Timely Detection and Treatment of Tuberculosis

Tuberculosis (TB) has been, and remains one of the greatest public health concerns since the Neolithic ages. Unlike small pox, chicken pox, plague, leprosy, and to a certain extent AIDS, where medical science has been able to eradicate or control the ailment to a large extent, tuberculosis is one disease that continues to challenge the medical fraternity. 

There are several reasons for this:

• This airborne disease is highly contagious and simple actions like coughing, sneezing and talking, helps spread the bacteria
• Several new strains of the two primary types of bacteria that cause TB, are detected all the time
• These new strains have developed resistance to the existing medications, making treatment difficult
• TB does not present typical symptoms and most of its symptoms can be confused with that of other diseases
• Growing the bacteria in laboratory cultures, is a slow process and it often produces unreliable results. The lab cultures are used to detect TB
• Similarly, the TB bacteria take a long time to die which makes the treatment an extremely lengthy process

Risk Factors

• AIDS and HIV infection
• Poverty and poor hygiene / Poor living conditions
• A weak immune system
• Diabetes
• Medication used to prevent rejection of transplanted organs
• Certain cancer treatments (Chemotherapy)
• Drug and alcohol abuse
• Diseases that are immunosuppressant in nature, such as the final stages of kidney disease, certain types of cancer
• Exposure to migrants from high TB-risk countries
• Healthcare professionals who treat TB patients

Typical symptoms

Depending on the type of TB contracted by the patient, and the stage of the disease, the symptoms can vary. However, the most common symptoms are:

• Consistent coughing that produces sputum every time
• Few drops of blood in the sputum
• Fever
• Poor to no appetite
• Rapid loss of weight and muscle
• Excessive sweating, while asleep at night

Diagnosing TB

There are several tests used to diagnose TB; tests which use a mix of physical and diagnostic examinations.

• Chest X-ray: Used to detect acute pulmonary TB that shows up as small cavities in the lungs
• Mantoux skin test: A dose of tuberculin is injected into the arm of the patient. The site is checked for any swelling 2 or 3 days later, on the patient’s return visit to the laboratory. Swelling at the site of the injection, is a positive sign of the existence of TB
• IGRA or Interferon Gamma Release Assays: The human immune response is known to produce a particular molecule called cytokine in response to TB bacteria. In this procedure or ‘assay’, a small sample of the patient’s blood is examined, to find the presence of a particular strain of cytokine called Interferon Gamma Cytokine
• Serodiagnostic tests: The blood sample of a patient suspected to have TB, is analyzed for the presence of specific antibodies
• Sputum smear microscopy: The patient’s sputum is smeared on slides and a particular stain is added. TB bacteria are known to pick up the stain (hence called “acid-fast bacteria”), thereby confirming the presence of TB
• Ziehl-Neelsen Florescent light microscopy: The sputum smears on the slides are examined under either a quartz halogen lamp, a mercury vapor lamp, or LED lamp, to detect the presence of TB bacteria

Once the strain of TB bacteria is detected, a relevant course of treatment is designed. Depending on the diagnosis, the treatment period could be anywhere from 6 to 9 to 12 months or even longer. All medications prescribed must be taken at the time specified. The medications may contain one or more types of antibiotics.

If you suspect that you may have been infected, then contact your primary care physician immediately, who after performing the preliminary tests and confirms the presence of TB, will refer you to a doctor who specializes in lung or infectious diseases.