Tuberculosis

My name is Dr. Gurmeet Singh Chabbra, working as a senior consultant Pulmonologist at QRG Health City, Faridabad.

Today I am going to talk about tuberculosis. Tuberculosis (TB) is caused by a bacteria called mycobacterium tuberculosis. It can also be caused by non-mycobacterium tuberculosis. Usually, it affects the lungs but it might affect other organs also like bones, kidneys, heart, brain, spine etc. Tuberculosis kills about 4,80,000 people per year i.e. about 1400 people in a day. It is more common in people who have more sad of living. It is more common in smokers. 55% is attributed to malnutrition which is very high compared to HIV. In diabetics, the instincts are more common.

Now how does it spread? Tuberculosis is spread by the one who is suffering from it, when he coughs, shouts, sneezes. The small droplets are exposed in the air. If someone inhales those droplets, it goes into the lungs. If controlled, it can be destroyed by the body. In some cases, it is just controlled and made dormant and it is called dormant TB or TB infection or latent tuberculosis. About 1/3 of the world's population is infected with the TB. The patients who have HIV, they have 24% of more chances of active TB. Latent tuberculosis if develops in active tuberculosis, is also called reactivation of TB. The patients who have latent tuberculosis, they will not spread TB. They will not look sick.

Latent tuberculosis can be diagnosed by skin Mantoux test or from a blood test for TB. We also have to examine the patient by chest x-ray to see whether the patient has active tuberculosis or not. Now about symptoms of tuberculosis. A cough for more than 2 weeks can cough out blood in the sputum, chest pain, fever, lethargy, weight loss, night sweat, not feeling well or in particular if any organ is involved than the patient might have the symptoms of organ involvement. For example: If the patient has spine TB, he will have a backache. If the patient has TB of the kidney, he may have blood in urine. Or he may also have enlarged swelling in the neck if he has a lymph node.

Now how is TB diagnosed? A patient is suffering from chest TB or pulmonary tuberculosis, we can examine sputum. We can send sputum test for CB-NATT test i.e. a DNA test for TB, also called geneexpert test or LPA. Another test like chest x-ray, ultrasound, CT scan will also help in diagnosis. 40% of the population of India has latent tuberculosis. The patients who are at the risk of TB, for example children, the age of less than 6, HIV positive patient, diabetics, they should get treated or examined for TB. The treatment for active TB involved in giving drugs. The patient who is suffering from TB they are treated by anti-tuberculated treatment with about 4 drugs to be given for 2-3 months and then about 3 drugs for 4-5 months. The patients who are suffering from MDR-TB, they require treatment for a longer time with more drugs. The key to success is that the treatment should not be interrupted. The drugs should be taken in proper doses and on time. In case, the patient develops any symptom or any side-effects, he should contact his doctor before stopping the drug. MDR-TB is about 6.19% cases of TB. And it is about 2.84% of new cases. And 11.6% of old cases. Thank You.