PULMONARY TUBERCULOSIS

This is also known as Respiratory Tuberculosis or Koch’s disease.

Pulmonary tuberculosis (TB) is a contagious bacterial infection that mainly involves the lungs, but may spread to other organs. It has a worldwide prevalence of 1.5 billion people infected with the disease. 10% of these infections are drug resistant and therefore harder to treat.

Pulmonary tuberculosis is caused by bacteria called Mycobacterium tuberculosis (M. tuberculosis). You can get tuberculosis by breathing in air droplets from a cough or sneeze of an infected person.

The initial stage of the infection is usually asymptomatic (without symptoms). Most people will recover from primary TB infection without further evidence of the disease. However, in some cases, the disease may become active within weeks after the primary infection, or it may lie dormant for years and later reappear.

Risk Factors for TB

The following people are at a higher risk for developing active TB:

·         The elderly- because their immune systems are failing.

·         Persons with weakened immune systems, for example due to AIDS, chemotherapy, or anti-rejection medicines given after organ transplant.

·         Infants- because they are yet to build up a strong immune system.

The risk of contracting TB also increases if you:

·         Are in frequent contact with people who have the disease.

·         Live in crowded or unsanitary living conditions.

·         Have poor nutrition.

The factors that may increase the rate of tuberculosis infection in a population include:

·         Increase in HIV infections

·         Increase in number of poor or homeless individuals (poor environment and poor nutrition)

·         The appearance of drug-resistant strains of TB

Symptoms of TB

·         Chronic Cough

·         Fever

·         Fatigue

·         Loss of appetite

·         Unintentional and often drastic weight loss

·         Coughing up of blood 

·         Phlegm-producing cough

·         Wheezing

·         Excessive sweating, especially at night

·         Chest pain

·         Difficulty breathing

Treatment

The goal of treatment is to cure the infection with drugs that fight the tuberculosis bacteria. The initial treatment may involve a combination of many drugs. It is continued until lab tests show which medicine works best. You may have to take a number of drugs daily for a long period of time.

Treatment usually lasts for 6-9 months, but longer courses may be needed for persons with AIDS or whose disease responds slowly.

You may need to be admitted to a hospital (quarantined) to prevent the spread of the disease to others until you are no longer contagious. In some cases admission is to ensure compliance and the medical personnel ensure the drugs are taken daily (daily observed therapy).

The Nigerian government provides subsidized drugs and treatment for people with TB in some specialized facilities nationwide. In some of these facilities the drugs are totally free.

Incomplete treatment of TB infections (such as failure to take medications for the prescribed length of time) can contribute to the emergence of drug-resistant strains of bacteria.

Prognosis

Symptoms may improve in 2 to 3 weeks. A chest x-ray will not show this improvement until much later. Prognosis is excellent if pulmonary TB is diagnosed early and treatment is started early.

Complications

Pulmonary TB can cause permanent lung damage if not treated early. Medicines used to treat TB may cause side effects, such as hepatitis and an orange or brown coloration of tears and urine. This change in color of tears and urine can be very dramatic and many Nigerians have been fooled into unnecessarily buying anti-TB drugs to “cleanse their blood” by road side drug hawkers.

When to seek Medical Advice

·         Visit your hospital if you have been exposed to tuberculosis, or if symptoms of TB develop.

·         Visit your hospital if symptoms persist despite treatment.

·         Visit your hospital if new symptoms develop, including indications that complications are developing.

Prevention of TB Spread

·         TB is a preventable disease, even in those who have been exposed to an infected person. Skin testing for TB is used in high risk populations or in individuals who may have been exposed to TB, such as health care workers.

·         A BCG vaccination to prevent TB is given in most countries with a high incidence of TB including Nigeria; this vaccine is one of vaccines that Fidelity Bank provides for newborns. It is not routinely used in the United States and other countries where TB is not prevalent. People who have had BCG may still be skin tested for TB and results of testing (if positive) should be discussed with one's doctor.

·         Prompt treatment is extremely important in controlling the spread of tuberculosis for those who have already progressed to active TB disease.

·         If you notice a family member or work colleague has developed the symptoms of TB contact Human Resources so we can ensure they receive adequate care and also prevent the spread to others.

Remember Prevention is better than cure.

Dr. Olukayode Williams