Tuberculosis

Tuberculosis

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Tuberculosis

Tuberculosis (TB) is a contagious disease that attacks the lungs. It may also spread to the brain and the spine. It is caused by a bacteria referred to as Mycobacterium tuberculosis. TB was one of the major causes of death in the 20th century. However, in the contemporary world, most TB cases are cured with antibiotics. One has to take the medication for 6 to 9 months. Having a TB infection does not imply that one has to get sick. Latent TB implies that an individual has the TB germs in the body. However, the immune system stops the spread of the disease. In such a situation, the individual would not have the symptoms of the disease and is not contagious. However, the infection is still in the body and can become active one day. An individual with HIV has a high risk of re-activation if the primary infection was within the last two years. Active TB implies that an individual has TB germs, which are multiplying in the body and can make the individual sick. 90% of the adult cases of active TB are from reactivation of a latent TB.

Patients with TB should be isolated in a private room that has negative pressure. The medical practitioners treating the patient should wear high efficiency disposable masks that can filter the TB germs. Isolation should continue until the sputum smears become negative after three consecutive tests. The initial treatment of TB commences with 4-drugs – isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol. After determining that the TB is fully susceptible, the fourth drug, which is can be either ethambutol or streptomycin, can be discontinued. TB patients should be subjected to sputum analysis for Mycobacterium tuberculosis every week until the sputum conversion is determined. TB patients with active seizing or who have overdosed on antimycobacterial medication should be subjected to a special regimen. They can be given diazepam to control seizure activity. They can also be given IV pyridoxine. If the ingested dose cannot be determined, 5 g of pyridoxine may be used empirically. Patients with an overdose who are awake and alert should be given an oral dose of activated charcoal (1g/kg) with sorbitol. Isoniazid, rifampin, and ethambutol should be used to treat pregnant women with TB. Pyrazinamide is the drug used to treat people with multi-drug resistant TB (MDR-TB) in the U.S. Other regions of the world use the drug to treat pregnant women with TB. Breastfeeding can be continued while a woman is on preventive therapy. The breastfed infant should be provided with supplemental pyridoxine. Children with TB are treated using isoniazid and rifampin for six months. During the first two months, they are also given pyrazinamide. MDR-TB is treated for 18-24 months using bedaquiline (Sirturo).

Various ethno-medicinal plants can be used in the treatment of TB. Some of the ethno-medicinal plants used in the treatment of TB in India include the root bark, stem bark, flower, and leaves of Adhahota vasica, the stem bark, flower extract, and fruit of Alanguin salvilfolium, the mucilage of bark of Grewia tenax, and the rhizome of Curcuma amada (Kachhi et al., 2018).

TB is a primary disease that affects the lungs. It is classified as a primary disease since it extends to the mediastinum and causes esophageal fistula and mediastinal bronchial artery aneurysm. The acute upper bleeding is caused by mediastinal bronchial artery neurysm. The bleeding is drained into the esophagus through the esophagomediastinal fistula (Alharbi, 2019).

Tuberculosis has a significant impact on the society in relation to healthcare and use of resources. It is one of the most common causes of death of young adults. It hinders the socio-economic development since a high proportion of the disease affects the productive age group that is between 15 and 54 years. In addition, 95% of all TB cases occur in developing countries with 99% of deaths from the disease also occurring in the developing countries. Sub-Saharan Africa and South East Asia have the highest prevalence of the disease. In 2006, the total budget of TB control in countries that were severely affected by the disease was $1.6 billion. In addition, the cost of the health system staff and the infrastructure required in TB control are very high (Fogel, 2015).

The costs associated with TB can be classified into three categories. These include direct costs, indirect costs, and intangible costs. Direct costs refer to immediate costs of diagnosing and treating TB. It also comprises of other costs related to medical care, which include costs of visiting doctors, costs of laboratory and radiological tests, medications, hospital costs, and transportation costs to and from the healthcare facility. Indirect costs comprise of the costs of losing employees travelling to healthcare facilities, the sale of assets to pay for TB treatment, and the loss in productivity due to TB illness and death. Finally, the intangible costs refer to the pain and suffering of patients suffering from the disease. It comprises of psychological distress and the reduction in the social function of a personal suffering from TB.

References

Alharbi, S. R. (2019). Tuberculous esophagomediastinal fistula with concomitant mediastinal bronchial artery aneurysm-acute upper gastrointestinal bleeding: A case report. World Journal of Gastroenterology, 25(17), 2144.

Fogel, N. (2015). Tuberculosis: a disease without boundaries. Tuberculosis, 95(5), 527-531.

Kachhi, R. S., Saket, V. K., Sharma, P. & Singh, P. (2018). Treatment of Tuberculosis using Ethno-medicinal Plants of Amarkantak Region. Asian Journal of Animal and Veterinary Advances, 13(1), 52-60.