What you need to know about TB

Tuberculosis is a serious infectious disease that mainly affects your lungs but can be found in other organs of the body. The bacteria that cause tuberculosis (TB) are spread from one person to another through tiny droplets released into the air via coughs and sneezes.

According to the World Health Organisation, South Africa is one of the countries with the highest incidence of TB. It is estimated that about 1% of the population of about 57 million develop active TB disease each year.

This is, worldwide, the third-highest incidence of any country after India and China. It is estimated by WHO also that about 60% of those infected have both HIV and TB infection. In addition, there is now increasing resistance to some of the anti-TB drugs, making TB the leading cause of death in SA.

And it discriminates based on socioeconomic status, disproportionally affecting males, the poor, the young and the nonwhite population groups.

It is also rampant in the mining industry because workers are still exposed to silica dust, overcrowded hostel living, poor nutritional status and stress, all of which are major contributors to the development of TB. When they become sick, they return to their families in rural areas and spread the disease to them.

Another reason it remains a major killer is the increase in drug-resistant strains of the bacteria. Since the first antibiotics were used more than 60 years ago, some TB germs have developed the ability to survive.

Some TB bacteria have developed resistance to the most commonly used treatments, such as Isoniazid and Rifampicin. Resistance is mainly caused by the patient not taking the medication as prescribed.

Picture: iStock

Are you at risk?

A healthy immune system protects you from being ill from contracting the TB bacteria. Any of the following conditions can weaken your immune system or increase your risk:

• HIV/Aids, cancer, diabetes mellitus, severe kidney disease, being on medication for cancer or rheumatoid arthritis.
• Malnutrition and poverty.
• Being very young or very old.
• Living in poor overcrowded areas with poor access to ventilation and proper healthcare.
• Drug or alcohol abuse.
• Tobacco smoking has also been shown to increase risk.
• Healthcare workers getting regular exposure to TB.

Signs and symptoms

• Coughing that lasts three or more weeks.
• Coughing up blood.
• Chest pain, or pain with breathing or coughing.
• Weight loss.
• Fatigue.
• Fever.
• Night sweats.
• Chills.
• Loss of appetite.

TB can also affect other parts of the body, including kidneys, joints, spine or brain. When TB occurs outside the lungs, signs and symptoms vary according to the organs involved.

For example, tuberculosis of the spine may give you back pain and tuberculosis in your kidneys might cause blood in your urine, in the joints you might have severely swollen painful joints, in the brain you will have headache, fever and neck stiffness.

Picture: iStock

Treatment

Medication is the only way of treatment. But treating TB takes much longer than treating other types of bacterial infections. You must take antibiotics for at least six to nine months.

The exact drugs and length of treatment depend on your age, overall health, possible drug resistance, whether or not you are getting infected for the first time, the form of TB (latent or active) and the infection’s location in the body.

Active tuberculosis, particularly if it’s a drug-resistant strain, will require several drugs at once. The most common medications used to treat tuberculosis include Isoniazid, Rifampicin, Ethambutol and Pyrazinamide.

If you have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable medications, such as Amikacin, Kanamycin or Capreomycin, are generally used for 20 to 30 months.

Some types of TB are developing resistance to these medications as well. It is important to take your treatment as prescribed and as long as prescribed.

Picture: iStock

Medication side-effects

Side-effects to medication do occur and can be dangerous. All tuberculosis medications can be highly toxic to your liver. When taking these medications, call your doctor immediately if you experience any of the following:

• Nausea or vomiting;
• Loss of appetite;
• A yellow colour to your skin;
• Dark urine; or
• A fever that lasts three or more days and has no obvious cause.

How to prevent the bacteria

Once you are diagnosed with active tuberculosis, it generally takes a few weeks of treatment. Follow these tips to help keep your loved ones from getting sick:

• Don’t go to work or school, or sleep in a room with other people;
• Ventilate the room; and
• Cover your mouth when you laugh, sneeze or cough.

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