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How does your doctor diagnose and treat TB?

Tuberculosis (TB) is a disease caused by bacteria that spreads from person to person through the air. When people with lung TB cough, sneeze or spit, they spread the TB germs into the air. Inhaling only a few of these germs can cause an infection in another person.

Having a strong and healthy immune system can prevent you from becoming sick.

There are two types of TB:

1. Latent TB: Also called inactive TB. This isn’t contagious. The bacteria remains in your body in an inactive state and causes no symptoms. Treatment is important if you have latent TB to help control the spread of the disease, as it can turn into active TB.

2. Active TB: This type makes you sick, and in most cases can spread to others. It can develop either in the first few weeks after being infected with the TB bacteria, or many years later.

Signs and symptoms of active TB include:

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

TB can also affect other parts of your body, including your kidneys, spine or brain. When it develops outside your lungs, signs and symptoms differ according to the organs involved.

For instance, TB of the spine may give you back pain, and TB in your kidneys might cause blood in your urine.

Tests used to screen for TB:

There’s no single test that can be used to test for TB in all circumstances.

1. A chest X-ray (best used to screen for active TB) is taken to look for changes in the lungs that could show signs of active TB or scars from a previous TB infection.

2. A tuberculin skin test is done by injecting a solution containing a protein made from tuberculosis bacteria just under the top layer of skin on the forearm. If after 48-72 hours the skin at the injection site develops a raised red bump, it indicates that you may be infected with TB.

If a skin test is positive, doctors will consider your risk factors and order additional testing to determine the best course of treatment. For this reason, doctors don’t rely on the skin test alone to confirm a diagnosis.

3. Blood tests may be ordered on their own or after a positive skin test. The different blood tests offer ways to measure the body’s immune response to the presence of bacteria.

4. Imaging tests

If you’ve had a positive skin test, your doctor will likely order a chest X-ray or a CT scan. This may show changes in your lungs caused by active tuberculosis. CT scans provide more-detailed images than X-rays do.

5. Sputum tests

If your chest X-ray shows signs of TB, your doctor may take samples of the mucus that comes up when you cough. The samples are tested for TB bacteria.

Sputum samples can also be used to test for drug-resistant strains of TB. This helps your doctor choose the medications that are most likely to work. These tests can take four to eight weeks to be completed.

Treatment

TB treatment takes much longer than treating other types of bacterial infections.

For active tuberculosis, you must take antibiotics for at least six to nine months. The types of medications and duration of treatment will depend on your age, health, possible drug resistance and the infection’s location in the body.

Preparing for your appointment

If you suspect that you have TB, see a doctor. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance. In addition,

  • Write down any symptoms you’re experiencing
  • Write down key personal information; include any recent life changes or international travel.
  • Make a list of all medications, vitamins or supplements you’re taking.
  • Write down questions to ask your doctor.

Some basic questions to ask your doctor include:

  • What’s the most likely cause of my symptoms?
  • Do I need any tests?
  • What treatments are available? Which do you recommend?
  • What if the treatment doesn’t work?
  • How long do I have to stay on the treatment?
  • How often do I need to follow up with you?
  • I have other health problems. How can I manage these conditions together?

References:

This form of TB cannot be treated!

Commonly known as TB, Tuberculosis is one of the top 10 causes of death worldwide, according to the World Health Organization.

It’s caused by bacteria that spreads from person to person, usually through the air. This condition usually affects the lungs but can also affect other parts of the body like the kidneys and spine.

With the correct care and treatment, TB can be cured. However, a form of TB called multidrug-resistant TB (MDR TB) cannot be treated.

What is MDR TB?

Multidrug-resistant TB is usually caused when the TB bacteria become resistant to even the strongest TB drugs called isoniazid and rifampicin.

This means, the drugs become ineffective and can’t treat the condition. MDR commonly develops as a result of the mismanagement of TB treatment and the continual spread of TB from person to person.

In some countries where MDR TB is common, it’s becoming increasingly difficult to treat the disease. This is because either treatment options are too expensive or some medicines aren’t available.

MDR TB is most common in people who:

  • Don’t take their TB medicine regularly
  • Take their TB medications incorrectly by not following their doctor’s instructions
  • Develop TB disease again, after having taken TB medicine in the past
  • Come from areas of the world where drug-resistant TB is common
  • Have spent time with someone known to have drug-resistant TB disease

Can you prevent MDR TB?

In 2017 alone, MDR TB was detected in 161 000 TB patients globally. Since there’s no available treatment for MDR TB, prevention is better than cure.

If you have TB, take all your medication exactly as your doctor prescribed it. Don’t miss any doses and don’t stop your treatment earlier than you should, even if you feel better.

Stay on top of your medication refills. If you’ll be travelling, check with your doctor to ensure that you have enough to last your entire trip.

If you don’t have TB, steer clear of those infected with TB and particularly MDR TB. Exposure is especially a risk in crowded places with TB patients like hospitals and clinics.

When to see your doctor

If you think you’ve been exposed to someone with TB or you suspect you have developed the condition yourself, see your doctor immediately. Tell him/her exactly when and where you spent time with anyone infected with TB.

Pay attention to the most common symptoms:

  • Weakness
  • Weight loss
  • A fever
  • Night sweats
  • Coughing and chest pain
  • Coughing up blood

If your doctor thinks your symptoms point to TB, you may be given a TB skin- or blood test. The faster you are diagnosed, the faster you’ll be treated. If you follow your treatment by adhering to your doctor’s orders, your risk for MDR TB is lowered significantly.

References:

The differences between TB and pneumonia

These two conditions have similar symptoms, but they are very different! Here’s what you need to know.

Signs and symptoms

It’s not possible to diagnose TB or pneumonia, without some investigations, like x-rays and sputum tests. They can look very similar, with coughing, weakness, and fever, but here are some of the main symptoms to look out for in each condition:

Tuberculosis Pneumonia
Chest pain, or pain with breathing and coughing Sweating
A fever higher in the afternoon Chest pain
Sweating excessively at night. Tiredness
Night chills Shortness of breath
Tiredness that gets worse as the day goes on Cough
Weight loss Increased heart rate
Loss of appetite Rapid breathing
Coughing that lasts three or more weeks with bloody sputum after a few days Chills
Nausea, vomiting or diarrhoea
Confusion or mental changes in elderly patients

 

Tuberculosis is contagious, while pneumonia is not. This is because different bacteria cause each complication.

Mycobacterium tuberculosis is responsible for TB, while many bacteria, including and most usually, Streptococcus pneumoniae can cause pneumonia. The good news is that there are vaccines for both diseases, but the TB vaccine is most useful for children, so it’s often used only in developing countries.

The tuberculosis bacterium spreads through droplets of moisture that are released when an infected person coughs or sneezes, speaks or laughs. The disease spreads among people who live or work closely together. If you’re on treatment, you generally stop being contagious after about two weeks.

Pneumonia, on the other hand, usually happens when your immune system is weak and the bacteria in your respiratory system start to breed (grow). Smoking or being in the hospital increases the likelihood of developing the disease. Sometimes, pneumonia happens when a particularly strong strain of a bacterium is present and your body simply can’t fight it off.

Tuberculosis also shows symptoms slowly over time, while pneumonia comes on quickly, but elderly patients, or those with diabetes or HIV may not show symptoms of pneumonia. This is when it becomes difficult to tell apart the infections.

While many believe TB only infects the lungs, the disease can affect the kidneys, spine or brain. The symptoms will be different according to which part of your body is infected. Infected kidneys can cause bloody urine, while a spinal infection can cause back pain. The bacterium can spread throughout the body in the bloodstream. Pneumonia is restricted to your respiratory system.

There are two types of TB, latent and active. Latent TB is when the disease exists but there are no symptoms and it’s not contagious. Latent TB can become active TB, which is contagious and causes symptoms. Active TB can also show symptoms only years after infection.

Diagnosis and treatment

Tuberculosis is diagnosed if a patient reacts to a skin test. If a hard bump develops under the skin after 48 hours, this is a sign of TB. It’s important to know that the skin test is not always reliable, so there are blood tests as well.

For pneumonia, doctors use blood tests and chest X-rays.

Your doctor will give antibiotics to treat both the diseases. Patients only need to take medication for around eight days, and symptoms can clear up within three to four days.

TB takes time to treat. The length of treatment depends on your age, strength, and the location of the disease, amongst other factors. Patients will only show signs of improvement after three or more days, while a fever can take weeks to come down. Tuberculosis patients have to take their medication for six months at least. Finishing the full course of antibiotics can cure the majority of TB patients.

References:

What exactly is TB? Here are the basics

In the past, TB was called ‘’consumption”, because of the way it literally consumed infected people from the inside. Luckily for us, today TB is treatable. Here’s what you need to know about it.

What is Tuberculosis?

Tuberculosis (TB) is an infectious disease caused by bacteria. While it mostly affects the lungs, it can also affect organs in the central nervous system, lymphatic system, gastro-intestinal system and circulatory system.

TB is classified as being either latent or active. Latent TB occurs when the bacteria are present in the body, but this state is inactive and presents no symptoms. Latent TB is also not contagious. Active TB is contagious, and it’s this type of TB that makes you sick with symptoms.

What Causes TB?

TB is caused by bacteria that are spread from person to person through airborne particles.

While some people have immune systems strong enough to quickly destroy TB bacteria when they enter the body, others will develop latent TB, and a fair number of people will become immediately ill and contagious with active TB. Anyone with a weakened immune system, including people with HIV, are more prone to developing active TB.

Signs and Symptoms to Watch Out for

A lot of people who become infected with the TB bacteria don’t actually show symptoms, but when symptoms are present, they include:

  • Sudden weight loss and loss of appetite
  • Tiredness or fatigue
  • Shortness of breath
  • A cough that lasts for more than 3 weeks
  • Coughing up blood
  • Chest pain
  • Pain when breathing or coughing

Can TB Be Treated?

If you’re at high risk for TB, there are anti-TB drugs that stop it from progressing to active TB.

People with active TB are usually treated with several anti-TB drugs to kill all the bacteria and stop them from becoming drug resistant. This usually means daily oral doses of medication for six months.

Fever & coughing: is it just flu or could it be TB?

Earlier this year, there was an outbreak of drug-resistant Tuberculosis in Australia. It started when a doctor in Sydney misdiagnosed a student with asthma and lung cancer – before realising it was TB.

Scary stuff! It’s understandable, though: TB shares symptoms with other conditions, such as flu, but they should be treated with completely different medications.

TB is caused by the organism Mycobacterium tuberculosis, which is easily spread when people with active lung disease expel the small airborne TB particles from their lungs into the air through coughing. Other people then breathe in the infectious droplets into their lungs, where the bacteria begin to multiply.

Influenza (flu) is caused by an influenza virus. The virus “sits” in the infected person’s nose and throat and when they speak, sneeze or cough, the virus becomes active – and infectious. It can be left on hands, surfaces, and items like tissues, washcloths and handkerchiefs. You can be infected with flu viruses via the air, or an infected hand or object touching your nose or mouth.

Symptoms in common

  • General coughing
  • Chest pain
  • Difficulty breathing (shortness of breath)
  • Weakness and fatigue
  • Loss of appetite and weight
  • Chills and fevers
  • Joint pain
  • Diarrhoea

TB is a beast of a disease that’s wreaking havoc across the country and continent. According to the World Health Organization, South Africa has the third highest incidence of any country after India and China.

How to know the difference:

  • A cough that starts out dry but later produces sputum (thick liquid from deep inside the lungs) or blood.
  • Coughing for longer than a month.
  • Rales (strange, rattling sound in the lungs when breathing).
  • Excessive sweating, including sweating at night.
  • Hearing loss.
  • Diarrhoea.
  • A persistent lump or lesion. (Especially lumps under the arms, from the lymph glands).
  • Clubbing of fingers or toes; (the nails become swollen, making the fingers look a bit like drum-sticks).

Those at risk for TB:

A weakened immune system is the most important factor in the development of TB after exposure to the organism. Even though research hasn’t directly linked TB to stress, it’s suggested that excessive stress weakens the immune system and generally increases one’s risk of contracting diseases. More than half of all TB patients also have HIV. The latest figure from the South African Department of Health is that 73% of TB patients are HIV positive. You are at higher risk of getting TB, if you:

  • have been in close contact with someone who has TB.
  • were born where TB is common.
  • live in an area where overcrowding, poor ventilation, malnutrition, substance abuse, and unemployment are rife.
  • have a condition that weakens the immune system (diabetes, cancer or kidney disease).
  • have already been infected with TB in the last two years.

When do I need the doctor?

In both conditions, you need medical care:

  • To prevent flu, you’ll need the flu-vaccine, and you can treat the symptoms with over-the-counter medication from your chemist.
  • For TB, you will take a TB test. Your doctor will then prescribe TB medication: which you will need to stay on until the course is complete: 6 months.

If any of the risk-factors apply to you, and you get a cough, it’s best to see your doctor ASAP. To treat TB successfully takes at least six months, and medication must be taken exactly as prescribed. Incomplete treatment or not following a consistent treatment regimen may cause you to develop drug-resistant strains of TB, which may be extremely difficult to cure and can even be fatal.

References

The cost of tuberculosis

Tuberculosis (TB) is a chronic infectious disease caused by a bacterium. It destroys parts of the lungs, making it difficult to breathe, but can also spread to and attack the bones, joints and nervous system.

The World Health Organization (WHO) estimates that about one percent of our population develops TB disease each year.

In South Africa the resistant strains of TB are on the increase. In fact, only five percent of TB is drug-resistant worldwide. This means that they are difficult to treat, time-consuming, and expensive.

According to WHO, it can cost several hundred times more to treat drug-resistant TB than TB that responds to standard drugs. A recent study found that drug-resistant TB can cost South Africa over R200 000 to treat (per patient).

Why so expensive?
There are two main types of drug-resistant TB: multi drug-resistant tuberculosis (MDR TB) and extensively drug-resistant TB (XDR TB). Multidrug-resistant TB (MDR TB) occurs when the bacteria become resistant to at least the two first-line drugs, Isoniazid and Rifampin.

This type of TB may emerge if:

  • You don’t take your medication regularly.
  • You don’t complete the full six month schedule.
  • You spend time with someone who has MDR TB. Crowded places and poor ventilation can increase your risk.
  • The wrong drugs or combination of drugs are prescribed.
  • The drug supply is unreliable or of poor quality.

XDR TB is a sub-form of MDR TB with additional resistance to anti-TB medications, meaning it responds to even fewer drugs.

Both MDR-TB and XDR-TB don’t respond to the standard six months of TB treatment with first-line anti-TB drugs. Treatments options are more expensive, not always available and aren’t guaranteed to work. Less than half of those infected are ever cured.

What’s more, these drugs can be costly to your health. You may have severe side-effects like deafness and psychosis. In some cases, even more severe drug resistant strains could develop. With new MDR TB strains on the rise and additional resistance to other drugs available for treating tuberculosis, the worst case scenario is that TB will become completely untreatable.

What you can do

  • Take your TB medication exactly as prescribed by your doctor.
  • Don’t stop your treatment early, even if you feel better.
  • Avoid those infected with TB or MDR TB.

Reference:

How to live better with TB

Tuberculosis (TB) is a chronic infectious disease caused by a bacterium called mycobacterium tuberculosis. It usually manifests and destroys parts of the lungs, making it difficult to breathe, but can also spread to and attack the bones, joints and nervous system.

TB bacteria can live in the body for years without any symptoms or spreading to others.

How TB is spread
TB travels through the air. When a person with TB of the lungs or throat coughs, sneezes, or talks, droplets of the TB bacteria are released into the air. People nearby may breathe in these bacteria and become infected.

Signs and symptoms of TB include

  • Persistent cough lasting longer than two weeks.
  • Night sweats.
  • Chest pain.
  • Weakness and fatigue.
  • Poor appetite.
  • Rapid weight loss.

Treatment
Successful treatment takes at least six months, and medication must be taken exactly as prescribed. Incomplete treatment or not following a consistent program may cause you to develop drug-resistant strains of TB, which could be extremely difficult to cure, and even fatal.

Patients are put on a course of treatment for six to eight months as soon as TB is diagnosed. You will then receive tablets, and in some cases, injections for the first two months of treatment.

The treatment is also known as DOTS (Daily Observed Treatment Short course). The tablets have to be taken under supervision to guarantee regular and effective therapy.

Patients usually respond well to treatment and can soon return to work and live relatively normally again.

Good to know

  • Stay on track with all your medical appointments.
  • Take your medicines as prescribed.
  • Report any side-effects of your medication. If you plan to move during the time that you’re being treated, let your doctor know so that arrangements can be made for you to continue the treatment.
  • Healthy eating and exercise will keep your immune system strong and help to prevent TB, and help you to recover faster.
  • During treatment, eat healthy foods and get enough sleep.
  • Aim for at least 30 minutes of exercise a day to help your body fight off the infection.

Keep safe

  • Don’t spend long periods in stuffy, enclosed rooms with anyone who has active TB until that person has been treated for at least two weeks.
  • Use protective measures, like face masks, if you work in a facility that cares for people who have untreated TB.
  • If you live with someone who has active TB, help and encourage the person to follow treatment instructions.
  • Cover your mouth when you sneeze or cough so as not to infect your family. Oranges, bananas and garlic are helpful in easing symptoms as they inhibit bacterial growth and boost your immune system.

References:

Can we stop TB for good?

Tuberculosis is a deadly disease that takes away 1.5 million lives from us every year. 1.5 million is not just a number – it also represents a sister, a child, a mother or a friend that could have been saved. TB is preventable and curable, and it’s up us to fight it.

The 24th of March is World TB Awareness day: so let’s gear up our knowledge so we can win this war. Continue reading “Can we stop TB for good?”