Tuberculosis: A Global Disease.

(Seerat Shahina, )

It may sound like a disease of the past, but Tuberculosis, or TB, is still a real concern today. Not many would actually realize that tuberculosis is a worldwide challenge and it is crucial for everyone in society to know about this disease.

In 1720, for the first time, the infectious origin of TB was identified by the English physician Benjamin Marten, while the first successful remedy against TB was the introduction of the sanatorium cure, for bed rest, clean air and more favorable treatment milieu. Isolation hospitals and sanatoriums were part of a decades-long experiment of quarantine. Sanitoriums have mostly been associated with the treatment of TB disease in the late nineteenth and early twentieth century, before the development of TB drugs. In 1882 Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease. Effective drug treatments for TB were first developed in the 1940s. The composition of TB treatment regimens has changed over time.

Tuberculosis (TB) is a global disease, found in every country in the world. Despite significant progress over the last decades, TB continues to be the top infectious killer worldwide. The TB
bacterium is spread through the air when an infected person coughs, sneezes, speaks, sings, or laughs. It’s not likely to be spread through personal items, such as clothing, bedding, eating utensils, handshake, toilet, or other items that a person with TB has touched. Good ventilation is the most important measure to prevent the transmission of TB.

Tuberculosis is an infection, caused by slow-growing bacteria called Mycobacterium tuberculosis. These bacteria grow best in parts of the body with high amounts of blood and oxygen, that is why TB usually affects the lungs. However, they also can develop in other parts of the body including the brain, the kidneys, or the spine.

There are two types of TB:
Latent tuberculosis: In latent TB a person has been exposed to tuberculosis, but he is not sick with it. This is not contagious. However, about 10 percent of people who have latent TB can develop active TB at some time in their life. This can be prevented with antibiotics.

Active tuberculosis refers to disease that occurs in someone infected with Mycobacterium tuberculosis. It is characterized by symptoms of active disease. The following are the most common symptoms of active TB. However, each person may experience symptoms differently

Symptoms of active TB include, a cough that lasts more than three weeks, loss of appetite and unintentional weight loss, fever. chills and night sweats. Coughing blood or sputum, chest pain.

People with weakened immune systems have a much greater risk of falling ill from TB. A person living with HIV/AIDS is about 20 times more likely to develop active TB. According to WHO, in 2020, an estimated 10 million people fell ill with tuberculosis (TB) worldwide. 5.6 million men, 3.3 million women and 1.1 million children. and 1.5 million died. (Including 214 000 people with HIV)

In 2020, the 30 high TB burden countries accounted for 86 percent of new TB cases. Eight Countries account for two thirds of the total, with India leading the count, followed by China, Indonesia, Philippines, Pakistan, Nigeria, Bangladesh and South Africa. (WHO). The United States has seen a drop in TB cases over the years, with the centers for Disease Control and Prevention (CDC)reporting just over 9,000 cases in 2018.

TB is often diagnosed with a skin test. In this test, a small amount of testing material is injected into the top layer of the skin. If a certain size bump develops within 2 or 3 days, the test may be positive for tuberculosis infection. Other tests include X-rays and sputum tests. A blood test can be done in place of the TB skin test.

TB is present in all countries and age groups. It is the leading infectious cause of death worldwide. But TB is curable and preventable, however, people with TB can die if they do not get proper treatment. Sometimes drug-resistant TB occurs when bacteria become resistant to the drugs used to treat TB. This means that the drug can no longer kill the TB bacteria.

Doctor or Health care Provider will figure out the best treatment for the TB patients based on the age, overall condition of health and past history. The treatment for active TB is combination
of drugs. This might involve taking a number of medications for 6 to 12 months. It is important to continue taking medication as long period as prescribed by the doctor. Otherwise, the patient could get sick again. Not completing the entire course of medication could also contribute to drug-resistant TB. Patient should need regular checkups to make sure his treatment is working.
According to WHO, only a small portion of global cases receive the necessary life-saving medicine. Over 4,000 people die of tuberculosis every day.

Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis (TB) disease. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. In Pakistan and India, it is recommended that BCG should be given to all newborns within 2 weeks of birth, as part of the National Immunization Program along with zero dose of Oral Polio Vaccine (OPV) BCG has been used since 1921 globally.

“While most experts agree that BCG is efficacious against severe forms of childhood TB, its efficacy against TB in adults is highly variable. As a result of the uncertain efficacy of the BCG vaccine, countries have developed different BCG vaccination policies”. (The BCG, World Atlas)

TB is more common in countries where many people live in absolute poverty because they usually live and work in poorly ventilated, overcrowded and un hygienic conditions, which provide ideal conditions for TB bacteria to spread. There is growing resistance to available drugs, which means the disease is becoming more challenging and difficult to treat. There is need to raise awareness about the devastating health, social and economic consequences of TB, and to step up efforts to end the global TB epidemic.





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Seerat Shahina
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