Tuberculosis (TB) is a highly contagious infection caused by the bacteria Mycobacterium tuberculosis. It primarily affects the lungs but can also target other parts of the body, such as the kidneys, spine, and brain.

TB poses a significant threat to global health, with the World Health Organization (WHO) estimating that approximately 1.5 million people died from TB in 2019 alone.

The burden of tuberculosis

TB has been a persistent challenge worldwide, particularly in developing countries with limited resources and inadequate healthcare systems. According to WHO, about 95% of TB-related deaths occur in low- and middle-income countries.

The burden of TB is further compounded by the rise in drug-resistant strains of the bacteria.

Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are more difficult to treat, requiring longer and more expensive treatment regimens.

Transmission and risk factors

TB is primarily transmitted through the air when an infected individual coughs or sneezes, releasing droplets containing the bacteria.

People in close contact with an infected person are at higher risk of contracting TB, especially if they have weakened immune systems.

Several factors increase the vulnerability to TB infection and disease progression:.

1. HIV/AIDS: Individuals with compromised immune systems, such as those living with HIV/AIDS, are more susceptible to TB.
2. Malnutrition: Poor nutrition weakens the immune system, making individuals more susceptible to TB infection.
3. Smoking: Tobacco smoke damages the lungs and impairs their ability to fight off infection, increasing the risk of developing active TB.
4. Overcrowded living conditions: TB spreads more easily in cramped spaces with inadequate ventilation.
5. Healthcare settings: Healthcare workers may be exposed to TB bacteria in hospitals or clinics, especially if proper infection control measures are not in place.

Symptoms and diagnosis

The symptoms of TB vary depending on whether it is active or latent. Latent TB infection does not cause any symptoms and is not contagious. However, it can progress to active TB if the immune system weakens.

Common symptoms of active pulmonary TB include:.

• Cough that lasts for more than three weeks
• Chest pain
• Coughing up blood or sputum
• Weakness and fatigue
• Weight loss
• Night sweats
• Fever

Diagnosing TB typically involves a combination of tests, such as:.

1. Tuberculin skin test: A small amount of TB protein is injected just below the skin, and if a raised bump develops within a specific timeframe, it indicates exposure to TB bacteria.
2. Blood tests: These tests detect antibodies or antigens associated with TB infection.
3. Chest X-ray: An X-ray can help identify any abnormalities in the lungs that may be indicative of TB.
4. Sputum test: A sample of sputum is collected and examined under a microscope for the presence of TB bacteria.
5. GeneXpert test: This test rapidly detects TB and determines if it is drug-resistant.

Treatment and prevention

TB is treatable, and early diagnosis and appropriate treatment are crucial. Standard TB treatment typically lasts for six to nine months and involves a combination of several antibiotics.

Patients must complete the full course of treatment to ensure complete recovery and minimize the risk of drug resistance.

Related Article WHO declares tuberculosis a global health threat on World Tuberculosis Day

Preventing the transmission of TB primarily focuses on two key strategies:.

1. BCG vaccination: The Bacille Calmette-Guérin (BCG) vaccine can offer some protection against severe forms of TB, especially in young children. While it doesn’t fully prevent TB infection, it reduces the risk of progressing to severe disease.
2. Infection control measures: Proper infection control practices in healthcare settings, including isolating TB patients, ensuring ventilation, and providing protective equipment, can prevent the spread of TB.

The impact of COVID-19 on TB

The ongoing COVID-19 pandemic has had a profound impact on global health systems, including TB prevention and treatment efforts.

The redirected resources, overwhelmed healthcare systems, and disruption of services have significantly affected TB detection and management.

Lockdowns and restrictions have led to reduced access to TB healthcare services, delays in diagnosis, interruptions in treatment, and a higher risk of TB-related complications and deaths.

It is vital to prioritize TB control efforts alongside COVID-19 response to minimize the impact on public health.

Global efforts to combat TB

Recognizing the immense global burden of TB, international organizations, governments, and healthcare authorities have been working together to accelerate TB control and eliminate the disease as a public health problem.

The WHO has set ambitious targets through the End TB Strategy, aiming for a 90% reduction in TB incidence and 95% reduction in TB deaths by 2035.

The strategy focuses on integrated patient-centered care, bold policies, and supportive systems to tackle TB comprehensively.

Improved diagnostics, access to affordable and quality-assured drugs, and research for new diagnostics, drugs, and vaccines are crucial in combating TB.

Additionally, community engagement and education play a vital role in raising awareness, reducing stigma, and promoting early detection and treatment-seeking behavior.

Conclusion

Tuberculosis continues to be a growing concern for global health, particularly in low- and middle-income countries.

The rise of drug-resistant strains, high mortality rates, and the impact of the COVID-19 pandemic have underscored the need for increased efforts in TB prevention, diagnosis, and treatment.

By prioritizing TB control, investing in healthcare systems, and fostering international collaborations, we can work towards achieving the ambitious goal of eliminating TB as a public health problem by 2035, saving countless lives and preventing further transmission of this debilitating disease.