Prolonged but curable
World Tuberculosis Day has just gone by with dire warnings about resistant strains of an old disease. PIONEER HEALTH talks about the issue
The treatment of TB is a long-drawn process. The first-line of treatment of TB involves taking a combination drugs daily over six months. This kind of a treatment regime is difficult to adhere to, especially when the symptoms disappear within the first 1 month of the treatment. As a result, only 30 % of the patients complete the treatment. When treatment is not completed, there are high chances of reinfection with severe forms such as multi-drug resistant TB (MDR-TB), extremely-drug resistant TB (XDR-TB) and the deadliest totally-drug resistant TB (TDR-TB). “The treatment of the severe forms of TB can take years. TB has emerged as one of the deadliest communicable diseases because it can quickly develop drug resistance. To add to the complexity of the issue, TB can infect any part of the body such lungs, spine, gastrointestinal tract, eyes, genitals etc. But because the disease is usually associated with lungs, the other forms of TB are often diagnosed at a later stage leading to delayed or wrong treatment. This leads to drug resistance of the infection,” Dr Kailash Naath Gupta, Chest & Critical Care Specialist (ICU) and Interventional Pulmonologist
Tuberculosis or TB is highly contagious and spreads through the air. A single sneeze releases up to 40,000 droplets. Each of these droplets may transmit the disease. 1 in 10 infections eventually progresses to active tuberculosis, which, if left untreated, kills more than 50% of those infected.
According to Dr Animesh Arya, senior consultant in Respiratory medicine, Sri Balaji Action Medical Institute: “Many complications can arise if TB is not cured on time such as MDR (multi-drug resistant) tuberculosis, meningitis or CNS TB, chronic or suppurative lung disease, bone and joint problems, liver and kidney disease etc. Another factor can be low immunity and lack of hygiene which tends to develop this disease. So it is advisable to maintain a good immunity and also avoid coming into contact with people having Tuberculosis. Few basic hygiene practices should be adopted like covering their mouth while coughing, refrain from spitting in public areas and to follow proper medication regimen.”
Treatment: The precise type and length of antibiotic treatment depend on a person's age, overall health, potential resistance to drugs, whether the TB is latent or active, and the location of infection (i.e. the lungs, brain, kidneys).
People with latent TB may need just one kind of TB antibiotics, whereas people with active TB (particularly MDR-TB) will often require a prescription of multiple drugs.
Antibiotics are usually required to be taken for a relatively long time. The standard length of time for a course of TB antibiotics is about 6 months.
All TB medication is toxic to the liver, and although side effects are uncommon, when they do occur, they can be quite serious. Potential side effects should be reported to a health care provider and include: Dark urine, Fever, Jaundice, Loss of appetite, nausea and vomiting.
DIAGNOSING TB
TB is a serious but treatable infectious disease. TB can occur in almost every part of the body. The most common areas are lungs, lymph nodes, intestine, bone and brain. It is advised that one should not try to diagnose TB on their own as some other disease may also mimic the same symptoms. Untreated TB disease can be fatal. Chest X-ray should be done if coughing last for more than two weeks. The Government provides free sputum examination for TB. TB is completely treatable if a patient follows the procedure religiously and regularly checks with the doctor.
--Dr Gyanendra Agrawal, Senior Consultant, Pulmonary & Critical Care Medicine, Jaypee Hospital, Noida
MYTHS & FACTS
Myth– Tuberculosis is incurable
Fact – Early diagnosis is crucial for the treatment of TB. The patient needs to follow a thorough line of treatment with regular follow-ups with the concerned doctor to cure TB completely.
Myth – Poor & underprivileged are prone to TB
Fact– Anyone, regardless of socio-economic background and living condition is susceptible to TB.
Myth- TB affects lungs only.
Fact- Although TB of the lung is the most common form of Tuberculosis but the bacterium is equally potent to affect the other parts of the body like lymph nodes, intestine, bone and brain.
Myth- BCG immunization can prevent TB infection for the lifetime
Fact- BCG provides only a short-term prevention from the disease.
Myth- TB once treated cannot reoccur
Fact-The chance of relapse of the disease increases if the patient does not complete the course of previous treatment.
Myth-TB is a genetic condition
Fact- TB does not run in families and has nothing to do with genes. TB bacteria spread out in the air and can be inhaled by a healthy individual and that is how they acquire TB.