Countries across the world, including Anguilla, commemorate World TB Day on March 24 to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB), and to step up efforts to end the global TB epidemic. Despite many advances in treatment, and the management of TB, this disease is still very prevalent in many countries. TB is a serious condition, but it can be cured if it is treated with the right antibiotics.
Why World TB day?
March 24 marks the day in 1882 when Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease. Many years later TB is still a leading infectious disease killing over 4 500 people a day worldwide. The emergence of multidrug-resistant TB (MDR-TB) poses a major health security threat and could risk gains made in the fight against TB.
The theme of World TB Day 2018 – “Wanted: Leaders for a TB-free world”- focuses on building commitment to end TB, not only at the political level with Heads of State and Ministers of Health, but at all levels from parliamentarians and community leaders, to people affected with TB, civil society advocates, health workers, doctors or nurses, NGOs and other partners. All can be leaders of efforts to end TB in their own work or terrain.
World TB Day provides the opportunity to shine the spotlight on the disease and mobilize political and social commitment to accelerate progress to end TB.
What is TB?
Tuberculosis (TB) is a potentially serious infectious disease that mainly affects the lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes. Since 1985 increasing TB cases have occurred partly because of the emergence of HIV, the virus that causes AIDS. HIV weakens a person’s immune system, so it cannot fight the TB germs. Many strains of tuberculosis resist the drugs most used to treat the disease. People with active tuberculosis must take several types of medications, for many months, to eradicate the infection and prevent development of antibiotic resistance.
What causes TB?
Tuberculosis (TB) is caused by a type of bacterium called Mycobacterium tuberculosis.
It is spread when a person with active TB disease in his/her lungs coughs or sneezes and someone else inhales the expelled droplets which contain TB bacteria.
Although TB is spread in a similar way to a cold or the flu, it is not as contagious.
You would have to spend prolonged periods (several hours) in close contact with an infected person to catch the infection yourself.
For example, TB infections usually spread between family members who live in the same house. It would be highly unlikely for you to become infected by sitting next to an infected person on a bus.
What are some signs and symptoms of TB?
You can have TB and do not have symptoms as you can have the organism that causes the disease, but your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between:
• Latent TB. In this condition, you have a TB infection but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection/ is not contagious. It can turn into active TB so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB.
• Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later.
Signs and symptoms of active TB include:
• Coughing that lasts three or more weeks
• Coughing up blood
• Chest pain, or pain with breathing or coughing
• Unintentional weight loss
• Fatigue
• Fever
• Night sweats
• Chills
• Loss of appetite
Tuberculosis can also affect other parts of your body including your kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.
When to see a doctor?
See your doctor if you have a fever, unexplained weight loss, drenching night sweats or a persistent cough. These are often signs of TB, but they can also result from other medical problems. Your doctor can perform tests to help determine the cause.
If you are in close contact with someone who has TB, you may have tests to see whether you are also infected. These can include a chest X-ray, blood tests, and a skin test called the Mantoux test.
Treatment
With treatment, TB can almost always be cured. A course of antibiotics will usually need to be taken for six months.
Several different antibiotics are used because some forms of TB are resistant to certain antibiotics.
If you are infected with a drug-resistant form of TB, treatment with six or more different medications may be needed.
If you are diagnosed with pulmonary TB, you will be contagious for about two to three weeks into your course of treatment.
You would not usually need to be isolated during this time, but it is important to take some basic precautions to stop the infection spreading to your family and friends.
Complications
Without treatment, tuberculosis can be fatal. Untreated active disease typically affects your lungs, but it can spread to other parts of your body through your bloodstream. Examples of tuberculosis complications include:
• Spinal pain.
• Joint damage. Tuberculous arthritis usually affects the hips and knees.
• Swelling of the membranes that cover your brain (meningitis). This can cause a lasting or intermittent headache that occurs for weeks. Mental changes are also possible.
• Liver or kidney problems.
• Heart disorders. Rarely, tuberculosis can infect the tissues that surround your heart, causing inflammation and fluid collections that may interfere with your heart’s ability to pump effectively. This condition, called cardiac tamponade, can be fatal.
Vaccinations
In countries where tuberculosis is more common, infants are often vaccinated with bacillus Calmette-Guerin (BCG) vaccine because it can prevent severe tuberculosis in children.
Conclusion
Tuberculosis is a very old infectious disease and occurs in several countries. Last year, WHO reported that 10.4 million people fell ill with TB and there were 1.8 million TB deaths in 2016, making it the top infectious killer worldwide. This disease is deeply rooted in populations where human rights and dignity are limited. While anyone can contract TB, the disease thrives among people living in poverty, communities and groups that are marginalized, and other vulnerable populations. Tuberculosis is curable and preventable, but the disease still occurs in many countries, hence the theme for this year’s world TB day: “Wanted: Leaders for a TB-free world”.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-five years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
