Tuberculosis, better known as TB, is caused by the bacterium Mycobacterium tuberculosis and is an air-borne disease transmitted through fine respiratory droplets from an infected person. 

19 Jul 2018

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Understanding Tuberculosis

Tuberculosis, better known as TB, is caused by the bacterium Mycobacterium tuberculosis and is an air-borne disease transmitted through fine respiratory droplets from an infected person.

It usually affects the lungs (pulmonary tuberculosis), but other parts of the body can also be affected (extrapulmonary tuberculosis), such as the brain, lymph nodes, the kidneys, bones, and joints.

If not treated properly, TB can be a fatal disease.

Most exposed casually do not become infected. For those who do become infected, most develop latent TB (LTBI). Persons with LTBI do not have symptoms of TB (e.g. cough) and do not spread TB to others.

In most healthy persons with LTBI (90%), the TB bacteria remains inactivein their body throughout their life.  About 5% develop active TB within the first two years. Another 5% may develop active TB sometime after two years and within their lifetime.

The risk of contracting Tuberculosis

The risk of progression to active TB is higher in people:

  • with underlying medical conditions such as HIV infection and diabetes;

  • who have a weakened immune system e.g. due to drugs or sickness;

  • who have poor nutritional status; and

  • are substance abusers/drug addicts.

TB is typically spread through close and prolonged contact with an infectious individual, and not by contact with items or surfaces touched by a person with TB. A person cannot get TB from sharing cups, eating utensils, food or cigarettes. TB is not spread by shaking someone’s hand, kissing, or by touching bed linens or toilet seats.

Symptoms of Tuberculosis

Symptoms of TB disease depend on the area affected. Some common symptoms of TB include:

  • A persistent cough that lasts 3 weeks or longer

  • Low-grade fever

  • Night sweats

  • Fatigue

  • Weight loss

  • Chest pain

  • Coughing up blood or sputum

Early detection is key. If you have a persistent cough that lasts 3 weeks or longer, you should consult a doctor immediately.  Your doctor may ask you to go for a chest X-ray and you may be referred to a specialist for further clinical and laboratory investigations.

Treatment of Tuberculosis

TB can be cured with anti-TB drugs. Treatment of active TB, which is sensitive to first-line anti-TB drugs, usually involves a combination of several different drugs, taken for 6 to 9 months. More than 95% of people with active TB are cured if they take all the medications as prescribed and until completion. Otherwise, TB may recur or become resistant to first-line anti-TB drugs.

Drug-resistant TB is extremely difficult to treat as less effective drugs will have to be used. In such situations, second-line TB drugs must be taken for a longer period in order to clear the infection. The chance of cure is also considerably reduced.

The DOT Programme

The best way to cure TB is to be treated under MOH’s Directly Observed Therapy (DOT) programme. The World Health Organization has advocated DOT as the standard of care for all TB patients. Under DOT:

  • the TB patient takes each dose of medication under the direct observation of a health care worker to ensure that the correct dosage and combination of TB medications are taken for the entire course of the treatment.

  • the TB patients’ response and adherence to treatment are closely monitored so that treatment failure, emergence of drug resistance and spread of the disease can be avoided.

What you should do if you have TB

If you have active TB, you can help keep your family and friends from getting sick by:

  • completing the full course of your TB medications. You must finish all your medicine even if the symptoms go away and you start to feel better.

  • staying at home in the first two weeks of treatment except when attending DOT treatment at polyclinics.

  • wearing a face mask in the presence of other people during the first two weeks of treatment.

  • covering your mouth with a tissue when you cough or sneeze.

To protect yourself and others:

  • keep your immune system healthy by adopting healthy eating habits, exercising regularly and having enough sleep.

  • consult your doctor if you have symptoms of TB.

  • Give your full support to family members, friends, colleagues or employees who have TB until they are cured.