Tuberculosis (TB) is an infectious disease caused by a germ known as mycobacterium tuberculosis. Up until about 50 years ago, there were no drugs to cure TB. Now, we have adequate facilities and means to diagnose, prevent and treat TB. Yet, we are still facing a worldwide epidemic of TB. Worse, we are seeing an emergence of a TB germ that is resistant to the drugs we use to treat the disease.
TB infections are spread by breathing in droplets containing the TB germs. When people who are infected cough or sneeze, they spray TB germs into the air. Other people get infected when they inhale these TB germs.
Not everybody who gets infected with the germ develops the disease. The body's immune system 'walls off' the TB germ, which can lie dormant in the body for years. TB disease develops in about 10% of those infected. If your immune system is weakened e.g. by AIDS or drugs the chance of getting TB will be higher.
Causes & risk factors
TB is an air-borne disease transmitted through respiratory droplets from a person with the disease.
The risk of developing active TB disease is higher in:
- Persons with prolonged close contacts with someone known to have untreated TB
- Persons with underlying medical conditions such as HIV disease and diabetes
- Persons who have a weakened immune system e.g. due to drugs or sickness
- Persons who have poor nutritional status
- Drug addicts
The following features raise the suspicion of TB:
- Cough lasting longer than 3 weeks
- Coughing out blood
- Feeling tired all the time
- Fever and night sweats
- Loss of weight
- Chest pain
Complications
Infection with TB can cause permanent lung damage if not treated early. It can also spread to other parts of the body such as the bone, intestine, brain and central nervous system where it can lead to life-threatening complications. The most serious complication, however, is when TB infection recurs and the strains causing the disease are resistant to multiple anti-TB medications.
Screening & diagnosis
If you have a cough that persists longer than 3 weeks or any of the other symptoms, see your doctor right away. If you know of someone who has the same symptoms, encourage the person to go as well. Your doctor will ask you to go for a chest X-ray. Some of you may be referred to a specialist for further investigations.
Treatment
TB disease can be cured with anti-TB drugs. To be effective, the drugs must be taken exactly as prescribed. Treatment usually involves a combination of several different drugs. Because TB germs die very slowly, anti-TB drugs must be taken for 6 to 9 months. You must continue to take your medicine until all the germs are killed, even if the symptoms of disease go away and you start to feel better.
Incomplete TB treatment means that the TB germs in the body that survive continue to grow and multiply. But this time, the germs may develop resistance to the usual TB drugs. In such situations, a different set of drugs with more side effects must be taken for a longer period. The chance of cure is also considerably reduced. What's more, the next person e.g. a family member, who gets infected, will have the same drug-resistant germs.
The World Health Organisation has advocated DOT as the standard of care for TB patients. DOT stands for Directly Observed Treatment. It means having your TB treatment supervised, usually at the polyclinics. Trained nurses will observe you taking the correct dosage and combination of TB medications. The best way to cure TB and curb its spread is to receive your treatment under the Ministry of Health's DOT programme.
Prevention
TB is a preventable disease. People with TB should be treated before they develop active disease. Also, one of the ways to control the infection is to take careful precautions with people hospitalised with TB.
There are also measures you can take on your own to help protect yourself and others:
If you have active TB, you can help keep your family and friends from getting sick by:
Infection with TB can cause permanent lung damage if not treated early. It can also spread to other parts of the body such as the bone, intestine, brain and central nervous system where it can lead to life-threatening complications. The most serious complication, however, is when TB infection recurs and the strains causing the disease are resistant to multiple anti-TB medications.
Screening & diagnosis
If you have a cough that persists longer than 3 weeks or any of the other symptoms, see your doctor right away. If you know of someone who has the same symptoms, encourage the person to go as well. Your doctor will ask you to go for a chest X-ray. Some of you may be referred to a specialist for further investigations.
Treatment
TB disease can be cured with anti-TB drugs. To be effective, the drugs must be taken exactly as prescribed. Treatment usually involves a combination of several different drugs. Because TB germs die very slowly, anti-TB drugs must be taken for 6 to 9 months. You must continue to take your medicine until all the germs are killed, even if the symptoms of disease go away and you start to feel better.
Incomplete TB treatment means that the TB germs in the body that survive continue to grow and multiply. But this time, the germs may develop resistance to the usual TB drugs. In such situations, a different set of drugs with more side effects must be taken for a longer period. The chance of cure is also considerably reduced. What's more, the next person e.g. a family member, who gets infected, will have the same drug-resistant germs.
The World Health Organisation has advocated DOT as the standard of care for TB patients. DOT stands for Directly Observed Treatment. It means having your TB treatment supervised, usually at the polyclinics. Trained nurses will observe you taking the correct dosage and combination of TB medications. The best way to cure TB and curb its spread is to receive your treatment under the Ministry of Health's DOT programme.
Prevention
TB is a preventable disease. People with TB should be treated before they develop active disease. Also, one of the ways to control the infection is to take careful precautions with people hospitalised with TB.
There are also measures you can take on your own to help protect yourself and others:
- Complete the full course of your TB medications.
- Go for regular testing.
- Lead a healthy lifestyle.
If you have active TB, you can help keep your family and friends from getting sick by:
- Staying at home all the time especially the first two to three weeks of treatment.
- Covering your mouth with a tissue when you cough or sneeze and wear a mask in the presence of other people during the first few weeks of treatment.
- Disposing properly the dirty tissue by sealing it in a bag and throwing it away.
This article was originally published in http://www.hpb.gov.sg
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