Why is it important to contain tuberculosis?
- TB remains the world’s deadliest killer caused by any bacteria. Each day, 4500 people lose their lives to tuberculosis and about 30,000 get infected every day. Global efforts to combat tuberculosis have saved 54 million lives since 2000. This has reduced mortality by 42%.
Which organs are involved in tuberculosis?
- Most of the individuals have lung tuberculosis. However, tuberculosis can affect each and every organ of our body except hair and nails. This includes the lymph nodes, skin, brain and meninges, bones and joints and many more. This means patient,s could either have pulmonary or extra-pulmonary tuberculosis.
What are the common symptoms of tuberculosis?
- The symptoms could be organ specific. Fever, cough, night sweats, weight loss, pain in chest and blood in sputum are extremely common symptoms of tuberculosis. Involvement of the spine can lead to symptoms of severe backache. Involvement of the eye can cause redness in the early phase. In some individuals, there may be no symptoms in the early phase.
What about tuberculosis in young women?
- The commonest cause of infertility in women in India may be tuberculosis. This leads to blockages of the Fallopian tube. Irregular menses, weight loss and pain in the lower abdomen could be other features. Hence early and adequate treatment is mandatory.
Who has increased susceptibility for tuberculosis?
- Those who have poor immunity against tuberculosis are vulnerable. This includes the poor and malnourished. In addition, people with diabetes are extremely susceptible. Diabetes increases the risk of tuberculosis and tuberculosis increases blood glucose. Those on immunosuppressive therapy like steroids, anti-cancer drugs, chronic alcoholism are susceptible. HIV infection lowers the immunity against tuberculosis and tuberculosis is the commonest infection in this group. In fact, one in every third individual has tuberculosis in his lifetime. This makes the whole Indian population at risk for tuberculosis.
What has the Indian Government done to combat tuberculosis?
- There have been tremendous contributions from the government. Right from free medications to free investigations and even travel allowances to patients who come from remote tribal areas to hospitals is available. Tests to diagnose drug resistance tuberculosis are also available free of cost in selected government hospitals. Doctors can dispense anti-tuberculosis drugs free of cost to patients. These are provided free of cost by the government to the doctors.
What are the challenges in treating tuberculosis?
- Multiple drug-resistant tuberculosis and extended drug resistance tuberculosis are difficult to diagnose and treat. They require additional drugs that may be toxic and may have additional side effects. In about one month of therapy for tuberculosis, most patients feel good and healthy. There is always this tendency to stop drugs. This leads to recurrence and administration of the same drugs again may not yield results. This is how drug resistance develops. Inadequate doses, poor compliance, uncontrolled diabetes, excess alcohol intake may impact the course of tuberculosis.
What is generally the drug therapy?
- As against most infections where one antibiotic is essential, in tuberculosis 4 antibiotics need to be used in the early phase. The treatment is for a minimum of 6 months. This may be extended to more than a year in bone or joints tuberculosis. In those who have Multiple Drug Resistant tuberculosis, the treatment may extend to 18 to 24 months. Proper and correct treatment as per the guidelines is recommended to prevent relapse and drug resistance.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.