Dr Najmudheen Manappattu
Tuberculosis is an ancient bacterial disease present all over the world. About 3500 years ago, Rigveda had mentioned about this as ‘Yaksim’. It claimed many million lives and caused untold miseries to the mankind over the years.
For many centuries,tuberculosis had been a dreaded disease; a slow death sentence for many.
Discovery of the bacteria by Robert Koch opened a new era in TB control. In 1904 he received Nobel prize for his great contributions.
TB mostly affects lungs. However no organ in the body nor any age is immune to the bacteria. It can damage lungs, spine, bones, joints and brain.
Common symptoms
Continuous cough for 3 weeks.
Blood stained sputum/spitting of blood.
Fever, especially evening rise of temperature,
Tiredness
Weight loss
Chest pain / Breathlessness
Painless swellings in neck
When a patient coughs up or sneezes out plenty of TB bacteria are shed in to air,They travel in to a healthy person’s lungs through breathing air. Usually his immune system will fight these germs and make them inactive. However in 5-10% of individuals the bacteria win over and produce lung damage. From the lungs it can spread to any parts of the body including brain
TB in Children
Tuberculosis affecting children is termed primary complex. Unlike in adults, it cannot spread to others i,e not contagious. We suspect this when the child shows symptoms like Loss of appetite, Poor weight gain/ failure to thrive or repeated respiratory infections , especially following an exposure to TB patient (s).
Your family doctor can diagnose the disease by investigations like Chest X-ray, Sputum analysis, Mantoux skin test, AFB culture etc. It is difficult to get sputum in children in whom a morning sample of stomach aspirate may help.
TB is now a controllable disease. The first antibiotic effective against TB -Strepomycin- was introduced in 1944. Advent of drugs like INH, Rifampicin Ethambutol & Pyrazinamide further fortified the armamentarium and hastened the recovery time.
BCG vaccine, first introduced in 1921, is very popular and widely used even today.
Nowadays combination therapy with more than one anti-bacterial drug is used for a period of 6-9 months. This is to prevent drug resistance.
In India, DOTS (Directly Observed Treatment-Shot course) therapy is in vogue. In this a health-worker directly observes and ensures the intake of medicine by the patient. This is very important because irregular or incorrect treatment can lead to emerge multi-drug resistant TB (MDR-TB).
Overcrowding ,malnutrition, unhygienic practices of open sneezing and coughing,lack of health education have all contributed to the spread of TB in the past.
There were high hopes of total eradication of TB thanks to improved health awareness,education, BCG vaccination and new drugs.
But, of late, tuberculosis is staging a comeback mainly due to HIV related immune-suppression and MDR-TB. According to WHO statistics 1.3 million people died from TB in 2012. In the same year the largest number (60%) of new TB cases globally were reported from Asia.
Remember !!
TB contagious and Air-borne
TB is curable and preventable
Precautions
-Seek medical advice when suspicious symptoms appear
-Avoid over-crowding/ close contact with TB patients
-Cover nose while sneezing and coughing
-Health education
-Ensure strict adherence to Anti-tuberculous treatment schedule
-BCG Vaccination right from birth.
Dr Najmudheen Manappattu MBBS, DLO, DNB; ENT Department; Naseem Al Rabeeh Hospital
