Sunday, March 31, 2013

24th March: World Tuberculosis Day

March 24th has been set aside annually to create public awareness and celebrate the achievements made so far in eradication of Tuberculosis the world over. The theme for 2013 was “Stop TB in my lifetime, call for a world free of TB” and there is a call to all government, private institutions, civil societies, health care providers, medical associations, non-governmental organizations to work towards the total eradication of the tuberculosis (TB) disease.
Setting this day aside each year provides an opportunity to create awareness on the incidence of TB worldwide, gives an update on the progress made on the prevention and control and helps to solicit for support from government and international organizations.   
TB mortality rate has reduced by over 40% worldwide since 1990 with a decline in occurrence of new incidence of the disease, Although TB occurs mostly among low to middle income earners; it is a risk to all due to the airborne nature. The World Health Organization statistics states that 1.4 million people died from TB in the year 2011.
The objective of this write-up is to enlighten people on TB as a disease, its causes and treatment.
Dr. Robert Koch first discovered the cause of TB on 24th March 1882 hence the memorial for the global awareness. It is caused by a bacterium called Mycobacterium tuberculosis, which usually attack the lungs but can also affect other parts of the body such as kidney, spine and brain; it can be fatal if not treated properly. It is an airborne disease that usually gets into the air from an infected person that coughs, sneezes, speaks or sings and then anyone who breathes in the bacteria becomes infected.
Two types of TB infected conditions exist: the latent TB infection and the TB disease:

Latent TB Infection: The TB bacteria can live in the body without making you sick. For most people that breathe in the bacteria and become infected, the immune system fights to stop the bacteria from growing therefore there are no symptoms. People with latent TB are not infectious or cannot spread the disease to others but if the TB bacteria become active in the body and multiply, the person will become sick therefore will change from having latent TB to having the TB disease. About 90% of all infections are latent and asymptomatic.

TB Disease: When a person breathes in TB bacteria, it multiplies in the body, the individual becomes sick and becomes infectious to other people. Some people develop TB disease within weeks after becoming infected before their immune system can fight the TB bacteria. Symptoms include bad cough, pain in the chest, coughing up blood or sputum, weakness or fatigue, weight loss, no appetite, chills, fever, sweating at night.
Risk Factors: In Sub-Saharan Africa where HIV rates are high, more people are susceptible to TB infections because the two diseases co-exist; overcrowding, poor nutrition and smoking are all factors that make people more susceptible to TB infections.

Diagnosis: Diagnosing active TB based on signs and symptoms is difficult; a definitive diagnosis can only be made by identifying the bacteria in a clinical sample such as sputum, pus or biopsy from tissue. The TB organism is slow growing so can take from two to six weeks for the culture to process. The Mantoux tuberculin skin test is often used to screen people at high risk for TB.
Prevention: Control and prevention of TB is by vaccination of infants while for active cases, detection and appropriate treatment is advised. The currently available vaccine is Bacillus Calmette- Guerin (BCG), which gives immunity for about 10years.
Management and treatment: Antibiotics can be used to kill the bacteria, the most effective antibiotics are isoniazid and rifampicin and treatment can take several months. Latent TB treatment uses a single antibiotics’ while the active TB disease is best treated using a combination of different antibiotics to reduce the risk of the bacteria becoming resistant to the antibiotics.
Achieving a world free of TB is a journey we must all embark on to ensure we stop TB in our lifetime.

Written by O’ Reese of En-pact Solutions Limited, 2013
Twitter: @O Reese2

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