India World TB Day: TB can affect any parts of body except nails, hair and eyes-Expert
“TB first affects the lungs, then this bacterial infection can affect almost all parts of your body except for nails, hair and eyes.” We got talking to Dr. Arvind Kate, Chest Physician and Pulmonologist at Zen Hospital, Mumbai to know more about this disease.
According to a WHO report, India is the country with the highest burden of tuberculosis and there were around 2.76 million cases of tuberculosis in India in 2016. The report also mentions that 10.4 million people were affected by TB and 1.7 million people died. More than 95 percent of TB related deaths happen in low- and middle-income nations. Around 1 million children fell ill due to TB and 250,000 children died, in 2016. TB is a major cause of death in HIV-positive people, accounting for 40 percent of TB-related deaths in 2016. We got talking to Dr Arvind Kate, Chest Physician and Pulmonologist at Zen Hospital, Mumbai to know more about this disease. Here is an excerpt.
Which parts of your body can be affected by TB?
Tuberculosis (TB) is a potentially serious contagious disease caused by a group of bacteria called Mycobacterium tuberculosis complex. This bacterial infection can affect almost all parts of your body except for nails and hair. One gets infected with this bacterium by inhaling it. This is the reason why TB first affects the lungs. If the infection is not treated on time it can spread to other parts of the body. It can practically spread to any part of the body, of course, except for nails, hair and eyes.
What are the different types of tuberculosis that one can suffer from?
Broadly tuberculosis can be classified into types: Pulmonary tuberculosis and extrapulmonary tuberculosis. Since tuberculosis is an airborne disease the lungs are the most vulnerable organ to get affected. When the infection is in the lungs and remains restricted to them it is termed as pulmonary tuberculosis. If the infection spreads to other parts of the body like the lymph nodes, bones, liver, intestines, spine, etc., it is called extrapulmonary tuberculosis. However, most cases of tuberculosis reported are of lungs, lymph nodes or stomach.
Are women more prone to TB than men?
No, the TB infection doesn’t see any bias and can affect anyone irrespective of age, sex, colour and ethnicity. However, in women, genital tuberculosis could be a cause for concern. If a woman affected with TB in her early life fails to get timely treatment or adhere to the same, the infection can pass to the female reproductive organs like the ovaries, uterus or fallopian tubules. In fact, genital tuberculosis can be a reason for female infertility too. While men can also suffer from genital tuberculosis but such cases are very rare.
How does one acquire a TB infection?
Tuberculosis is a potentially serious contagious disease caused by a group of bacteria called Mycobacterium tuberculosis complex. One can get infected with TB if one comes in contact with the exhaled air by an infected person that contains the bacteria or the sputum of the infected person.
How is TB treated?
The tuberculosis treatment does not have a one-size-fits-all approach. Screening of tuberculosis needs to be done to understand the extent to which the infection is spread so doctors can prescribe drugs accordingly. The standard treatment for TB has always been to put patients on the first line of drugs or antibiotics to fight the bacterial invasion. If the TB bacteria continue to proliferate in the body and develop resistance to the prescribed drugs it turns to become drug-resistant TB. It evolves when one is infected with a TB strain that is resistant to one or more of the standard antibiotics. Patients who develop resistance to isoniazid (INH) and rifampin (RIF) are said to harbour MDR-TB. MDR-TB cases worldwide have extensive drug-resistant TB (XDR-TB) where the infection becomes resistant to at least four anti-TB drugs. This makes treating the condition a challenge.
What makes one prone to multi-drug resistant TB?
The major concern these days in treating tuberculosis is that unlike before we receive patients who are suffering from primary multi-drug resistant TB. There could be a number of reasons for the same –antibiotic resistance, dropping out of a previous TB treatment, wrong medication, misuse of TB drugs, inability to stick to treatment and much more.
Who are at risk of developing TB?
Anyone and everyone can develop TB. However, people who have a health crisis that suppresses their immunity like diabetes, cancer or other illness it makes one vulnerable to a TB infection.
Can one face a TB relapse?
Yes, it is possible for one to get a TB infection a second time even if one had an infection before and completed the full course of treatment. However, when one gets a TB infection for the second time it is necessary to do a detailed diagnosis and know what went wrong and where. It is necessary to check if the representation of the infection the second time is that of multi-drug resistant TB as it came back despite the treatment was completed. A treatment has to be planned accordingly checking for strains of TB.
When should one go for a TB test or screening?
The diagnosis of tuberculosis starts with a physical examination wherein a doctor examines your lungs with a stethoscope and checks your lymph nodes for swelling. This is one of the foremost steps in the detection of TB. If your doctor suspects TB, then he/she may next order a chest X-ray or a CT scan to know more about the condition. If the chest X-ray is suggestive of TB, your doctor may take samples of your sputum (the mucus brought up by coughing) and test for the bacteria. In addition to this, there are other tests that are used to detect TB. These include Mantoux test and Nucleic Acid amplification test.
Why does one fail to stick to a TB treatment?
The treatment for TB is a long and lengthy one. An infected person has to take the prescribed medications for at least six months to a year. If it is multi-drug resistant TB the treatment can last for two to 2.5 years. Since the treatment calls for a long-term commitment many fail to stick to the course to complete the treatment. Many stops taking the medications once they feel better or the symptoms are suppressed. This makes the bacteria resistant to the medication when they start the treatment again.
What are the symptoms that one should be watchful of?
The representations of the symptoms might vary from person to person and it also depends on the organs involved and infected. Apart from a persistent cough, fatigue, weight loss, abdominal pain, memory loss, nausea, headache and loss of appetite could be few of them.
By Debjani Arora