Tuberculosis
Facts about tuberculosis
Tuberculosis is a contagious bacterial disease, which spreads
through the air. Only people who are sick with pulmonary TB
(TB of the lungs) are infectious. When infectious people cough,
sneeze, talk or spit, they propel TB bacteria into the air.
A person needs only to inhale one of these to be infected. People
infected with TB will not necessarily get sick with the disease.
The immune system walls off the TB bacteria, which can lie dormant
for many years. When the immune system is weakened, the chances
of getting sick are greater.
Directly
Observed Treatment, Short-course (DOTS) is the most effective
strategy available for controlling the TB epidemic today.
DOTS treatment has five key components to the treatment:
- Government commitment to activities to control TB.
- Case detection by 'sputum smear microscopy' among patients
showing symptoms of the disease.
- Standardised treatment regime of six to eight months for
all people who test positive, including directly observed
therapy for at least the first two months.
- A regular, uninterrupted supply of all essential anti-TB
drugs.
- A standardised recording and reporting system that allows
assessment of treatment results for each patient and of
the TB control programme performance overall.
The WHO-approved TB treatment
regimens have an initial intensive phase lasting for two months
and a continuation phase lasting for four to six months. The
essential TB drugs include isoniazid, rifampicin, pyrazinamide,
streptomycin, ethambutol, thioacetazone.
Almost 30 per cent of people with HIV are also infected TB.
TB is the most common opportunistic infection among people
with HIV and is a leading cause of death among people who
are HIV-positive. TB treatment extends the lives of people
with HIV for two to five years.
Incomplete treatment of TB can lead to the development of
bacteria that are resistant to the drugs most commonly used.
This may lead to development of multi-drug resistant TB which
has emerged as a serious global problem in recent years. Drug-resistant
TB DOTS cures up to 95 per cent of drug-susceptible patients,
but these cure rates fall well below an acceptable rate in
areas of high MDR. Drug-resistance threatens the success of
DOTS and global TB control as it is more difficult and more
expensive to treat, and more likely to be fatal. The need
to prevent the emergence of multi-drug resistant TB and to
manage present cases in areas of high prevalence is a priority
and this combination is the known as DOTS Plus.
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