Shed TB burden

According to WHO, TB had infected 2.2 million people in India in 2011.Dr Sandeep Nayar tells you how to prevent the disease

Tuberculosis or TB, is a disease caused by a type of air-borne bacteria, and mainly attacks and infects the lungs. It may however also spread to the other parts of the body, such as the brain, spine and kidneys. 

One of the leading causes of death due to infectious diseases worldwide and in India, TB had infected 2.2 million people in India alone in 2011 (as per estimates from the World Health Organisation) out of 9.6 million cases noted globally. Hence, our country is accounting for around one-fourth of the global TB burden.

Here are some important things to know about this deadly disease.

• TB can happen to anyone: TB is usually spread through air when someone with untreated TB coughs, sneezes and/or talks, or when you come in close contact with such a person (this increases the chances of breathing in the mycobacterium that causes TB). 

TB is a contagious disease, and having a weakened immune system or living in and around a person having TB, or in areas that are overcrowded and or having poor ventilation, may increase your chances of contracting TB. However, there is no one risk factor that is absolute for catching TB. Anyone, anywhere in the world, and at any age whatsoever, can get TB.

• You can have TB and not know it: Latent TB is common, especially among infants and children. You may have the harmful germs present in your body, yet your body’s immune system is preventing them from multiplying.

Since the people with latent TB infection usually do not feel sick at all, or display any symptoms as such, there remains a chance that it can go entirely undiagnosed for a long period, or people may be unaware that the infection is alive in his/her body. It is important to note here that around five-10 per cent of people who do not receive adequate treatment shall go on to develop Active TB at some point of their lives later on.

• Drug-Resistant TB: The TB bacterium is able to naturally defend some medical drugs, and may even acquire drug resistance via genetic mutation. Various studies from the recent past have suggested that Drug-Resistant TB is on the rise currently in India and across the globe.

This type of TB usually occurs when the drugs for treatment of TB are being misused or mismanaged. Multidrug-Resistant TB or MDR TB happens when it becomes resistant to more than one first-line anti-TB drug. Treatment of Drug-Resistant TB is a complicated affair as compared to other forms, and inappropriate management can prove to be life-threatening.

• Can be cured entirely: Yes, it’s true that TB has time and again resurfaced across various parts of the world as a killer disease. But that does not mean it is non-curable.

If TB is spotted early and unless you are having Drug-Resistant TB, the doctor will prescribe a course of antibiotics that may last for six months or more. It is important that the full course is completed to get rid of the disease.

WHAt to do

• HIV: TB takes a devastating turn, if it happens to a personwho is already sufferingfrom HIV.
• The very first step is to do the test for TB infection in HIV patients, if detected further test is done to rule out Active TB disease. Thereafter the treatment is started for latent TB or TB disease as per the result.
• Diabetes: Diabetes triples the risk of developing TB. Diabetes suppresses the immune system and increases the risk latent TB to active. People affected with diabetes and TB is not diagnosed or is diagnosed too late.
• Keep a check on glucose level.                                           
• Initially tuberculin skin test (TST) is recommended to all diabetes patients, if found positive then isoniazid (INH) treatment is advised for 6-12 months.
• Tobacco Smoking: Tuberculosis and smoking has a strong association. Smoking increases the risk of TB and even death.
• Quitting smoking can reduce the risk of TB.

Alcohol: Intake of alcohol triples the risk of TB which damages the liver badly.

• By strictly adhering to the treatment and quitting alcohol can minimize the risk of TB
• Organ Transplant: The recipient of lung transplant has the highest risk of TB incidences. Mostly TB occurs in the first 6 month of transplantation.
• Identification of latent TB before transplantation is necessarywith both PPD and IGRA test may increase sensitivity for detection.
• Rifampicin-containing regimens is recommended.
• Usage of Rifabutin lowers the risk.