Tuberculosis

Tuberculosis


Overview

Tuberculosis (TB) is an infectious disease that most often affects the lungs and is caused by a type of bacteria. It spreads through the air when infected people cough, sneeze or spit.

Tuberculosis is preventable and curable.

About a quarter of the global population is estimated to have been infected with TB bacteria. About 5–10% of people infected with TB will eventually get symptoms and develop TB disease.

Those who are infected but not (yet) ill with the disease cannot transmit it. TB disease is usually treated with antibiotics and can be fatal without treatment.

In certain countries, the Bacille Calmette-Guérin (BCG) vaccine is given to babies or small children to prevent TB. The vaccine prevents TB outside of the lungs but not in the lungs.

Symptoms

People with latent TB infection don’t feel sick and aren’t contagious. Only a small proportion of people who get infected with TB will get TB disease and symptoms. Babies and children are at higher risk.


Certain conditions can increase a person’s risk for tuberculosis disease:diabetes (high blood sugar)
weakened immune system (for example, HIV or AIDS)
being malnourished
tobacco use.


Unlike TB infection, when a person gets TB disease, they will have symptoms. These may be mild for many months, so it is easy to spread TB to others without knowing it.


Common symptoms of TB:prolonged cough (sometimes with blood)
chest pain
weakness
fatigue
weight loss
fever
night sweats.


The symptoms people get depend on where in the body TB becomes active. While TB usually affects the lungs, it also affects the kidneys, brain, spine and skin.

Prevention

Follow these steps to help prevent tuberculosis infection and spread:Seek medical attention if you have symptoms like prolonged cough, fever and unexplained weight loss as early treatment for TB can help stop the spread of disease and improve your chances of recovery.
Get tested for TB infection if you are at increased risk, such as if you have HIV or are in contact with people who have TB in your household or your workplace.
If prescribed treatment to prevent TB, complete the full course.
If you have TB, practice good hygiene when coughing, including avoiding contact with other people and wearing a mask, covering your mouth and nose when coughing or sneezing, and disposing of sputum and used tissues properly.


Special measures like respirators and ventilation are important to reduce infection in healthcare and other institutions.
Diagnosis

WHO recommends the use of rapid molecular diagnostic tests as the initial diagnostic test in all persons with signs and symptoms of TB.

Rapid diagnostic tests recommended by WHO include the Xpert MTB/RIF Ultra and Truenat assays. These tests have high diagnostic accuracy and will lead to major improvements in the early detection of TB and drug-resistant TB.

A tuberculin skin test (TST) or interferongamma release assay (IGRA) can be used to identity people with infection.

Diagnosing multidrug-resistant and other resistant forms of TB (see multidrug-resistant TB section below) as well as HIV-associated TB can be complex and expensive.

Tuberculosis is particularly difficult to diagnose in children.

Treatment

Tuberculosis disease is treated with antibiotics. Treatment is recommended for both TB infection and disease.

The most common antibiotics used are:isoniazid
rifampin
pyrazinamide
ethambutol
streptomycin.

To be effective, these medications need to be taken daily for 4–6 months. It is dangerous to stop the medications early or without medical advice. This can allow TB that is still alive to become resistant to the drugs.

Tuberculosis that doesn’t respond to standard drugs is called drug-resistant TB and requires more toxic treatment with different medicines.




Website: International Conference on Infectious Diseases.

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