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A Case For The Early Detection of Tuberculosis

by Dr. Ope Oshodi

Tuberculosis, popularly known as TB remains one of the most challenging infectious bacterial diseases affecting human health. It is caused by a tuberculosis germ called Mycobacterium Tuberculosis. Because it is highly communicable, this disease is easily spread via the coughs and sneezes of the infected person.

Tuberculosis may sound like a disease of the past, but it is still a real concern today. Matter of fact, in 2018 alone, more than 10miliion people were sick with TB and 1.5million people died of the disease with Nigeria as one of the 8 countries in the world that account for most cases of the total global burden of tuberculosis.

Note that a diagnosis of active tuberculosis is not a death sentence. In fact, the disease is almost always curable if the sick person seeks medical help and adheres to using his/her medications for the stipulated period. Thus, it is always better to detect it early than to wait till it has caused a lot of damage.

Having active tuberculosis should not prevent someone from living a normal life, but more importantly, it helps if it is discovered at its infant stage as early detection has proven to:
• Prevent prolonged illness, disability or possible death
• Improve the chances of cure and prevent complications
• Prevent transmission of the tuberculosis bacteria to friends and family

This is what happens when a person is exposed and infected with the Tuberculosis bacteria:

It develops through a latent stage then metamorphose to the active stage. The infected person’s immunity first builds a wall around the germ to prevent it from growing and multiplying (Latent Tuberculosis). But before long, and especially if not detected early, the body’s immunity becomes weak, thereby making the disease to grow and start to cause symptoms (Active Tuberculosis).

Latent TUBERCULOSISActive TUBERCULOSIS
  No symptoms and the person will feel fine  Has symptoms and the person feels sick
  Chest x-ray is usually normal  Chest x-ray is usually abnormal
  Cannot transmit the germ to others  Can transmit the germ to others

Tuberculosis has been known to affect the following areas of the body:
• The Lungs: The commonest site. (pulmonary tuberculosis)
• Other parts of the body: kidneys, spine, brain. (Extrapulmonary tuberculosis)
• Multiple sites of the body (Miliary or Disseminated tuberculosis).

Risk factors for Tuberculosis infection

Anyone can get the disease but the people at increased risk include,
• Friends, family or co-workers of people who have active tuberculosis
• People who had tuberculosis in the past but did not take or complete their medications
• Babies who did not receive their tuberculosis vaccines
• Elderly people
• People with weak immune system (HIV and cancer patients)
• Working or living in a hospital or nursing home
• Being part of a group where tuberculosis is more likely to spread (homeless people, IV drug users, prisoners)
• Smokers

Photo credit: Canva

Signs and symptoms of Tuberculosis infection

Photo credit: Canva

The early signs develop slowly and may go unnoticed. They include:
• Cough
• Chest pain
• Loss of appetite
• Weight loss
• Tiredness
• Fever
• Night sweats
• Chills

How is Tuberculosis spread?

Tuberculosis disease in the lungs can be infectious.
• It can be spread when someone sick with TB coughs, talks, sneezes or sings and sprays the disease germ into the air
• A person can get tuberculosis when he/she breathes in the disease germ after spending prolonged periods with a sick patient.

Tuberculosis CANNOT be spread by:

• Shaking someone’s hand
• Sharing food or drink
• Touching bed linens
• Touching toilet seats
• Sharing personal belongings.

The Infectious period:

The infectious period is the time when a sick patient with active tuberculosis can pass the germ to other people. It usually begins several months before any obvious signs of tuberculosis are noticed.

The infectious period continues until:
• The patient is on appropriate treatment
• The patient is getting better
• The patient has 3 consecutive smear negative specimen.

Detecting Tuberculosis

Photo credit: Canva

It may be important to get screened for tuberculosis if you have any of the following:
• Cough especially if it is more than 3 weeks
• Bloody sputum
• Losing weight (without going on a weight loss diet)
• Sweating a lot at night
• You live with someone who has the disease or chronic cough
• You are immunosuppressed

A person with signs and symptoms suggestive of tuberculosis can then be asked to do one or more of the following tests:
•Sputum to test for the tuberculosis germ
• Chest x-ray to check for changes in the lungs
• Blood tests to check for signs of tuberculosis infections or reduced immunity
• Skin test (Mantoux test) which is also positive in latent tuberculosis

Treating Tuberculosis

Tuberculosis treatment depends on whether a person has active or latent tuberculosis. With latent tuberculosis, your doctor may decide to give you medications to kill the bacteria if you are at risk of getting active tuberculosis. But If you already started to see any symptom of active tuberculosis, please see your doctor as soon as you can for further testing.

When it has gotten to full blown active tuberculosis, the sick person is given several tuberculosis medications to kill the bacteria. Taking these drugs as prescribed is important to prevent the tuberculosis germs from becoming resistant. The drugs do not affect strength, sexual function or ability to work. They are taken for prolonged periods (usually 6 months or more) because the disease bacteria grow slowly and are slow to die. It is not uncommon for most TB patients to start feeling well after only a few weeks of treatment, but the tuberculosis germs are still alive in the body. Therefore, the medications must be taken religiously and without interruptions for the entire duration of the treatment. It is imperative to know how dangerous quitting tuberculosis medicines early or taking them irregularly can be because of the tendency of the disease bacteria to start to grow again, making the patient sicker and infectious again. In worse case scenarios, the bacteria become resistant to the medications.

Furthermore, new and different medicines will be needed to kill the bacteria and these new drugs will have to be taken for longer periods, They usually include daily injectables and may have more side effects.

A Call to Stop the Spread of Tuberculosis

If you have active tuberculosis, follow these tips until your doctor says you are no longer infectious:
• Take all your medicines as prescribed until your doctor takes you off them
• Keep all your doctor’s appointments
• Cover your mouth with a tissue when you cough or sneeze and seal the tissue in a plastic bag before you throw it away
• Wash your hands after coughing or sneezing
• Stay home from public places.
• Don’t visit other people and don’t invite them to visit you
• Don’t use public transportation
• Open your windows to allow fresh air to move around.

In conclusion, tuberculosis is still a global menace especially in developing countries like Nigeria. Symptoms of tuberculosis include cough of more than three weeks, coughing up blood, night sweats, weight loss and chest pain. People with active tuberculosis are most likely to spread the disease to people they spend time with every day.

The good news is that tuberculosis is both preventable and curable, but we all have a part to play in ensuring this.

The best time to detect TUBERCULOSIS is now!

Consult a doctor at kompleteCare to know your TUBERCULOSIS status today!

References

Basic TUBERCULOSIS facts. Centre for Disease control and Prevention. December 2018. Available from https://www.cdc.gov/Tuberculosis/about/default.htm

Global Tuberculosis report 2019. World health Organization. October 2019. Available at https://www.who.int/Tuberculosis/publications/global_report/en/

Tuberculosis. Lung Disease and Respiratory health. WebMD. Available at https://www.webmd.com/lung/understanding -tuberculosis-basics

12 points of Tuberculosis. Patient Education. Georgia Public Health TUBERCULOSIS Unit. April 2012. Available at https://dph.georgia.gov


Dr. Ope Oshodi

Dr. Ope (MBBS, MWACP) is a Senior Registrar (Family Medicine) at National Hospital Abuja, Nigeria.

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