World Tuberculosis Day: Is India on track to becoming a TB-free nation by 2025?

Did you know?

  • Tuberculosis (TB) is one of the world’s deadliest infectious diseases
  • Tuberculosis is one of the top ten leading causes of death worldwide and the leading cause from a single infectious agent, ranking above HIV/AIDS
  • TB is a leading killer for people with HIV infections

The above data from World Health Organization (WHO) Global TB 2018 report indicates the severity of this noxious lung infection. What makes it even more brutal is how communicable it is – easily. The bacteria that cause TB can easily spread to other people through tiny droplets released into the air when someone with TB coughs or sneezes.

The health, social and economic impacts of tuberculosis today are tremendous. To raise awareness among the general public about TB and its impact, World TB Day is commemorated on 24 March every year.

The date also marks the day in 1882 when Dr Robert Koch made the astonishing announcement of discovering the bacterium that causes tuberculosis, the TB bacillus or Mycobacterium tuberculosis. This opened up the possibility of diagnosing the condition and potential solutions towards ending the global TB epidemic.

 World Tuberculosis Day: Is India on track to becoming a TB-free nation by 2025?

New research holds promise for shorter treatment courses for people with drug-resistant TB. Image courtesy: Daniel Irungu/EPA

According to the WHO 2018 TB report, 10 million people around the world were diagnosed with TB in 2017 alone. Of these millions, 27 percent were new cases registered in India – home to the highest of the top 30 TB-burdened nations.

As a matter of fact, India along with seven other nations – China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa – are when 87 percent of the world’s new cases emerged.

The above data, therefore, makes it even more important to know about this disease, which is both curable and preventable. So, let’s find out. 

What kinds of tuberculosis are there?

One of the two types of TB are culprits for the lung infection, which is capable of spreading to other parts of the body as well. 

Latent TB

In this case, though the bacteria is present in the body, it remains in an inactive state and thus, causes no harm. Latent TB has no symptoms and isn't contagious either.

Only 10 percent of latent TB cases have the chances to become active and that too in those people whose immune system is at a risk. For instance, smokers, people suffering from malnutrition or living with HIV-infected individuals are more vulnerable.

Not all people with latent TB infection actually need treatment. That said, in countries like India where the TB burden is high, people with latent TB that are living with HIV, a partner with HIV, or sharing a house with children under the age of five are among some of the high-risk groups that should get treated.

Representational Image. Reuters

Representational Image. Reuters

Active TB

This is a severe form of tuberculosis that makes a person feel sick. It is also contagious and requires the urgent intervention of a doctor. The most common types of organs affected by TB are the lung, intestine, spine, lymph nodes and the skin.

What are the causes and symptoms of TB?

TB is caused by a bacteria called Mycobacterium tuberculosis, which spreads in many ways – speaking, coughing, sneezing, spitting, etc. It largely infects people who spend a considerable amount of time around or living with or working with a TB patient.

Some symptoms of active TB are

  • Cough that lasts three weeks or longer
  • Coughing blood
  • Chest pain or an ache while breathing or coughing
  • No appetite for food
  • Unintended weight loss
  • Unexplained tiredness
  • Fever and night sweats

In case the tuberculosis spreads to other parts of the body, the symptoms change to organ-specific ones, i.e. as it spreads to the brain, it can lead to meningitis; to the spine, it may cause back pain, to the heart, it is most fatal as it can damage the organ's ability to pump blood.

TB is the top infectious disease killer in the world. Image: WHO

TB is the top infectious disease killer in the world. Image: WHO

Who are at risk of a TB infection?

TB is more of young adult disease, but it can affect all age groups.

This is evident in data from the 2017 WHO report, which states that 1 million children between 0–14 years of age fell ill from TB and 230,000 children with HIV-associated TB died from it.

Tuberculosis is more prominent among people living in developing countries, from where over 95 percent of cases and mortality were reported.

The disease is 20-30 times more likely to affect individuals with HIV than others. Also, those with a weaker immune system are too at a higher threat. Smoking or tobacco intake is another factor that increases the risk of this illness and death.

Around 7.9 percent of TB cases worldwide are associated with smoking.

How is TB diagnosed?

The most common type of TB – which affects the lungs – is diagnosed by tests done on the sputum and a chest X-ray. A skin test called the Montoux test or a new technique called IGRA can also point towards latent TB infection.

To confirm these findings, cultures of sputum or other body tissue or fluid are needed.

Is there a treatment for TB?

The right medication and its administration is a cure for a majority of TB cases. The dose and the period of the remedy is dependent upon the patient's

  • age
  • overall health
  • any resistance to drugs if at all
  • whether the TB is latent or active
  • organ of the infection (spine, lungs, brain, kidneys)

The treatment is a combination of drugs to be taken regularly for months and diligent follow-ups to check for how the infection is responding to the treatment and side effects – both of which are critically important.

Leaving the treatment midway can expose both the patient and the community to a risk of MDR TB (Multi-Drug Resistant TB), which is thrice as difficult to treat and has less success in treatments than treatable forms of TB.

The TB medicines can be bought from government hospitals or community DOTS centers free of charge.  

A 36-year-old Tuberculosis patient Kallu, who also suffers from HIV, gives his fingerprint as part of a verification program to Operation ASHA program counselor Shammo Khan. AP

36-year-old Tuberculosis patient Kallu, who also suffers from HIV, gives his fingerprint as part of a verification program to Operation ASHA program counselor Shammo Khan. AP

Can TB be prevented?

If there is one patient of TB in a household or work environment, others can be prevented from getting TB by either taking preventive medicine protocol or avoiding close contact and maintaining hygiene. It's important to discuss this aspect with the doctor treating a TB patient.

In the community, the best way to avoid the spread of TB is to ensure that all TB patients complete their treatment. Another way is to improve hygiene and better nutrition levels of all people in the community.

A vaccine for TB called the bacillus Calmette-Guerin (BCG) vaccine should be given to newborns and to unvaccinated people – discuss it with your doctor.

India’s efforts towards controlling TB

In accordance with the WHO deadline that aims to have less than one case of TB for a population of a million people, the Indian Government announced in 2017 it is targeting 2025 as the year to make the country TB-free. India has seen 1.7 percent drop in cases from 2016 to 2017, with the number of deaths, too, having dropped from 423,000 to 410,000 over the same period of time.

As a citizen, it is important to become a part of the movement and the theme of World TB Day 2019 – 'It’s time'. The theme aims to emphasize the urgency to act on the commitment made to treat 40 million people affected by TB by 2022, rid the world from TB, and to stay dedicated by taking timely action.

You, too, can do that by urging people with TB-like symptoms to seek medical care and those with TB to complete their treatment.

The author is a senior consultant in the medical team at Docprime.com.

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Updated Date: Mar 22, 2019 15:58:20 IST