o          Bones and joints

o          Skin

o          Walls of blood vessels

o          Voice box, also called larynx.

When to see a doctor

The symptoms of tuberculosis are similar to symptoms of many different illnesses. See your health care provider if you have symptoms that don’t improve with a few days of rest.

Drug-resistant TB

Some forms of the TB bacteria have become drug resistant. This means that drugs that once cured the disease no longer work.

This happens, in part, because of naturally occurring genetic changes in bacteria. A random genetic change in a bacterium might give it some quality that makes it more likely to survive the attack of an antibiotic. If it does survive, then it can multiply.

Problems that can lead to such drug-resistant strains of bacteria include the following:

o          People didn’t follow directions for taking the drugs or stopped taking the drugs.

o          They weren’t prescribed the right treatment plan.

o          Drugs were not available.

o          The drugs were of poor quality.

o          The body didn’t absorb the drugs as expected.

Preventing the spread of disease

If you have active TB disease, you’ll need to take steps to prevent other people from getting an infection.

You will take drugs for six months.Take all of the drugs as directed during the entire time.

During the first 2 to 3 weeks, you will be able to pass TB bacteria to others. Protect others with these steps:

o          Stay home.

o          Don’t go to work or school.

o          Isolate at home.

o          Spend as little time as possible among members of your household.

o          Sleep in a separate room.

o          Ventilate the room. Tuberculosis germs spread more easily in small, closed spaces. If it’s not too cold outdoors, open the windows. Use a fan to blow air out.

o          If you have more than one window, use one fan to blow air out and another to blow air in.

o          Wear face masks. When you have to be around other people.

o          Ask other members of the household to wear masks to protect themselves.

o          Cover your mouth. Use a tissue to cover your mouth anytime you sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.

Vaccinations

In countries where tuberculosis is common, like The Gambia infants often are vaccinated with the bacille Calmette-Guerin (BCG) vaccine. This protects infants and toddlers who are more likely to have active TB disease in the fluid surrounding the brain and spinal cord.

Tuberculosis can be preventable if we diligently take note of all the precautionary measures and visit the hospital immediately if we notice any symptoms.

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