Tuberculosis

Tuberculosis (TB) is a bacterial infection spread through the air that is caused by the organism Mycobacterium tuberculosis. It primarily affects the lungs, but it can also affect other organs and tissues.

 

You don't always get sick from a tuberculosis infection. The disease is divided into two types:

 

If you have latent tuberculosis, the germs are present in your body, but your immune system prevents them from spreading. You're not contagious and don't have any symptoms. However, the infection is still alive and could resurface at any time. If you're at high risk for reactivation, such as if you have HIV, have had an infection in the last two years, have an abnormal chest X-ray, or have a weakened immune system, your doctor will prescribe medications to prevent active TB.

 

When you have active tuberculosis, the germs multiply and make you sick. You have the ability to spread the disease to others. In adults, 90% of active cases are caused by a latent tuberculosis infection.

 

A drug-resistant TB infection, whether latent or active, means that certain medications won't work against the bacteria.

 

The main symptoms of tuberculosis variants and stages are listed, with many symptoms overlapping with those of other variants and others being more (but not entirely) specific to specific variants. Multiple variants may exist at the same time.

 

Tuberculosis can affect any part of the body, but the lungs are the most common site of infection (known as pulmonary tuberculosis). Tuberculosis that develops outside of the lungs is known as extrapulmonary tuberculosis, though it can coexist with pulmonary tuberculosis.

 

Fever, chills, night sweats, loss of appetite, weight loss, and fatigue are all common signs and symptoms. Nail clubbing is also a possibility.

 

If tuberculosis becomes active, the infection usually affects the lungs (in about 90 percent of cases). Chest pain and a persistent cough with sputum are common symptoms. About a quarter of the population may be symptomless (i.e. they remain "asymptomatic"). People may cough up small amounts of blood occasionally, and in extremely rare cases, the infection may erode into the pulmonary artery or a Rasmussen's aneurysm, causing massive bleeding. Tuberculosis can develop into a long-term illness that results in extensive scarring in the upper lobes of the lungs. Tuberculosis affects the upper lung lobes more frequently than the lower ones. The reason for this disparity is unknown. It could be due to increased airflow or a lack of lymph drainage in the upper lungs.

 

The infection spreads outside the lungs in 15–20 percent of active cases, causing other types of tuberculosis. "extrapulmonary tuberculosis" is the term used to describe all of these conditions. People with a weakened immune system and young children are more likely to develop extrapulmonary tuberculosis. In people living with HIV, this happens in more than half of the time. The pleura (in tuberculous pleurisy), the central nervous system (in tuberculous meningitis), the lymphatic system (in scrofula of the neck), the genitourinary system (in urogenital tuberculosis), and the bones and joints (in Pott disease of the spine) are just a few examples of extrapulmonary infection sites. "disseminated tuberculosis" also known as miliary tuberculosis, is a potentially more serious and widespread form of TB. Miliary tuberculosis accounts for about 10% of all extrapulmonary cases.

 

If you have latent tuberculosis, your doctor will prescribe antibiotics to kill the bacteria and prevent the infection from becoming active. Isoniazid, rifapentine, or rifampin may be given separately or in combination. You may be required to take the medication for up to 9 months. Call your doctor right away if you notice any signs of active tuberculosis.

 

Active tuberculosis is also treated with a combination of medications. Ethambutol, isoniazid, pyrazinamide, and rifampin are the most common. You'll be taking them for six to twelve months.

 

If you have drug-resistant tuberculosis, your doctor may prescribe one or more medications. You may have to take them for a longer period of time, up to 30 months, and you may experience more side effects.

 

Bacillus Calmette-Guérin is the only vaccine available (BCG). In children, it reduces the risk of infection by 20% and the risk of infection progressing to active disease by nearly 60%.

 

Anti-TB drugs have been used for decades, and strains resistant to one or more of them have been identified in every country studied. Drug resistance develops when anti-TB medicines are prescribed incorrectly by health care providers, drugs are of poor quality, and patients discontinue treatment prematurely.

 

MDR-TB is a type of tuberculosis caused by bacteria that are resistant to the two most effective first-line anti-TB drugs, isoniazid and rifampicin. MDR-TB can be treated and cured with second-line drugs. Second-line treatment options, on the other hand, are limited and require extensive chemotherapy (up to 2 years of treatment) with expensive and toxic medicines.

 

More severe drug resistance can develop in some cases. Patients with tuberculosis caused by bacteria that do not respond to the most effective second-line anti-TB drugs may have no other treatment options.

 

MDR-TB is still a public health crisis and a health security threat in 2019. In 2019, 206 030 people with multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB) were detected and notified globally, up 10% from 186 883 in 2018. India, China, and the Russian Federation account for roughly half of the global MDR-TB burden.

 

Only 57 percent of MDR-TB patients in the world are currently being successfully treated. In 2020, the World Health Organization (WHO) recommended a new, shorter (9-11 months), fully oral regimen for MDB-TB patients. Patients find it easier to complete the regimen when compared to longer regimens that can last up to 20 months, according to this study. Prior to starting treatment with this regimen, fluoroquinolone resistance should be ruled out.

 

MDR/RR-TB detection, according to WHO guidelines, requires bacteriological confirmation of TB and drug resistance testing using rapid molecular tests, culture methods, or sequencing technologies. A course of second-line drugs for at least 9 months and up to 20 months is required, along with counselling and adverse event monitoring. The WHO recommends that all-oral regimens be made more widely available.

 

In an effort to improve the effectiveness of MDR-TB treatment, 89 countries began using shorter MDR-TB regimens by the end of 2019, and 109 countries had imported or begun using bedaquiline.

 

•On March 24, 1882, Robert Koch identified and described the bacillus that causes tuberculosis, M. tuberculosis. In 1905, he was awarded the Nobel Prize in Physiology or Medicine for this discovery.

 

• The Mantoux tuberculin skin test is frequently used to screen people who are at high risk of contracting tuberculosis. A false-positive test result may occur in those who have previously been immunised with the Bacille Calmette-Guerin vaccine.

 

• Rapid diagnosis of tuberculosis may be possible with nucleic acid amplification tests and adenosine deaminase testing. These tests, on the other hand, are rarely recommended because they rarely change how a person is treated.

 

• In 2019, 1.4 million people died from tuberculosis (TB) (including 208 000 people with HIV). TB is one of the top ten causes of death worldwide, and the leading cause of death from a single infectious agent (behind HIV/AIDS).

 

• Globally, an estimated 10 million people contracted tuberculosis (TB) in 2019. There are 5.6 million men, 3.2 million women, and 1.2 million children in the country. Tuberculosis is found in all countries and in all age groups. TB, on the other hand, is both curable and preventable.

 

• Globally, 1.2 million children were diagnosed with tuberculosis in 2019. Health providers frequently overlook child and adolescent tuberculosis, which can be difficult to diagnose and treat.

 

• In 2019, the 30 countries with the highest TB burden accounted for 87 percent of all new TB cases. India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa account for two-thirds of the total, with India leading the pack, followed by Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa.

 

• Multidrug-resistant tuberculosis (MDR-TB) is still a public health emergency and a security threat. In 2019, 206 030 people with multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB) were detected and notified globally, up 10% from 186 883 in 2018.

 

• Globally, TB incidence is decreasing at a rate of about 2% per year, with a 9 percent reduction between 2015 and 2019. This was less than half of the way to the End TB Strategy's goal of a 20% reduction in TB cases between 2015 and 2020.

 

• Between 2000 and 2019, TB diagnosis and treatment saved an estimated 60 million lives.

 

• One of the United Nations Sustainable Development Goals is to end the tuberculosis epidemic by 2030. (SDGs).