Tuberculosis

What is Tuberculosis?

Tuberculosis, better known as TB, is caused by the bacterium Mycobacterium tuberculosis and is an air-borne disease transmitted through fine respiratory droplets from an infected person.

It usually affects the lungs (pulmonary tuberculosis), but other parts of the body can also be affected (extrapulmonary tuberculosis), such as the brain, lymph nodes, the kidneys, bones, and joints.

If not treated properly, TB can be a fatal disease.

Most exposed casually do not become infected. For those who do become infected, most develop latent TB (LTBI). Persons with LTBI do not have symptoms of TB (e.g. cough) and do not spread TB to others.

In most healthy persons with LTBI (90%), the TB bacteria remains inactive in their body throughout their life. About 5% develop active TB disease within the first two to three years following infection. Another 5% may develop active TB disease sometime within their lifetime.

The risk of progression to active TB disease is higher in people:

• With underlying medical conditions such as HIV infection and diabetes;

• Who have a weakened immune system (e.g. due to drugs or sickness);

• Who have poor nutritional status; and

• Are substance abusers/drug addicts.

What are the symptoms of Tuberculosis?

Symptoms of TB disease depend on the area affected. Some common symptoms of TB include:

• A persistent cough that lasts 2 weeks or longer

• Low-grade fever

• Night sweats

• Fatigue

• Appetite loss

• Weight loss

• Chest pain

• Coughing up blood or sputum

Early detection is key. If you have a persistent cough that lasts 2 weeks or longer, you should consult a doctor immediately. Your doctor may ask you to go for a chest X-ray and you may be referred to a specialist for further clinical and laboratory investigations.

What are the potential complications of Tuberculosis?

Infection with TB disease can cause permanent lung damage if not treated early. It can also spread to other parts of the body, such as the bone, intestine, brain, and central nervous system, where it can lead to life-threatening complications.

How does Tuberculosis spread?

TB is typically spread through close and prolonged contact with an infectious individual, and not by contact with items or surfaces touched by a person with TB. A person cannot get TB from sharing cups, eating utensils, food or cigarettes. TB is not spread by shaking someone’s hand, kissing, or by touching bed linens or toilet seats.

How do I prevent Tuberculosis?

To protect yourself and others from TB:

• Keep your immune system healthy by adopting healthy eating habits, exercising regularly, and having enough sleep.

• Consult your doctor if you have symptoms of TB.

• Give your full support to family members, friends, colleagues, or employees who have TB until they are cured.

If you have TB disease, you can help keep your family and friends from getting sick by:

• Completing the full course of your TB medications. You must finish all your medicine even if the symptoms go away and you start to feel better.

• Staying at home in the first two weeks of treatment except when attending directly-observed therapy (DOT) at polyclinics (see section on DOT treatment below).

• Wearing a face mask in the presence of other people during the first two weeks of treatment.

• Covering your mouth with a tissue when you cough or sneeze.

The incubation period may range from weeks to years.

How is Tuberculosis treated?

TB disease can be cured with anti-TB drugs. Treatment of TB disease which is sensitive to first-line anti-TB drugs, involves a combination of several different drugs, taken for 6 to 9 months. More than 95% of people with TB disease are cured if they take all the medications as prescribed and until completion. Otherwise, TB may recur or become resistant to first-line anti-TB drugs.

Drug-resistant TB is extremely difficult to treat as less effective drugs will have to be used. The chance of cure is also reduced compared to drug-sensitive TB.

The best way to cure TB disease is to be treated under MOH’s DOT programme. The World Health Organization has advocated DOT as the standard of care for all TB patients. Under DOT:

• The TB patient takes each dose of medication under the direct observation of a health care worker to ensure that the correct dosage and combination of TB medications are taken for the entire course of the treatment.

• The TB patients’ response and adherence to treatment are closely monitored so that treatment failure, emergence of drug resistance and spread of the disease can be avoided.