Mikaela Millan
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We at Hyfe, Inc., are a company devoted to working on tools to better understand the importance of cough. It is Hyfe’s intention in the future to seek regulatory approval for medical products that analyze cough in order that they may be used to diagnose, monitor, and facilitate better treatment of respiratory illnesses.
Tuberculosis (TB) is an infection of the lungs that can easily spread from person to person. Aside from the lungs, it may also affect the digestive, reproductive, and nervous systems.
Today, developed countries rarely see cases of TB, but it continues to be a widespread and serious problem in developing nations 1. It not only carries a huge burden of morbidity and mortality, but it can also have devastating long term effects if left untreated.
Fortunately, TB is curable and preventable. Knowing more about this disease will not only help you recognize potential signs and symptoms of TB, but also how to curb its spread and keep your loved ones safe and healthy.
Tuberculosis is a bacterial lung infection most commonly presenting with respiratory symptoms 2. It is caused by the Mycobacterium tuberculosis organism and spread through the inhalation of infected droplets. This is why we should observe proper cough etiquette whenever we go out, whether by covering our nose and mouth when we cough or sneeze, or wearing a mask.
Once in the lungs, M. tuberculosis damages the immune cells that try to eliminate it, causing inflammation and cell death that lead to the cardinal symptoms of TB and the appearance of the hallmark diagnostic finding of granulomas on a chest x-ray.
The four most common signs and symptoms of TB are3:
You may also experience chest pain, coughing up blood or mucus, and fatigue. If other organs are affected, they may also manifest with symptoms, particularly in the kidneys, spine, or brain 4.
As with any medical condition, your doctor will assess your symptoms through a thorough history and physical examination.
To diagnose TB, they may order a skin or blood test5:
If these two tests are inconclusive, or if the physician thinks the TB has become extrapulmonary (has spread outside the lungs), further tests may be necessary. These can include:
The treatment of confirmed TB requires a combination of drugs to effectively eradicate the disease 6. The usual regimen involves the use of four drugs:
These drugs may be administered as single combination tablets (e.g., Rifater) or multiple. Treatment lasts for around 6 months, given with Vitamin B6 to prevent nerve damage.
The regimen will vary depending on age, immune status, organ systems affected, and drug resistance. Consult your doctor if you suspect you have TB so you may be given the appropriate treatment regimen.
The COVID-19 pandemic has certainly taught us a lot about disease prevention. For TB, the same precautions apply to prevent the spread of the disease 7.
Although TB is present globally, developing countries bear most of the disease burden, particularly in Asia, Africa, Eastern Europe, and Latin and Central America 8. These low- and middle-income countries account for 80% of cases and deaths due to TB 9. Poverty, malnutrition, and wars are risk factors for TB. Developed countries see TB cases mostly in health care workers, HIV-positive individuals, and travelers coming from tuberculosis-endemic areas.
People with compromised immune systems such as those with HIV/AIDS, anti-cancer medications, and young children are at increased risk for contracting TB. Persons with HIV are 18 times more likely than those without HIV to develop TB, due to their lowered immunity 10.
Malnutrition is also a huge risk factors – there were 2.2 million new TB cases attributable to undernutrition in 2021 11.
Miners and construction workers are also at risk for TB as an occupational hazard.
It may also be time to quit alcohol and tobacco smoking, as these account for 0.74 and 0.63 million new TB cases in 2021, respectively.
This data tells us that while there are certain risk factors that cannot be changed such as the country we live in, we should focus on the factors that can be modified such as improving nutrition, smoking and alcohol cessation, and safe sex practices in order to lower the risk of contracting HIV.
In places where TB is endemic, infants and those under the age of 16 are given the Bacillus Calmette-Guerin (BCG) vaccine at birth to combat TB12. However, this is not usually given to adults as it is not effective. Research continues to grow as new TB vaccines are being developed.
Visit your doctor if you experience any of the symptoms of TB:
You should also get checked if you suspect that you have been exposed to someone with TB.
The following people should be screened for TB as they are at increased risk13:
Tuberculosis is not commonly treated with home remedies and requires a visit to the doctor. In doing so, other diseases can be ruled out and the appropriate TB regimen may be started. The sooner the symptoms are identified, the sooner the disease can be treated.
TB is the 13th leading cause of death worldwide and the second leading infectious killer after COVID-19. Data from the World Health Organization (WHO) shows that 1.6 million people died from TB in 2021 14and 1.2 million children globally fell ill from TB. Multi-drug resistant TB continues to be a public health crisis and, sadly, only 1 in 3 people with this condition received treatment in 2020.
Thankfully, the incidence of TB has fallen about 11% from 2015 to 2020, with an estimated 66 million lives saved through TB diagnosis and treatment between 2000 and 2020.
In terms of prognosis, majority of patients with TB have a good outcome due to effective treatment. If untreated, the mortality rate of TB is more than 50%, which is why it is important to identify symptoms early.
Tuberculosis is a treatable and preventable disease. However, barriers such as the lack of awareness, delayed diagnosis, and poor access to medications lead to the compounding number of cases 15. Health organizations around the world are banding together to prevent the spread of this disease. New anti-tuberculosis medications are also being developed and studied in an effort to not only shorten but also simplify treatment. Hopefully, these combined efforts plus the simple measures we take individually all aid in putting an end to tuberculosis.
References
Mikaela is a dentistry clinician at the University of the Philippines.
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