What is Tuberculosis?

 

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs but can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with the bacteria becomes sick. As a result, two TB-related conditions exist: a latent TB infection (LTBI) and TB as a disease. If not treated properly, the disease may be fatal.

Tuberculosis is a health threat that should not be ignored, especially when it comes to people living with HIV. This is because they are more likely to acquire TB as compared to others. According to available statistics, TB is one of the leading causes of death among people living with HIV worldwide.

Without treatment, as with other opportunistic infections, HIV and TB can work together to shorten lifespan. Someone with untreated latent TB infection and HIV infection is more likely to develop the disease during his or her lifetime than someone without HIV infection.

Among people with latent TB infection, HIV infection is the strongest known risk factor for progressing to TB disease. This is because ones’ immune system is weakened hence the emergence of the active progressive TB.

A person who has both HIV infection and TB disease has an AIDS-defining condition. {Expound on the AIDS-defining condition}

People infected with HIV who also have either latent TB infection or TB disease can be effectively treated over time in a series of steps. The first step is to ensure that people living with HIV are tested for the infection. If found to have TB infection, further tests are needed to rule out TB disease. The next step is to start treatment for latent TB infection or TB disease based on test results.

Treatment

Untreated latent TB infection can quickly progress to the disease in people living with HIV since the immune system is already weakened and without treatment, the disease can quickly progress from sickness to death.

Fortunately, there are a number of treatment options for people living with HIV who have either latent TB infection or TB disease

Signs & Symptoms

The signs and Symptoms of TB disease depend on where in the body the TB bacteria are growing. The bacteria usually grow in the lungs (pulmonary TB). An infection in the lungs may be characterized by several signs and symptoms such as

  • A bad cough that lasts 3 weeks or longer
  • Pain in the chest
  • Coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms of TB disease are

  • Weakness or fatigue
  • Weight loss
  • No appetite
  • Chills
  • Fever
  • Sweating at night

The symptoms of the disease when it affects other parts of the body depend on the affected area.

People who have latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB to others.

How TB Spreads

The bacteria are spread through the air from one person to another. The TB bacteria are released into the air when a person with TB of the lungs or throat coughs, speaks, or sings. People nearby may breathe in these bacteria and become infected.

TB is also spread through:

  • Shaking someone's hand
  • Sharing food or drink
  • Touching bed linens or toilet seats
  • Sharing toothbrushes
  • Kissing

When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there lungs they move through the blood to other parts of the body, such as the kidney, spine, and brain.

TB in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.

People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates

Symptoms of TB

Typical symptoms of TB include:

  • A persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
  • Weight loss
  • Night sweats
  • High temperature (fever)
  • Tiredness and fatigue
  • Loss of appetite
  • Swellings in the neck

You should see a doctor if you have a cough that lasts more than three weeks or you cough up blood.

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What causes TB?

TB is a bacterial infection. TB that affects the lungs (pulmonary TB) is the most contagious type, but it usually only spreads after prolonged exposure to someone with the illness.

In most healthy people, the body's natural defense against infection and illness (the immune system) kills the bacteria and there are no symptoms.

Sometimes the immune system can't kill the bacteria, but manages to prevent it spreading in the body.

You won't have any symptoms, but the bacteria will remain in your body. This is known as latent TB. People with latent TB aren't infectious to others.

If the immune system fails to kill or contain the infection, it can spread within the lungs or other parts of the body and symptoms will develop within a few weeks or months. This is known as active TB.

Latent TB could develop into active TB disease at a later date, particularly if your immune system becomes weakened.

Read more about the causes of TB.

Treating TB

With treatment, TB can almost always be cured. A dose of antibiotics will need to be administered for six months.

Different antibiotics are used because some forms of TB are resistant to certain antibiotics.

If one is infected with a drug-resistant form of TB, treatment with six or more different medications may be needed.

In the event that one is diagnosed with pulmonary TB, one is considered contagious for about two to three weeks into the course of treatment.

There is usually no need for one to be isolated during this time, but it's important to take some basic precautions to stop the infection spreading to your one’s family and friends.

One should:

  • Stay away from work, school or college until the TB treatment team advises that it is safe to return
  • Always cover the mouth when coughing, sneezing or laughing
  • Carefully dispose of any used tissues in a sealed plastic bag
  • Open windows when possible to ensure a good supply of fresh air in the areas where one spends time
  • Avoid sleeping in the same room as other people

If you're in close contact with someone who has TB, you may have tests to see whether you're also infected. These can include a chest X-ray, blood tests, and a skin test called the Mantoux test.

Vaccination for TB

The BCG vaccine offers protection against TB, and is recommended on the NHS for babies, children and adults under the age of 35 who are considered to be at risk of catching TB.

The BCG vaccine isn't routinely given to anyone over the age of 35 as there's no evidence that it works for people in this age group.

At-risk groups include:

  • Children living in areas with high rates of TB
  • People with close family members from countries with high TB rates
  • People going to live and work with local people for more than three months in an area with high rates of TB

If you're a healthcare worker or NHS employee and you come into contact with patients or clinical specimens, you should also have a TB vaccination, irrespective of age, if you haven't been previously vaccinated (you don't have a BCG scar or the relevant documentation), and the results of a Mantoux skin test or a TB interferon gamma release assay (IGRA) blood test are negative

Countries and Parts of the world with high rates of TB include:

  • Africa – particularly sub-Saharan Africa (all the African countries south of the Sahara Desert) and West Africa
  • Southeast Asia – including India, Pakistan, Indonesia and Bangladesh
  • Russia
  • China
  • South America
  • The western Pacific region (to the west of the Pacific Ocean) – including Vietnam, Cambodia and the Philippines

 

Pearl Generation

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  • info@pearlgenerationuganda.com
  • Ntinda (Kiwatule Road)
    Behind Steka House
  • Tel: +256 414 663 365
            +256 700 732 238


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