What Is Tuberculosis (TB)
Tuberculosis (TB) is an airborne bacterial infection caused by Mycobacterium tuberculosis1. It is an organism discovered by Dr Robert Koch on March 24, 18821. M. tuberculosis primarily affects the lungs and moves through the blood to other parts of the body, such as the brain, spine and kidney2. In 2010 alone, TB had infected about 8.8 million people worldwide3. In the same year, the incidence of TB in Malaysia was 81.4 per 100,000 population3.
TB can be divided into Latent TB infectionTB disease. The individual with latent TB infection is asymptomatic and cannot infect others because the bacteria remain inactive in the body4. An individual with latent TB would present with a normal chest X-ray and a negative sputum smear 4. However, one with latent TB will present with a positive TB skin test or blood test4. The individual should consider latent TB infection treatment to prevent progression into TB disease. An individual with an active TB disease, on the other hand, would present with multiple symptoms (see below) and is in a contiguous state.
Symptoms Of Tuberculosis In The Lungs
When an individual with TB of the lungs or throat coughs, sneezes, sings, or talks, he/she will disperse TB bacteria into the air3. Those who are nearby can potentially inhale the bacteria and become infected. Therefore, tuberculosis is transmitted from one person to another person on an air-borne basis.
People with TB will experience the following symptoms4:
- A bad cough that lasts 3 weeks or longer
- Pain in the chest
- Coughing up blood or sputum (phlegm from deep inside the lungs)
- Weight loss
- Loss of appetite
- Fatigue or weakness
- Fever
- Night sweats
Who Is At Risk Of Tuberculosis
An individual with the following risk factors5-6:
- A weak immune system (i.e. HIV infection, diabetes mellitus, on certain drug treatments such as corticosteroids)
- A recent TB infection (i.e. close contacts of a person with infectious TB disease, children less than 5 years old who have a positive TB test)
- Tobacco use
- Excessive intake of alcohol
- Young age and/or elderly
Complications Of Tuberculosis
Untreated TB disease can lead to the following health complications6:
- Impairment of kidney or liver function
- Inflammation of the meninges surrounding the brain (meningitis)
- Joint damage around the hips and knees (tuberculosis arthritis)
- Back pain and stiffness
Vaccination For Tuberculosis
Bacille Calmette-Guerin (BCG) is the tuberculosis vaccine for TB disease. In Malaysia, BCG is often given to newborns and primary school children. This has been implemented since 1961. BCG injection is given at the upper arm and indicative by having BCG scar after the injection7. Immunity will develop after the injection and prevent the child from getting serious TB disease.
Conclusion
In short, tuberculosis is a major public health concern where this deadly epidemic has claimed many lives globally. It is preventable and curable with appropriate management. If you have a bad cough for more than 2 weeks, tuberculosis is suspect and diagnostic tests should be carried out by visiting the nearby clinics. For more information, you may also approach our pharmacists and ask for advice.
References
- History | World TB Day | TB | CDC [Internet]. Cdc.gov. 2016 [cited 5 February 2021]. Available from:https://www.cdc.gov/tb/worldtbday/history.htm
- Learn About Tuberculosis [Internet]. American Lung Association. [cited 5 February 2021]. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/learn-about-tuberculosis
- Ministry of Health Malaysia, Academy of Medicine Malaysia, Malaysian Thoracic Society, World Health Organization. Clinical Practice Guidelines Management of Tuberculosis (3rd Edition) [Internet]. Vol. (5)2, Ministry of Health Malaysia. 2012. 109 p. Available from: http://apps.who.int/bookorders.
- CDC. Questions and Answers About Tuberculosis 2014. Tuberculosis [Internet]. 2014; Available from: http://www.cdc.gov/tb/publications/faqs/pdfs/qa.pdf
- TB Risk Factors | Basic TB Facts | TB | CDC [Internet]. Cdc.gov. [cited 5 February 2021]. Available from: https://www.cdc.gov/tb/topic/basics/risk.htm#:~:text=Persons%20who%20have%20been%20Recently%20Infected%20with%20TB%20Bacteria,-This%20includes%3A&text=Persons%20who%20have%20immigrated%20from,and%20persons%20with%20HIV%20infection
- Tuberculosis: Signs, Symptoms, Risk Factors, Causes & Treatment [Internet]. Dr Lal PathLabs Blog. [cited 5 February 2021]. Available from: https://www.lalpathlabs.com/blog/tuberculosis-signs-and-symptoms/
- BCG tuberculosis (TB) vaccine overview [Internet]. nhs.uk. [cited 5 February 2021]. Available from: https://www.nhs.uk/conditions/vaccinations/bcg-tuberculosis-tb-vaccine/
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