TUBERCULOSIS- where do we stand today?

Dr Devender Singh,Thoracic surgeon

Tuberculosis (TB) awareness is crucial because this infectious disease remains a significant global health challenge. Spreading knowledge about TB helps in early detection, prevention, and treatment. Here’s why it’s so important:

Early Diagnosis Saves Lives: TB is curable when detected early.
Breaking Stigma:. Awareness efforts can reduce the stigma, fostering a supportive environment.
Preventing Spread: TB is contagious, and raising awareness about cough hygiene and infection control can stop its transmission.
Promoting Treatment Adherence: TB treatment is long and complex. Awareness campaigns emphasize the importance of completing the full course of medication to prevent drug-resistance.

Common symptoms of tuberculosis (TB) include:

Persistent cough lasting more than three weeks, often accompanied by sputum (sometimes blood-streaked).
Fever, usually low-grade but persistent, particularly in the evening.
Night sweats, which can soak your clothing or bedding.
Unexplained weight loss, due to reduced appetite
Fatigue or weakness, even without engaging in strenuous activities.
Chest pain or difficulty breathing.

If someone has these symptoms, it’s important to consult a Doctor promptly for diagnosis and treatment.

Testing for tuberculosis (TB) typically involves the following steps:

Consult : If you have symptoms or have been in contact with someone with TB, visit a doctor .
Tests for TB:

Skin Test (Mantoux Test): A small amount of fluid (tuberculin) is injected under the skin of your forearm. After 48-72 hours, the injection site is checked for swelling, which indicates TB exposure.
Blood Test: Interferon-gamma release assays (IGRAs), such as the QuantiFERON-TB Gold test, measure the immune system’s response to TB bacteria.

3. Chest X-ray: If initial tests suggest TB, an X-ray is done to look for changes in the lungs caused by the disease.

4. Sputum Test: For active TB, a sample of mucus from coughing (sputum) is analyzed in a lab to detect TB bacteria.

5. Other Investigations: In certain cases, more tests like CT scans or biopsy of affected tissues may be done.

Early diagnosis is key!

Early diagnosis of tuberculosis (TB) is critical for several reasons:

Prevents Disease Progression: Detecting TB in its early stages allows for timely treatment, reducing the risk of the disease spreading to other organs or becoming life-threatening.
Stops Transmission: TB is highly contagious. Identifying and treating it early helps prevent its spread to family& friends.
Improves Treatment Outcomes: Starting treatment early increases the likelihood of a full recovery and reduces the chances of complications or drug-resistant TB developing.
Reduces Healthcare Costs: Early intervention can prevent prolonged illness, hospital stays, and more expensive treatments, easing the financial burden on individuals .
Protects Vulnerable Groups: Children, the elderly, and those with weakened immune systems (e.g., people with HIV) are particularly susceptible to severe TB.

The treatment of tuberculosis (TB) has evolved significantly, reflecting advancements in medical science and global health initiatives.

Development of Short-Course Therapy-

The introduction of Directly Observed Therapy, Short-Course (DOTS) was a major milestone. This ensured that patients adhered to their treatment regimen under supervision. treatment has been shortened to 6-9 months only.

2. Addressing Drug-Resistant TB –

Multidrug-resistant TB (MDR-TB) emerged due to improper use or incomplete treatment.
Newer drugs like Bedaquiline and Delamanid were developed to combat MDR-TB and extensively drug-resistant TB (XDR-TB).
Regimens for resistant TB became more specialized and sometimes extended up to 20 months.

3. Recent Advances –

Research on vaccines, such as M72/AS01E, offers hope for better prevention in the future.
Improved diagnostic tools, digital health technologies, and patient-centered care models have strengthened TB control efforts globally.

Today, TB treatment is a combination of medical science, public health strategies, and patient education.