Diagnosis and Treatment of Tuberculosis

Pakistan ranks fifth in terms of TB diagnosis and mortality worldwide. This means that the rate of TB here is quite high.

For this reason, Pakistan was declared a TB emergency state in 2001 and the government was given a target to make the country TB-free by 2035. The government has launched the National TB Control Program to achieve this goal. According to the 2021 data of this program, 259 people out of every 100,000 population in Pakistan suffer from TB disease. Twenty of them die of TB and its related complications.

Introduction

More than 100 trillion bacteria live in your body at any one time. Nature has put more than 100 trillion microbes in place to protect your body parts and your natural health. Scientists have finally started to understand the usefulness of these health-promoting microbes, that’s why today you can find probiotics (pro-pro-biotic) i.e. natural Life-saving drugs from microbes are gaining popularity.

These probiotics are found naturally in common household items such as yogurt, lassi, certain types of cheese, vinegar-based vegetable pickles, and real chocolate. And they keep your immune system strong. Especially the ones we mentioned, these foods are friendly to the protective microbes in your gut, and more than half of all illnesses today originate in the gut. So try to include some of these ingredients in your daily meals. Well, TB was being talked about, so why did this matter come to the middle? It is because common people do not understand the difference between infection or inflammation or swelling and symptomatic disease. While most diseases, including TB, occur in these two phases, both cases occur.

Stages of TB

Latent: Infection is the stage in which the germs have entered the body but the symptoms of the disease have not yet appeared because the immune system has become active against them and at this stage it is heavy on the microbes. However, in the next phase, when the fight of the immune forces with the microbes becomes more intense, the resulting cellular damage or chemical defects appear as symptoms of the disease.

TB Symptoms and Transmission

Symptoms of TB can be specific or general. For example, TB can occur in any part of the body, such as the brain, kidney, spine, and uterus, and without treatment, the patient can die. TB of the brain looks like meningitis, TB of the spine causes back pain, TB of the uterus causes infertility or menstrual problems, TB of the kidneys or intestines causes abdominal pain and problems in the affected area but Tuberculosis is the most common.

In the case of lung involvement, persistent cough for three weeks and blood with phlegm are typical symptoms of tuberculosis, while weight loss, night sweats, persistent low-grade fever, physical fatigue, feeling sick. All are common symptoms of TB germs in the body. TB is a communicable disease. Therefore, by spitting, coughing, sneezing, speaking, even singing, a person infected with pulmonary TB can spread the germs to others. These germs can survive in the air for a long time, so if a person breathes in this contaminated air, he can also get TB disease.

However, if this germ is weakened and enters the body, the infection is latent TB. In this case, the TB germs have entered the body, but the immune system has won the battle, due to which neither the symptoms appeared nor these people can transmit the germs to others. However, in the state of this ongoing battle in the body, it may not happen that the germs win and the disease appears, so as a precaution, only one type of TB drug should be given to these patients with slow infection for six months. Or two types of drugs are given consecutively for a total of three months. In order to help the immune system to completely eliminate the germs and avoid the harmful effects of the disease in the future.

However, in people who get TB, because the germs are spreading so fast, the numbers are so high that they can become airborne through the respiratory tract and infect other people. Therefore, immediate isolation and treatment of these patients is very important. Otherwise, the whole family becomes sick in the form of a group and if treatment is not done, there may be death.

Attitude Towards TB Patient

It is very important to mention that if there is strong expression of grief, anger, fear or hatred towards people, then people start to panic about stopping diagnosis and even if there are symptoms, treatment is a far cry from going to the doctor. They also start to shiver. Thus, by the time the diagnosis and treatment is started, the disease has become serious and the stigma falls on the doctor or medicine. In some cases, it has also been seen that the entire neighborhood gets engulfed by it. So please be kind and patient. Explain the suspicious person well. And even if from outside the boundaries of the house, some human connection and encouragement or assistance should also be provided to the sick person. By doing so, a healthy social trend will be established in which people will prioritize pre-treatment and early diagnosis over needless deaths. Sitting close to an infected person in a stuffy room for about 20 minutes increases the rate at which germs enter you. Therefore, do not make the formal relationship difficult for such a patient and his family, but be a source of ease for them.

Prevent TB

The vaccine against TB is called BCG. Although its use has been abandoned in developed countries, in countries where there are still significant rates of TB patients, its use is paid for by government agencies as a basic health right. Is. Therefore, every newborn should receive the TB vaccine in the upper arm within 72 hours of birth. Although it does not prevent the disease 100%, but it definitely reduces the disease as far as possible. About 80% of cases of severe disease have been avoided. This vaccine is given to people under 35 years of age in foreign countries only on a case-by-case basis, i.e. if someone is traveling to a TB-affected area or if a relative has come to visit these areas, children and Adults will also be vaccinated. In such a case, it would be good if you inform them in advance.

Similarly, those from foreign countries who go to TB-affected areas due to their connection with the health sector, are also vaccinated if they are under thirty-five years of age. Because its performance in people over 35 years of age is not clear. In Pakistan, China, Russia, Africa, Philippines, India, Bangladesh and some other countries, they are part of the national vaccination campaign and every child should be vaccinated. It is worth mentioning here that there is no need for isolation after vaccination.

TB Screening Tests

If you have spent significant time with a patient with TB symptoms or if you are showing symptoms yourself, both should be tested. However, if you have only met a relative who had no symptoms i.e. latent disease or disease no, then the test is not required. This means that if one person in a household has TB, they should be isolated from other people and get their tests and treatment as needed so that the entire population is not infected.

There are two types of tests to diagnose TB: a skin test or a blood test. Skin test (Mantouxt test) is called. In this test, some weakened TB germs are injected into the upper surface of the skin on the inside of your arm, and after more than forty-eight hours, a trained professional comes to see what the result is. That is, whether the rash has appeared on the skin or not, and if so, to what extent ihas spread. A minor abscess or small blister may form at the injection site. This test is prohibited for pregnant women.

Another method is a blood test that looks at the immune system to see how many germs are present. And how do the white cells perform against them? If these tests are positive, meaning that there is a problem, your chest x-ray and mucus are checked for the presence of TB germs. A diagnosis of TB is not possible if a single test is positive, but a diagnosis is made based on the comparison of two to three tests and the symptoms present in the patient. In case of severe symptoms of the disease, diagnosis and treatment is based on these symptoms and X-ray instead of the Mantoux test.

If there is TB in a place other than the lungs, a CT scan, MRI, or spinal fluid test (Lumbar Puncture) is done as needed. If TB of body parts is diagnosed, if the rest of the family has no symptoms, consult a doctor about the need for diagnostic tests.

Treatment of TB

TB is a disease that is almost nine thousand years old and until 1882, one out of every seven people in Europe and America died due to TB. However, due to antibiotics, a revolution occurred and the average life expectancy of humans increased by several years. Today, three to four types of antibiotics are used to treat TB for a period of six months to a year.

It is very noteworthy that if the medicine is stopped suddenly after taking it or if the medicine is not taken according to the prescription or by observing the time, then instead of curing the disease, it becomes resistant and becomes more severe. The treatment of this resistant TB is somewhat difficult and very long-term (about nine months to two years) and even with treatment, there is a risk of spreading to other parts of the body i.e. becoming malignant. Since, according to the immune system, the germs come out by changing their shape and becoming more tough, then the bitterness of the medicine has to be increased many times.

Also, it should be kept in mind that within a few days or a few weeks after taking the medicine, the patient starts to feel better, but it will take the doctor’s prescribed period to eliminate the germs from the blood and the cells in the organs. To establish regularity of medication and treatment facilities, the government has also started DOTS i.e. Direct Observation Treatment System, by which the patient remains connected to his treatment center and if he suddenly disappears, the people of this institution look for him. and examine why this happened. And try to get the patient back into the program and re-initiate and complete the treatment.

Unlike TB of the lungs, TB of body parts does not spread to other parts of the body, but often develops after TB of the lungs. So you have to consult your doctor for more details. We can also tell you that even if there is a lung disease, within two to three weeks of starting the medicine, the germ has weakened enough that the patient can go back to normal people.

Side Effects of TB Treatment and their Prevention

Taking TB medication is a daunting task. Because these medicines are very bitter, only then can they eliminate this tough bacteria tuberculosis mycobacterium. However, while eating them, if you ever feel jaundice, blurred vision, spots on the skin, the color of urine is very thick, fever, body or joint pain, loss of appetite or nausea. Contact your doctor or DOTS center if you experience ringing in the ears or abdominal pain. Sputum/sputum tests are done at regular intervals during treatment to help monitor the effectiveness of the treatment. However, at home, dispose of used tissues or cloths containing saliva or mucus in a tightly closed container. And eat a good, balanced diet. Which is low in fat.

You don’t have to eat meat to get protein, but local egg whites, pulses and porridge, black and white gram and peanuts are also useful and should be consumed by the patient while taking TB medicines. Also, all the seasonal fresh fruits, vegetables and adequate amount of water, including the foods probiotics that we have mentioned earlier, all play a special role in helping the patient to recover quickly and avoid the side effects of drugs.

Safeguards

One caution is equally important for all that even if the house is small, arrange and organize the ventilation well. Whether it’s winter or summer, open windows and doors to let air and light into the home. And get rid of excess items quickly. Eliminate dampness and mildew etc. and apply lime on seamed walls. Immunocompromised people with AIDS, diabetes, kidney problems or organ transplants and related problems, and above all poverty, where cramped housing and malnutrition contribute to the growth and spread of TB. Also, drug addicts easily fall victim to it.