Tuberculosis is a serious infectious disease that primarily affects the lungs, though it can also impact other parts of the body. TB is still a major worldwide health concern despite tremendous advances in medical knowledge. The goal of this guide is to give readers a thorough overview of tuberculosis, including its causes, symptoms, diagnosis, treatment, and preventative strategies, all in an approachable way. Tuberculosis (TB) is a contagious bacterial infection caused by Mycobacterium tuberculosis, primarily affecting the lungs but capable of spreading to other parts of the body. When someone with the infection coughs, sneezes, or speaks, it spreads through airborne particles.

Common symptoms include persistent chest pain, cough, night sweats, fever, and weight loss. For early discovery and successful treatment, which usually entails a lengthy course of antibiotics, an understanding of tuberculosis is essential. Dr. Virendra Singh offers a patient-centered and clinically grounded guide on understanding and preventing tuberculosis, emphasizing accurate diagnosis, treatment adherence, and the benefits of newer rapid diagnostics. He also emphasizes the need for community initiatives and awareness-raising in halting the spread of tuberculosis. Dr. Virendra Singh’s guide makes it easier to understand TB and shows simple steps we can all take to protect ourselves and others.

Understanding Tuberculosis 

What is Tuberculosis?

Tuberculosis is caused by the bacterium Mycobacterium tuberculosis. When someone with active tuberculosis in their lungs coughs, sneezes, or speaks, they release microscopic droplets into the air that other people may inhale. There are two TB-related conditions: latent TB infection and active TB disease. Not every person who comes into contact with the bacteria becomes ill.

Latent TB Infection VS. Active TB Disease

  • Latent TB Infection (LTBI): In this state, although the germs reside in the body, they remain dormant, and the patient shows no symptoms. However, if the person’s immune system deteriorates, the germs may later become active.
  • Active TB Disease: The germs are active and growing in this state, producing symptoms and possibly spreading to other people. Immediate medical attention and treatment are critical for individuals with active TB.

How is Tuberculosis Spread? 

As an airborne disease, tuberculosis is transmitted from person to person through the air. The air may be contaminated with TB bacteria when a person with active TB of the throat or lungs coughs, talks, or sings. These germs can be inhaled by those in close proximity, leading to infection.

Symptoms of Tuberculosis 

The afflicted organ might impact the symptoms of tuberculosis. But among the most typical signs of pulmonary (lung) tuberculosis are:

  • Weight loss
  • Persistent cough lasting more than three weeks
  • Chest pain
  • Coughing up blood or sputum
  • Fatigue and weakness
  • Loss of appetite
  • Chills and fever
  • Night sweats

Extrapulmonary TB 

Extrapulmonary TB is the term used to describe TB that develops outside of the lungs. Depending on the organ involved, symptoms can include:

  • Tuberculosis of the kidneys: Blood in the urine
  • Tuberculosis of the spine: Back pain 
  • Tuberculosis of the lymph nodes: Swelling in the neck
  • Tuberculosis of the brain (TB meningitis): Confusion, headaches

Diagnosis of Tuberculosis 

Effective treatment and control of tuberculosis depend on an accurate and prompt diagnosis. The following tests are commonly used to diagnose TB:

  • Tuberculin Skin Test (TST): One popular technique for identifying latent TB infection is the Mantoux tuberculin skin test. Usually, on the forearm, a tiny quantity of tuberculin is injected beneath the skin. After 48 to 72 hours, the injection site is examined for a reaction.  A raised, hard area or swelling may indicate TB Infection.
  • Interferon-Gamma Release Assays (IGRA): The immune system’s reaction to the TB germs is measured by IGRA blood testing. Since IGRAs are unaffected by previous vaccination, these tests are frequently used to identify latent TB infection and may be helpful for those who have had the BCG vaccine.
  • Chest X-Ray: A chest X-ray can assist in identifying changes in the lungs caused by TB. When TB disease is suspected, especially if the IGRA or tuberculin skin test is positive, it is frequently employed.
  • Sputum Tests: The mucus (sputum) coughed up from the lungs is analyzed in sputum testing. Both the presence of TB germs and their resistance to particular drugs can be ascertained by these tests.
  • Molecular Tests: The TB bacteria and their resistance to the antibiotic rifampicin can be identified by molecular testing, like the Xpert MTB/RIF test. These tests are highly accurate and provide results quickly, aiding in the early diagnosis and treatment of TB.

Treatment of Tuberculosis

  • Latent TB Infection :- The goal of treating a latent tuberculosis infection is to stop the germs from becoming active. The drugs isoniazid, rifapentine, and rifampin are frequently used. The treatment duration can range from three to nine months, depending on the medication regimen. 
  • Active TB Disease:- Antibiotics must be used in combination for a long period of time, usually six to nine months, to treat active TB disease. He standard treatment regimen includes:
  1. Isoniazid
  2. Ethambutol
  3. Rifampin
  4. Pyrazinamide
  • Drug-Resistant TB:- Drug-resistant TB is the result of TB bacteria developing a resistance to the medications frequently used to treat the illness. This may occur if the germs evolve naturally or if the treatment plan is not properly followed. Drug-resistant TB is more difficult to treat and necessitates longer courses of second-line medication, which may have more serious adverse effects.
  • Preventing Tuberculosis:- Public health initiatives, immunizations, and individual acts are all part of the TB prevention process.
  • Vaccination : The Bacillus Calmette-Guérin (BCG) vaccination is widely used in nations where tuberculosis is highly prevalent. The vaccination works best to protect children from severe forms of tuberculosis, like TB meningitis. However, its efficacy in preventing pulmonary TB in adults is variable.