Tuberculosis: A Death Sentence?

Tuberculosis (TB) is a disease caused by a group of organisms called the  Mycobacterium tuberculosis complex.  It is a common infection in Low and Middle Income Countries with the advent of HIV as one of the most important drivers of the disease. HIV weakens the immune system, so the body loses its ability to fight the TB germs. Tuberculosis can affect different parts of the body but most times it affects the lungs.  

While the body’s immune system can usually suppress the organisms that cause TB, preventing overt symptoms, any changes in the effectiveness of the immune system can result in appearance of symptoms of TB. There are two classifications of TB regarding the presence or absence of symptoms. 

1. Latent TB: When TB infection is present but the organism is inactive and cause no symptoms. Latent TB can also be called inactive TB or TB infection and isn’t contagious. But latent TB can turn into active TB, so treatment is important. 
2. Active TB: Also called TB disease, results in symptoms and can spread to others. It can occur weeks or years after infection with the TB bacteria. 

Signs and symptoms of active TB include coughing for two or more weeks, coughing up blood or mucus, chest pain, or pain with breathing or coughing, unintentional weight loss, fatigue, fever, night sweats, chills, and loss of appetite 

Tuberculosis can also affect other parts of the body, including the kidneys, spine or brain. When TB occurs outside the lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine causes back pain, and tuberculosis in the kidneys could cause blood in the urine. 

While anyone can get tuberculosis, certain factors can increase the risk: 

1. Weakened immune system: A healthy immune system often successfully fights TB bacteria. But several conditions and medications can weaken your immune system, including HIV/AIDS, diabetes, chronic kidney disease, cancers, cancer treatment, such as chemotherapy, drugs to prevent rejection of transplanted organs, Some drugs used to treat rheumatoid arthritis, Crohn’s disease and psoriasis, malnutrition or low body weight, very young or advanced age 
2. Traveling or living in certain areas: Traveling to or living in places where TB is very common increases your risk for developing TB. Such places include Africa, Asia, Eastern Europe, Russia, and Latin America. 
3. Using Intravenous drugs or excessive alcohol use weakens the immune system. 
4. Using tobacco. Tobacco use greatly increases the risk of getting TB and dying of it. 
5. Working in health care. Regular contact with people who are ill increases your chances of exposure to TB bacteria. Wearing a mask and frequent hand-washing greatly reduce your risk. 
6. Living or working in a residential care facility. Living or working in prisons, homeless shelters, psychiatric hospitals or nursing homes puts an individual at a higher risk of tuberculosis due to overcrowding and poor ventilation. 
7. Living with someone infected with TB. Close contact with someone who has TB increases the risk. 

Prevention 

Prevention of active disease is the goal in TB care all over the world. Vaccinations are a key step in preventing TB in countries where the disease is common. Infants often are vaccinated with bacille Calmette-Guerin (BCG) vaccine. This reduces the risk of developing TB.  

Treatment 

TB is not a death sentence; TB is curable. But the length of treatment has been the major issue with TB treatment alongside new strains that are resistant to available anti-TB drugs. Individuals who test positive for latent TB infection require medications to reduce the risk of developing active tuberculosis. Only active TB is contagious. For active tuberculosis, you must take anti-TB medications for at least six to nine months. 

The exact drugs and length of treatment depend on your age, overall health, and possible drug resistance and where the infection is in your body