Tuberculosis

Posted by Joanna Webster on May 10th, 2021

Tuberculosis is both a dangerous and an infectious disease. The bacterium known as mycobacterium tuberculosis causes the illness. The disease attacks lungs but can also affect other organs of the body. The disease has become rare in developed countries but remains a significant epidemic in the middle and low-income countries. An approximate of one and a half million people suffer from the disease annually. This makes it the highest killer disease in adults, second from another infectious disease AIDS, with a majority of deaths in low-income countries. The treatment remains a constant constraint to patients and a heavy burden for health care systems across the world. Researchers have studied this disease for about forty years, and there is hope that a new drug, which tuberculosis cannot resist, will soon be in the markets. With tuberculosis being a principal killer disease, it is essential to study the causes, risks, treatment, diagnosis and developments the health care system has made in an attempt to avert the condition.

Mycobacterium is a small rod-shaped bacterium about 2 to 4 um in length that besides causing tuberculosis can cause several illnesses in humans. Mycobacterium is an acid-fast organism. This is the name that stains scientists and researchers use in the evaluation of tissue specimens. This strand of bacterium, multiplies slower than other bacteria. This is the reason why tuberculosis has a slow evolution, taking up to weeks, months or years. These bacteria are strictly aerobic, and they thrive in environments with an oxygen supply. Bacteria may remain latent for years in the secondary stage of infection, sometimes even for months or years. Active tuberculosis may occur months or years after the primary infection. The slow rate of occurrence is because of the slow multiplication of mycobacterium. Pulmonary tuberculosis affects lungs; it is common in patients with HIV/AIDS, because their antibodies are weak to resist TB disease. This TB spreads to other body organs during a silent phase of the ailment, often in the early stages of infection. Active TB can develop in numerous parts of the body such as lymph nodes, vertebrae, kidney, genital organs, and abdominal cavity. Young children and HIV-infected persons are more susceptible to extrapulmonary tuberculosis, which develops in other parts of the body, for instance lymph nodes, because their body immune system is weak and incapable of fighting tuberculosis germs and bacteria.

HIV/AIDS patients and children are at a higher risk of acquiring tuberculosis, because their body immune systems are weak to handle the bacteria. HIV/AIDS weakens the body immune system making people vulnerable to this disease. Women are highly vulnerable to the disease as compared to the other people. Throughout the world, women tolerate a disproportionate burden of poverty, infirmity and malnutrition. Once infected, women of reproductive age are more susceptible to developing tuberculosis than men of the same age group (it is vital further research to take place to verify why women of reproductive age face worse TB effects as compared to men). Women in this age group are also at a high risk of contracting HIV/AIDS infection, because they have compromised immunity systems; therefore, they have a high opportunity to develop active TB. As a result, young women aged between fifteen years to twenty-four years of age with tuberculosis outnumber young men of the same age. The main reason for TB prevalence among women is poverty and inability to access health facilities.

Mycobacterium causes the disease when allowed to grow within the body system. It takes long for the disease to develop after infection, because the bacteria multiply slowly. Tuberculosis is an airborne disease, which passes from one person to the other through respiration. The source of infection is a person with pulmonary or laryngeal tuberculosis. These are the only types of tuberculosis that spread. Extrapulmonary tuberculosis is not a transmittable disease. The reason pulmonary tuberculosis and laryngeal tuberculosis are transmittable is because they are in the lungs and larynx respectively. As a result, bacteria encounter air exhaled during coughing, conversations, sneezing or even normal breathing. During these activities, an infected person produces tiny infectious droplets of bacteria. These droplet nuclei are about one to five microns in diameter. The droplets can remain pending in the air for several hours, depending on the environment. Transmission occurs when one inhales these droplets. Other causes are rare, such as Mycobacterium Bovi transmitted through cow milk. Children are less likely to transmit tuberculosis because of the weaker sputum in their coughs and low bacillary load.

Some people do not show any signs of active tuberculosis. Others may develop coughs sometimes with blood stained mucous, fever night sweats, unintentional weight losses and decreased appetite. These symptoms arise due to the bacteria using up oxygen in the body. This leads to coughs and shortness of breath. In some people, there are no symptoms, because the bacteria have a slow progression process. This lengthens the latency stage of the bacteria. In the latent stage, the bacterium is inactive and does not show any signs

There are several diagnostic methods for tuberculosis, among which is sputum smear microscopy and staining method. Sputum smear method allows rapid and reliable identification of patients with pulmonary tuberculosis where the bacilli sputum concentration exceeds five thousand bacilli per millilitre. Reliability of the sputum depends on the quality of sputum. Taking sputum in the morning yields more reliable results than at any other time. At night, one rarely spits sputum since they are asleep. This makes the sputum produced in the morning highly concentrated with bacilli. The reason why health practitioners use the sputum spread method to test pulmonary tuberculosis is that sputum passes through the trachea and is likely to contact bacteria. The staining method is another diagnostic that medical practitioners use. This method uses a technique where mycobacterium retains a primary stain after exposure to decolorizing acid-alcohol. The two staining methods that nurses and other health practitioners use most of the time are carbolfuchsin procedure and flouro-chrome methods. Flouro-chrome method has the advantage of allowing fast results for rapid slide reading. The two methods work best in high-load laboratories. The reason why doctors use the stain method is that this strategy can detect even other forms of tuberculosis besides pulmonary tuberculosis.

The first step towards preventing tuberculosis is to identify the main cause. An individual contact is the main method of transmission of the epidemic. The majority of the people who spread this disease are undiagnosed and do not know that they are ailing. This makes it necessary for governments and health systems to create tuberculosis awareness campaigns to let people know the importance of testing for tuberculosis. This will help identify an individual with the disease and inform them on the transmission methods. This approach aims to hinder an individual with the tuberculosis disease from passing it to others. Awareness programs will also help a tuberculosis patient know the risks of contracting tuberculosis. Also, it offers insight into preventive measures that one can take to safeguard him- or herself from this disease.

The treatment of tuberculosis involves taking drugs such as isoniazid, rifampicin, pyrazinamide and ethambutol under the supervision and direction of a qualified medical practitioner for six months. This form of treatment is useful for administration to reduce the number of visits patients make to the hospital. This aims to reduce transmission of the disease within the hospital facility. This is because the majority of sick people in health facilities have weak immune systems as a result of their various ailments, thus making them highly susceptible to tuberculosis. Health practitioners administer the drug under the supervisions of a clinician to help in case of side effects.

Tuberculosis is an infectious disease acquired through inhaling bacteria that cause the disease. About ninety percent of individuals infected do not show any signs of the disease, a situation known as latent infection. If the disease goes untreated, about a half or third of all infection cases will die from the disease. Research shows that in 2011, about nine million people around the world got tuberculosis disease. According to the estimates, approximately one million people die annually from the disease, especially in developing countries. About ninety-five percent of deaths are from low-income areas. There are more deaths in low-income areas than developed economies. This is due to deficiency of resources and health care medicines to combat the illness in the developing countries. This makes it impossible for patients to access medical treatment, which results in many deaths.

The first major breakthrough in combating tuberculosis was identifying the causes and transmission methods. This led to public measures and awareness. The discovery of ways to grow the bacteria in laboratories and to develop tuberculin skin test and x-ray imaging were the major developments in the nineteenth and twentieth century. Recent studies have elicited how Mycobacterium tuberculosis becomes dormant when its environment becomes hostile. When the bacteria are in a dormant state, they appear to be resistant to common anti-tuberculosis medications. New drug development procedures now test potential agents against both active and inactive forms of the bacilli.

Gene array studies are showing that bacterial molecules and molecular pathways can be the targets of potential new drugs. Researchers are currently testing several medicines developed this way. This is centrally to what was possible in the early years when the health practitioners knew almost nothing about the condition. Treatment was not possible during that time since even the cause of the disease was a mystery to people.

Since research has unearthed more information about the bacteria, newer, faster, and more accurate tuberculosis diagnostic methods are replacing the old methods. These new techniques also give clues to how the human immune system deals with infection. Unravelling the genetic sequence of the bacteria has fostered the development of gene amplification tests that can diagnose the disease and detect drug resistance. These techniques can accomplish in hours or a few days what medical practitioners used to take weeks, thus reducing the chances of a person spreading the disease before diagnosis and treatment. This development marks the milestones taken in fighting this disease. In the past, this was not possible since the old methods were slow and inaccurate, which resulted to false diagnosis. This is probably the reason as to why it was extremely difficult to treat and prevent the spread of tuberculosis in the past. In terms of vaccination, researchers have made remarkable developments ever since the first discovery of the first tuberculosis vaccine, Bacilli Chalmette-Guerin, which French researchers developed in 1921. Contrary to Bacillus Calmette-Guerin Vaccine, modern vaccines work in different regions. It is essential to note that one of the weaknesses of the Bacilli Calmette-Guerin vaccine is it did not work in all geographical areas.

In conclusion, tuberculosis is a significant epidemic and killer disease in the world. The disease had greatly reduced to low levels in the past, but with the high prevalence of HIV/AIDS, the disease has returned. Developing countries account for about ninety percent of the disease because of poverty, malnutrition, deficiency of health care services, and the lack of awareness of the disease. Tuberculosis has existed for thousands of years, and during this time, researchers have made tremendous progress in the fight against the disease.

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