World Tuberculosis Day
World Tuberculosis Day is observed annually on March 24th. It aims to raise awareness about tuberculosis (TB), a bacterial infection that primarily affects the lungs but can also affect other parts of the body. The day commemorates the discovery of the bacteria that causes TB by Dr. Robert Koch on March 24, 1882. World Tuberculosis Day serves to educate people about the symptoms, prevention, and treatment of TB, as well as to advocate for increased funding and efforts to eradicate the disease globally.
A study discovered that over 80% of tuberculosis (TB) patients do not exhibit a persistent cough.
A recent study published in The Lancet Infectious Diseases revealed that over 80% of individuals in Asia and Africa diagnosed with culture-confirmed pulmonary tuberculosis (TB) do not exhibit one of the disease’s hallmark symptoms. Conducted by an international team of scientists, the research aimed to investigate the prevalence of subclinical pulmonary TB across 12 high-burden countries in these regions. Surprisingly, it was found that more than 80% of TB patients did not present with a persistent cough, while over 60% had no cough at all, and more than a quarter displayed no other associated symptoms. This absence of a persistent cough holds significant diagnostic implications, as it is a key indicator for initiating TB diagnostic procedures in HIV-negative patients. Consequently, individuals who do not report a persistent cough may experience delays in diagnosis and treatment for a disease that claimed the lives of 1.3 million people in 2022, making TB the second-leading cause of death from a single infectious agent, following COVID-19. These findings shed light on the substantial disparity between the reported global TB cases (7.5 million in 2022) and the estimated number of individuals who contract the disease (10.6 million in 2022) each year. Dr. Frank Cobelens, corresponding author of the study and a professor of global health at Amsterdam University Medical Center, emphasized the significance of these results, stating that the lack of a persistent cough as a diagnostic indicator could lead to delayed or missed diagnoses, potentially resulting in further transmission of the infection.
Symptoms of Tuberclosis
The symptoms of tuberculosis (TB) can vary depending on whether it’s active or latent TB.
For active TB, symptoms may include:
1. Persistent coughing that lasts more than three weeks
2. Chest pain
3. Coughing up blood or phlegm
4. Fatigue
5. Fever
6. Night sweats
7. Loss of appetite
8. Weight loss
9. Weakness or fatigue
10. Chills
Latent TB, on the other hand, may not show any symptoms, but the bacteria can still be present in the body and can become active later. It’s essential to seek medical attention if you experience any of these symptoms, especially if you’ve been in contact with someone who has TB or if you’re at higher risk due to other factors. Early detection and treatment are crucial for managing TB effectively.
Details about Tuberculosis
Tuberculosis (TB) stems from the bacterium Mycobacterium tuberculosis, typically affecting the lungs but capable of attacking various body parts. The disease spreads when individuals with TB in their lungs or throat release bacteria into the air through activities like coughing, sneezing, speaking, or singing.
Transmission occurs as nearby individuals inhale the bacteria, leading to infection. Consequently, environments where many people congregate for extended periods, such as healthcare facilities, pose significant transmission risks.
To heighten awareness and educate the public about TB’s impact and bolster prevention efforts, World TB Day is observed on March 24th. CTSI contributes to World TB Day initiatives by providing infection control testing and consulting services. Utilizing highly sensitive real-time Polymerase Chain Reaction (PCR) techniques, air testing is conducted to curb the dissemination of Mycobacterium tuberculosis. Furthermore, CTSI employs its expertise in mechanical ventilation, engineering controls, and other methodologies to minimize exposure risks and safeguard patients, healthcare workers, and occupants of high-risk settings from TB transmission.
Effect of TB on human body
Tuberculosis (TB) can have significant effects on the human body, particularly if it progresses to active TB disease. Here are some of the effects:
1. Lung Damage: TB primarily affects the lungs, causing inflammation and damage to lung tissue. This can lead to symptoms such as coughing, chest pain, and difficulty breathing.
2. Systemic Symptoms: TB can cause systemic symptoms such as fever, night sweats, fatigue, and weight loss. These symptoms can be debilitating and affect overall well-being.
3. Complications: Without proper treatment, TB can lead to serious complications such as pleurisy (inflammation of the lining around the lungs), pneumonia, and respiratory failure. TB can also spread beyond the lungs to other parts of the body, causing conditions such as TB meningitis, TB bone and joint infections, and TB of the kidneys or spine.
4. Immune System Impact: TB can weaken the immune system, making individuals more susceptible to other infections and diseases.
5. Transmission Risk: Active TB disease can spread to others through the air when an infected person coughs or sneezes, posing a risk to close contacts and the community at large.
Overall, TB can have a profound impact on both physical health and quality of life if left untreated or if treatment is delayed. Early detection and appropriate treatment are essential for managing TB and reducing its effects on the body.
Prevention of Tuberculosis
Preventing tuberculosis (TB) involves a combination of public health measures, vaccination, and individual actions. Here are some key steps for preventing TB:
1. Vaccination: The Bacillus Calmette-Guérin (BCG) vaccine is widely used to prevent TB, particularly in countries with high TB prevalence. It’s typically given to infants in these regions to provide protection against severe forms of TB, such as TB meningitis and disseminated TB in children.
2. Screening and Early Detection: Individuals at high risk of TB, such as those with HIV/AIDS or those in close contact with TB patients, should undergo regular screening for TB infection. Early detection through methods like chest X-rays, sputum tests, and tuberculin skin tests (TST) allows for prompt treatment and reduces the risk of transmission.
3. Treatment of Latent TB Infection: People with latent TB infection (LTBI), who have the TB bacteria in their bodies but do not exhibit symptoms, can develop active TB if left untreated. Treating LTBI with medications like isoniazid or rifampin can prevent the progression to active TB.
4. Ensuring Completion of Treatment: TB treatment requires a course of antibiotics taken for several months. It’s crucial for patients to adhere to their treatment regimen and complete the entire course to prevent the development of drug-resistant TB and ensure cure.
5. Infection Control Measures: Implementing infection control measures in healthcare settings and congregate settings like prisons and homeless shelters helps prevent TB transmission. This includes proper ventilation, isolation of TB patients, and use of personal protective equipment by healthcare workers.
6. Promoting Respiratory Hygiene: Encouraging individuals with TB symptoms to practice respiratory hygiene, such as covering their mouth and nose when coughing or sneezing, can reduce the spread of TB bacteria in the air.
7. Addressing Social Determinants: Addressing underlying social determinants of TB, such as poverty, malnutrition, overcrowded living conditions, and lack of access to healthcare, is essential for TB prevention efforts.
8. Education and Awareness: Public education campaigns about TB transmission, symptoms, and treatment can help reduce stigma, improve treatment-seeking behavior, and encourage preventive measures in communities.
By implementing these preventive measures at both the individual and population levels, the burden of TB can be significantly reduced, leading to fewer cases and better health outcomes for affected individuals and communities.
Unveiling the Significance of Subclinical Tuberculosis
In a groundbreaking study aiming to understand the prevalence of subclinical pulmonary tuberculosis (TB), researchers, led by Cobelens and colleagues from the scTB Meta Investigator Group, delved into national TB prevalence surveys across 12 countries. These surveys, conducted in collaboration with the World Health Organization (WHO) between 2007 and 2019, utilized chest X-rays and symptom screenings to identify TB cases among individuals aged 15 and older, with TB confirmed through positive Mycobacterium tuberculosis sputum cultures.
Defining Subclinical TB
The term “subclinical pulmonary TB” was coined to encompass individuals with TB pathology who do not exhibit clinically recognizable symptoms. The study utilized three case definitions for subclinical pulmonary TB: absence of a persistent cough (lasting 2 weeks or more), absence of any cough, and absence of other typical TB symptoms such as chest pain, fever, night sweats, and weight loss.
Key Findings
– Analysis of individual participant data, comprising 602,863 participants, revealed 1,944 cases of culture-confirmed TB.
– Adjusting for factors like incomplete sensitivity of X-ray screenings and missed or contaminated cultures, the study found that 82.8% (95% CI, 78.6% to 86.6%) of TB cases exhibited no persistent cough, while 62.5% (95% CI, 56.6% to 68.7%) showed no cough at all.
– In a subset of surveys containing additional symptom information, 27.7% (95% CI, 21.0% to 36.4%) of TB patients displayed no symptoms.
– Women, younger participants, and urban residents demonstrated higher average proportions of TB cases with no persistent cough or no cough at all.
– Among smear-positive TB patients, who are more contagious, 29.1% (95% CI, 25.2% to 33.3%) had no persistent cough, and 23.1% (95% CI, 18.8% to 27.4%)o exhibited no cough at all.
Implications
The study underscores the potential significance of subclinical tuberculosis as a major source of global transmission. Delayed or missed diagnoses associated with subclinical TB could have contributed to the less-than-anticipated impact of TB control efforts on global TB incidence in recent decades, according to the study authors.
Call for a Fresh Approach
According to Cobelens, the study’s outcomes signal the urgency for a reevaluation of TB detection strategies and the implementation of expanded case-finding methods, such as chest X-ray screenings.
He emphasized in the press release, “Current practices, particularly in the most resource-constrained settings, are evidently overlooking significant numbers of TB patients. We must pivot towards prioritizing X-ray screenings and the advancement of novel, affordable, and user-friendly diagnostic tests.”
Moreover, the adoption of innovative technologies like mobile radiology vans, computer-assisted radiology systems, and rapid molecular tests holds promise in augmenting active case-finding endeavors and uncovering more cases of subclinical TB.
The researchers underscored, “Subclinical tuberculosis underscores a higher-than-acknowledged prevalence of the disease and presents an imminent obstacle to the World Health Organization’s goal of eradicating TB by 2035.” They advocate for further exploration of subclinical TB through interdisciplinary studies in microbiology, public health, and clinical care to refine policies pertaining to its diagnosis, treatment, and management.