Tuberculosis (TB) is a contagious disease caused by the tubercle bacillus, mycobacterium tuberculosis. It commonly affects the lungs but can affect bones and the spine.
The infection is transferred when a person inhales droplets from an infected person. This may be when the infected person coughs, sneezes or exhales. Each person can infect about 10-15 people every year if not treated.
At least 9:10 people infected with the tubercle bacillus do not develop symptoms or have positive chest x-rays. In the USA five percent of infected persons get sick within 12-24 months. Once an individual inhales these droplets, one of four incidences can occur.
1.Their immune system can kill the bacteria, the person does not become infected, the disease is not contagious
2.The bacteria can become dormant and never grow, the infection is not contagious.
3.The bacteria can become dormant for a period, and then begin to grow; symptoms appear later and the infection becomes contagious.
4.The bacteria will multiply rapidly and active TB symptoms appear almost immediately. The disease is contagious
About 2 million deaths occur annually, most occurring in the developing countries. It is estimated than 1/3 of the worlds population is infected with the tubercle bacillus, the largest number of cases occurring in South East Asia
Signs and Symptoms
Contact with an infected person
Cough with sputum more than two weeks
Loss of weight
Low grade fever
Loss of appetite
Risk factors- The HIV infection is a major risk factor for tuberculosis, together the two infections are a deadly combination. Persons living with HIV are twice as likely to develop TB or die of the disease as persons not infected with the HIV. Another high risk factor is tobacco smoking. Compared with non-smokers, smokers have an increased risk of:
Dying from TB
Having a positive tuberculin test
Having active TB
Other risk factors are:
Indoor pollution from bio mass fuel
Patients with organ transplants
Intravenous drug users
Patients with silicosis
Treatment- Drug therapy is the treatment of choice. A combination of drugs including antibiotics makes treatment at home possible. The aims of drug therapy are:
1.Lowering the number of bacilli as quickly as possible, thereby reducing the risk of transmitting the infection
2.Preventing the development of drug resistance
3.To prevent relapse
If drugs are not effective in controlling the disease, surgery may be necessary. The following procedures can be done:
1.Removal of one or more ribs.
2.Removal of part of the lung, or the entire lung
3.Collapsing the lung by pneumothorax
Infection control measures such as isolation and hospitalization are necessary to reduce the risk of transmitting the disease. This is usually of short duration. While at home, the following measures are necessary:
Compliance with medication
Monthly sputum tests
Monitoring of side effects
Preventing Tuberculosis- HIV is the cause of the increase incidence of TB. Twice as many HIV victims are dying of TB than was expected. Any prevention measures should include testing and treating this high risk group. They should include:
1.Testing HIV victims for TB
2.Treating HIV victims for TB
3.Testing all TB cases for HIV
World Health Organization (WHO) has a global prevention strategy to stop TB by the year 2015. A Stop TB partnership is extended to all globally. By engaging all they expect to control tuberculosis and eliminate drug resistance.