Tuberculosis (TB) is a contagious bacterial infection primarily affecting the lungs, though it can also target other parts of the body, including the kidneys, spine, and brain. It is caused by Mycobacterium tuberculosis, a slow-growing bacterium that spreads through the air when an infected person coughs, sneezes, or talks.

Symptoms of Tuberculosis

The symptoms can vary depending on the part of the body affected, but the most common signs of pulmonary TB (lung tuberculosis) include:

• Persistent cough (lasting 3 weeks or longer)
• Coughing up blood or sputum (mucus)
• Chest pain
• Fatigue
• Weight loss
• Fever
• Night sweats
• Loss of appetite

For extra-pulmonary TB, symptoms may be more specific to the affected organ, such as back pain in spinal TB or headaches in TB affecting the brain.

Types of Tuberculosis

1. Latent Tuberculosis Infection (LTBI): This is when the bacteria are present in the body but the immune system keeps them under control. People with latent TB do not show symptoms and cannot spread the disease, but the infection may reactivate if the immune system becomes weakened.

2. Active Tuberculosis: This is when the bacteria multiply and cause symptoms. If untreated, active TB can be fatal and is contagious to others.

Diagnosis of TB

TB is diagnosed through:

• Skin test (Tuberculin skin test or TST): A small amount of TB protein is injected under the skin, and the site is checked for a reaction.
• Blood tests: The interferon-gamma release assay (IGRA) can detect TB infection.
• Chest X-ray: Helps identify lung damage or the presence of infection.
• Sputum smear and culture: A sample of mucus from the lungs can be tested for the bacteria.
• Molecular tests: PCR tests can detect TB DNA, allowing for faster diagnosis.

Treatment of Tuberculosis

TB is treatable with antibiotics, but it requires a long course of medication, usually lasting 6 months or longer. The standard treatment for drug-sensitive TB involves a combination of drugs, including:

• Isoniazid (INH)
• Rifampin (RIF)
• Pyrazinamide (PZA)
• Ethambutol (EMB)

Adherence to the full treatment course is critical to prevent the development of drug-resistant TB, which is more difficult to treat.

Drug-Resistant Tuberculosis

• Multidrug-resistant TB (MDR-TB): TB that is resistant to at least two of the most effective anti-TB drugs (isoniazid and rifampin).
• Extensively drug-resistant TB (XDR-TB): A more severe form of MDR-TB resistant to additional second-line drugs.

Drug-resistant TB requires longer treatment with more expensive and potent medications, often with more side effects.

Prevention of Tuberculosis

• Vaccination: The BCG (Bacillus Calmette-Guérin) vaccine is given to children in many countries to protect against severe forms of TB, particularly TB meningitis and disseminated TB.
• Infection control: In healthcare settings, TB patients should be isolated to prevent the spread. Good ventilation and protective equipment (like masks) are also important.
• Screening: Regular screening for TB among high-risk populations (such as healthcare workers, individuals with HIV, and close contacts of TB patients) can help catch latent infections early.

Global Impact

TB remains one of the leading causes of death from infectious diseases globally, particularly in low- and middle-income countries. HIV infection significantly increases the risk of developing active TB. Efforts to combat TB include improving access to diagnosis, treatment, and preventative care, as well as addressing social determinants of health like poverty and malnutrition.

If you have any specific questions about TB or its management, feel free to ask!

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