India has the highest burden of Tuberculosis in the whole world. According to WHO report in 2011, India has 25% of the TB affected population in the world. Almost 20 to 30 lacs Indians are infected with Tuberculosis. Hence TB is the measure of India’s health and wellness scale.
TB gets transmitted by air. Coughing, sneezing, speaking even singing by an infected individual can throw the bacteria in the air. By inhalation of this contaminated air, TB spreads to other people.
Tuberculosis mainly affects lungs. It is called as pulmonary tuberculosis. It can also spread to different other parts of the body including liver, intestines, brain, kidney, joints etc. It is called as extra pulmonary TB. The percentage of pulmonary TB is far common than extra pulmonary TB.
In patients having following symptoms, TB should be suspected:
- Cough not responding to treatment for more than 3 weeks
- Blood in sputum and cough
- Chest pain
- Unexplained weight loss
- Fever with chills
- Loss of apetite
- shortness of breath
- night sweats
In extra pulmonary TB, the symptoms will be according to the site involved.
The doctor will ask you a complete past, medical, family, drug history. History of concomitant diseases and conditions will be asked. You can get infected by TB if any of the family members had previous history of TB. HIV patients have higher risk of contracting TGB due to decreased immunity.
A thorough physical examination will provide information about the weight loss more than 10 kilograms in the last 3 months. Listening to lung sounds with the help of a stethoscope while you breathe will be useful in deciding further steps. The doctor will check the lymph nodes in your body by palpation. They are swollen in infective conditions.
The Mantoux Test
This test is done by injecting a small amount of fluid called PPD that is purified protein derivative into the layer beneath the skin. This area is not washed for two days. It is kept for 2 to 4 days and the resulting wheel around the prick is observed. If the patient is infected with TB, there will be an induration (swelling). If the diameter of the swelling is more than 10 mms then it is considered to be positive. However, it is falsely positive in people who have gotten BCG vaccine in their lives. Hence this test is mostly not of use in India as all the kids are given BCG vaccine at the time of their birth.
A chest X ray is taken. It can show a primary tuberculous lesion. Small nodules, cavities can also be seen on chest X ray. The enlarged lymph nodes are also seen on chest X ray. Abnormal chest X ray is not diagnostic test for TB. But chest X rays are used to rule out the possibility of a pulmonary TB.
Fresh sputum is collected on 2 consecutive days and sent for microscopic examination and culture. Presence of mycobacterium tuberculosis bacteria on sputum smear and culture media confirms the diagnosis of TB.
The burden of TB and the resistance to existing drugs in our country is on the rise. Most important part in prevention is early detection and prompt treatment of all the patients infected with TB. A complete course of treatments is necessary to avoid drug resistance. Use a handkerchief while coughing and sneezing. Go to a doctor if suffering from the symptoms listed above.
Let’s all get informed about Tuberculosis and work towards eliminating it from our country!!