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Tuberculosis: Causes, Symptoms, Diagnosis and Treatment

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can also affect other parts of the body, such as the kidneys, spine, and brain. TB is spread through the air when an infected person coughs, sneezes, or talks, and others breathe in the bacteria.

TB can be latent, where the bacteria are present in the body but the person does not have symptoms and cannot spread the disease, or active, where the bacteria are causing symptoms and can be transmitted to others.


Understanding the Prevalence of Tuberculosis

Tuberculosis (TB) is a significant global health issue. According to the World Health Organization (WHO), an estimated 10 million people worldwide fell ill with TB in 2019. TB is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent (above HIV/AIDS). However, TB is curable and preventable, and efforts to control the disease have been successful in many parts of the world.

What are the signs and symptoms of tuberculosis?

The signs and symptoms of tuberculosis (TB) can vary depending on whether the TB infection is latent (inactive) or active.

Latent TB infection:

  • There are typically no symptoms
  • The person is not contagious
  • TB bacteria are present in the body but are inactive

Active TB disease:

  • A cough that lasts three or more weeks/li>
  • Chest pain
  • Coughing up blood or sputum (phlegm)
  • Weakness or fatigue
  • Weight loss
  • Loss of appetite
  • Chills
  • Fever
  • Night sweats

It's important to note that symptoms of TB can be similar to those of other conditions, so it's important to see a healthcare provider for an accurate diagnosis if you experience any of these symptoms.

Tests for Diagnosing Tuberculosis

There are several tests used to diagnose tuberculosis (TB), including:

Tuberculin Skin Test (TST): Also known as the Mantoux test, this involves injecting a small amount of a substance called PPD tuberculin into the skin of the forearm. The injection site is checked 48 to 72 hours later for a reaction, which may indicate TB infection.

Interferon-Gamma Release Assays (IGRAs): These blood tests measure the release of interferon-gamma by white blood cells in response to TB antigens. IGRAs are more specific than the TST and are not affected by prior Bacillus Calmette-Guérin (BCG) vaccination.

Chest X-ray: A chest X-ray can reveal signs of TB infection in the lungs, such as abnormal shadows or nodules.

Sputum Culture: This test involves collecting a sample of sputum (phlegm) coughed up from the lungs and culturing it in a lab to see if TB bacteria grow. This test can confirm the presence of TB and help determine which antibiotics will be most effective.

Nucleic Acid Amplification Tests (NAATs): These tests use polymerase chain reaction (PCR) to detect the genetic material of TB bacteria in sputum samples. NAATs are rapid and can provide results within a few hours.

Drug Susceptibility Testing (DST): This test is used to determine which antibiotics will effectively treat the TB bacteria by testing their susceptibility to various drugs.

The specific tests used will depend on the individual's circumstances and the healthcare provider's judgment. It's important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment if TB is suspected.

How do I know if I should get tested for tuberculosis?

You should consider getting tested for tuberculosis (TB) if you have been in close contact with someone who has TB, if you have symptoms of TB (such as a persistent cough, chest pain, coughing up blood, fatigue, fever, night sweats, or weight loss), if you are at higher risk for TB due to factors such as HIV infection, immunosuppressive therapy, or certain medical conditions, or if you are planning to travel to or have recently traveled to a country where TB is common.

Additionally, healthcare workers, employees or residents of high-risk settings (such as prisons or homeless shelters), and people who inject drugs may also be recommended to get tested for TB regularly.

If you think you should be tested for TB, it's important to consult with a healthcare provider. They can assess your risk factors and recommend appropriate testing if necessary.

How is tuberculosis treated?

Tuberculosis (TB) is typically treated with a combination of antibiotics taken over a course of several months. The most commonly used antibiotics for TB treatment include isoniazid, rifampin, ethambutol, and pyrazinamide.

Treatment for TB usually involves two phases:

  • Initial phase (2 months): A combination of antibiotics is taken to rapidly kill the majority of TB bacteria.
  • Continuation phase (4-7 months): A different combination of antibiotics is taken to eliminate the remaining TB bacteria.

It's important to take the full course of antibiotics as prescribed by a healthcare provider, even if you start feeling better. Not completing the full course of treatment can lead to the development of drug-resistant strains of TB, which are more difficult to treat.

In addition to antibiotics, other treatments may be necessary depending on the severity of the TB infection and the presence of complications. It's important for individuals being treated for TB to have regular check-ups with a healthcare provider to monitor their progress and ensure the effectiveness of the treatment.

What are side effects of treatment?

The side effects of tuberculosis (TB) treatment can vary depending on the medications used and the individual's response to treatment. Common side effects of TB treatment include:

  • Nausea and vomiting: Some TB medications can cause gastrointestinal upset, leading to nausea and vomiting.
  • Loss of appetite: TB medications can affect the sense of taste and lead to a loss of appetite.
  • Liver problems: Certain TB medications can affect liver function, leading to elevated liver enzymes or, in rare cases, liver damage.
  • Jaundice: In some cases, TB medications can cause jaundice, a condition characterized by yellowing of the skin and eyes due to liver problems.
  • Rash: Some individuals may develop a rash as a reaction to TB medications.

It's important to report any side effects to your healthcare provider promptly. They can assess the severity of the side effects and make adjustments to your treatment regimen if necessary. In some cases, side effects may require discontinuation of certain medications or additional supportive care.

How soon after starting treatment for active TB will I feel better?

The time it takes to start feeling better after starting treatment for active tuberculosis (TB) can vary from person to person. In general, most people start to feel better within a few weeks to a month after starting treatment. However, it's important to continue taking your medications as prescribed, even if you start feeling better.

TB treatment usually involves taking multiple antibiotics for at least six months. It's important to complete the full course of treatment to ensure that all the TB bacteria are killed and to prevent the development of drug-resistant TB. If you stop taking your medications early, the TB bacteria may become resistant to the antibiotics, making them harder to treat.

During treatment, your healthcare provider will monitor your progress and may adjust your treatment regimen if necessary. If you have any concerns about your treatment or if you are experiencing side effects, it's important to discuss them with your healthcare provider.