Understanding Tuberculosis: A Comprehensive Guide for Indian Patients

Introduction: Tuberculosis (TB) is a contagious infection that mainly affects the lungs, but it can also impact other parts of the body, such as the brain and spine. It results from the bacterium Mycobacterium tuberculosis. In the past, TB was a leading cause of death, but antibiotics can now cure it. Treatment, however, requires several months. This article aims to provide a clear understanding of TB for Indian patients.

Types of Tuberculosis

There are two types of TB:

1. Latent TB:
The TB bacteria are present in the body, but the immune system prevents them from spreading. There are no symptoms, and the person is not contagious. However, latent TB can become active in the future. If you are at risk, your doctor may prescribe medications to prevent it from becoming active.

2. Active TB:
Active TB occurs when the TB bacteria multiply and cause symptoms. It is contagious. Most cases of active TB in adults stem from a prior latent TB infection. In some cases, active TB can also be drug-resistant, which means some medications may not effectively treat it.

Signs and Symptoms of TB

Latent TB does not cause symptoms. A skin or blood test can determine if you have latent TB.

Signs of active TB disease include:

• Persistent cough lasting more than 3 weeks
• Chest pain
• Coughing up blood
• Fatigue
• Night sweats
• Chills
• Fever
• Loss of appetite
• Weight loss

If you experience any of these symptoms, consult a doctor. Seek immediate medical help if you have chest pain.

Causes and Risk Factors

TB spreads through the air, similar to the common cold or flu. You can catch TB by coming into contact with someone who has active TB. Certain factors increase your risk of contracting TB, including:

• Close contact with someone who has active TB
• Living in or traveling to areas where TB is common
• Belonging to a high-risk group, such as people with HIV or those who inject drugs
• Working or living in healthcare settings
• Smoking
• Having medical conditions that weaken the immune system

Transmission of Tuberculosis

TB is not easily transmitted. Typically, it requires prolonged exposure to someone with a high amount of TB bacteria in their lungs. The most common sources of transmission are close contacts, such as co-workers, family, and friends. TB germs do not survive on surfaces, so you cannot get infected by shaking hands or sharing food or drinks.

Tests and Diagnosis

There are two common tests for tuberculosis:

1. Skin Test:
In the Mantoux tuberculin skin test, a small amount of fluid is injected into your lower arm. After 2-3 days, the healthcare provider checks for any swelling at the injection site. A positive result suggests the presence of TB bacteria.

2. Blood Test:
Interferon-gamma release assays (IGRAs) test your body’s response to TB proteins mixed with a sample of your blood. These tests do not confirm whether your infection is latent or active. Additional tests such as chest X-rays or CT scans may be needed to confirm the diagnosis.

Treatment of Tuberculosis

Treatment depends on the type of infection:

1. Latent TB:
If you have latent TB, your doctor may prescribe medications to kill the bacteria and prevent the infection from becoming active. Common medications include isoniazid, rifapentine, or rifampin.

The treatment can last up to 9 months.

2. Active TB:
Active TB requires a combination of medications, including ethambutol, isoniazid, pyrazinamide, and rifampin. Treatment lasts 6 to 12 months. Drug-resistant TB may require a different set of medications, and treatment could last up to 30 months. Completing the full course of treatment is crucial to prevent resistance.

Medication Side Effects

Common side effects include:

• Isoniazid: Numbness, tingling in hands and feet, upset stomach
• Ethambutol: Chills, joint pain, upset stomach
• Pyrazinamide: Nausea, joint pain, lack of energy
• Rifampin: Rash, upset stomach, diarrhea

Complications of Tuberculosis

TB can lead to complications such as joint damage, infections of the bones, spinal cord, brain, or lymph nodes, and liver or kidney problems. Inflammation around the heart can also occur.

Prevention of Tuberculosis

To prevent the spread of TB:

• Take all prescribed medications for latent TB to prevent it from becoming active.
• If you have active TB, minimize contact with others, cover your mouth when coughing or sneezing, and wear a mask during the initial weeks of treatment.
• Avoid crowded places with sick individuals when traveling to areas where TB is common.
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Tuberculosis Vaccine

The BCG vaccine is given to children in areas where TB is widespread. In the U.S., it is not common and does not always prevent TB. It is mainly recommended for children living with someone who has drug-resistant TB.

Outlook for Tuberculosis

The outlook for TB depends on your overall health, the severity of the infection, and your adherence to treatment. With proper treatment, TB is curable, and in the U.S., more than 95% of cases are successfully treated.

For more information on the TB, visit our dedicated page.

For information on TB drug resistance, visit the website.