Tuberculosis (TB) is one of the most common infections in the world. About 2 billion people are infected with tuberculosis and nearly 3 million of these people die each year. In our country, approximately 70 thousand new cases occur each year and, on average, 4 thousand deaths.
Cause of Tuberculosis
Tuberculosis is caused by bacteria of the mico bacterial family, mainly by Mycobacterium Tuberculosis also called Koch’s bacillus. It affects several organs of our body, but preferentially affects the lung , so pulmonary tuberculosis is the most frequent and most relevant to public health, since it is responsible for transmission.
Doctors distinguish between two types of tuberculosis infection: latent and active .
- Latent tuberculosis – bacteria remain in the body in an inactive state. They do not cause symptoms and are not contagious , but they can become active.
- Active tuberculosis – bacteria cause symptoms and can be passed on to others.
A person with a healthy immune system has only a 10% chance that allows the tuberculosis bacteria to activate and cause the symptoms of tuberculosis.
If the immune system is weakened due to HIV or other diseases, the risk of moving from an inactive infection to an active symptomatic disease increases to 70%. Babies, preschoolers, pregnant women and the elderly also have a higher risk of activation due to the weaker immune system.
Causes of Tuberculosis
Although tuberculosis does not spread easily , it is usually spread among people who are in close contact (working together or living together).
Only people who have active tuberculosis infections can spread the bacteria. Coughing, sneezing, even talking can release them into the air, infecting others. Once a person is infected, the bacteria settle in the alveoli and, in most cases, will be contained by the immune system.
There are several risk factors that contribute to the development of tuberculosis. Certain groups are at greater risk, for example, those working in hospitals and other areas where people infected with tuberculosis may reside, such as prisons, nursing homes, homes for HIV patients or shelters.
Group of risk
Other potentially susceptible people include:
- With head or neck cancer;
- Diseases that suppress the immune system, such as HIV / AIDS;
- Kidney disease;
- With malnutrition;
- Medicines that suppress the immune system, such as anticancer drugs;
- Pregnant women;
- People undergoing radiation therapy.
Tuberculosis in Pregnancy
Pregnant women are 69% more likely to develop the disease than the rest of the general population. The greater likelihood of contracting the bacteria is related to the weakening of the immune system caused by pregnancy.
Treatment of tuberculosis in pregnancy should be started whenever the possibility of the disease is moderate to high . Although the drugs used to treat tuberculosis in pregnancy cross the placenta, they do not appear to have any harmful effects on the fetus.
Newborns of women with tuberculosis in untreated pregnancies can be born underweight and can also contract the disease. The skin test for tuberculosis is considered safe throughout pregnancy. However, the blood test has not been evaluated for the diagnosis of tuberculosis infection in pregnancy.
There are no symptoms associated with inactive tuberculosis. This means that someone may have acquired the bacteria and still show no signs of infection. Symptoms only appear when the infection becomes active.
They develop gradually, and it may take several weeks before you notice that something is wrong.
The most common include:
- Weight loss
- Night sweat
- Chest pain
- Lack of air
- Loss of appetite
The occurrence of additional symptoms depends on where the disease has spread beyond the chest and lungs. For example, if tuberculosis spreads to the lymph nodes, it can cause swollen glands on the sides of the neck or under the arms .
When it spreads to bones and joints, it can cause pain and swelling in the knee or hip. The genitourinary tuberculosis can cause pain in the flank with frequent urination, pain or discomfort during urination and blood in the urine.
Diagnosis of Tuberculosis
The diagnosis of primary pulmonary tuberculosis is confirmed by a joint analysis of clinical and radiological criteria and by the tuberculin skin test (PT).
A skin test that allows the doctor to check the immune response to the tuberculosis bacteria. The skin test involves an injection into the forearm, which after two or three days, is interpreted by the doctor.
If it is indicated by a hard and swollen area at the injection site, it means that the body has been infected by the bacteria. But that does not mean that the person has active tuberculosis.
X-rays of the chest can also be performed, and sputum samples can be analyzed in the laboratory. In these cases, the results are used only to rule out or confirm active tuberculosis .
The doctor may also suggest other tests to confirm a diagnosis or check for disease in other parts of the body.
The antibiotics are used to treat tuberculosis, it is a bacterial infection . Tuberculosis treatment is performed on an outpatient basis, for a minimum period of 6 months, daily, without interruption, and must be supervised by the nearest health service, at the patient’s home or work.
Three or four antibiotics are combined during the first two months of tuberculosis therapy and treatment. Two of these are then administered for another four to six months.
Depending on the number and type of antibiotics used, as well as the sensitivity pattern of the bacterium grown, some people may need to take antibiotics for up to 12 months.
Most people will take medication every day for the first 2 months, and a few times a week for the remaining treatment. It is important to take the medication in the manner prescribed by the doctor, and during the full course of treatment.
This helps to prevent the types of tuberculosis bacteria that are resistant to antibiotics, that take longer and are more difficult to treat.
If a particular type of tuberculosis infection is resistant to regular antibiotic treatment (a condition known as multi-drug resistant TB or MDR-TB ), a combination of different drugs to treat tuberculosis should be taken for 18 to 24 months.
Once the symptoms disappear, the doctor can re-test the sputum to see if the tuberculosis bacteria are still present. If there is an infection of the disease in other parts of the body (for example, bones or joints), it is possible to require treatment for more than a year.
To prevent the spread of tuberculosis , it is important to get a quick treatment and follow it to completion . This can stop the transmission of bacteria and the appearance of antibiotic-resistant strains.
It is important to follow the treatment for as long as the doctor recommends it. If the person stops taking his medications before the doctor suggests, tuberculosis can recur. She may have active tuberculosis, or the bacteria from the disease may become resistant to the medications she is taking.
Is There Any Vaccine For Tuberculosis?
The BCG vaccine is the vaccine which limits the spread of bacteria after tuberculosis infection . It is applied to newborns and reduces the chances of developing severe forms of the disease, such as tuberculous meningitis, but it is not effective against pulmonary tuberculosis.
It is only available in countries or communities where the risk of tuberculosis infection is greater than 1% per year. In other countries like Canada for example, there is controversy about the use of this vaccine, as they claim that it does not prevent the initial infection.
Some general measures can be taken to prevent the spread of active tuberculosis:
If you are diagnosed with active tuberculosis, you should:
- Keep the house well ventilated;
- When coughing, cover your mouth with a preferably disposable tissue;
- Wash your hands well;
- Stay as long as possible outdoors;
- If possible, sleep alone in a separate and properly ventilated room;
- Do not share glasses or cutlery with other people;
- Avoid using public transport or when using, use a mask;
- Avoid agglomerations such as shopping malls or nightclubs so as not to spread the disease
See also: Child Vaccination – Lifelong Protection
My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.
Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.